超声在急性心肌梗死后亚急性左室游离壁破裂诊断和预后评估中的应用价值  

Application of ultrasonography in evaluation of subacute left ventricular wall rupture after acute myocardial infarction

作　　者：曲红培[1] 杨杨 冯喆 董平栓[2] 王可[2] 魏利娟[3] QU Hongpei;YANG Yang;FENG Zhe;DONG Pingshuan;WANG Ke;WEI Lijuan(Color Doppler Echocardiography Center,First Affiliated Hospital of Henan University of Science and Technology,Luoyang 471003,China.)

机构地区：[1]河南科技大学第一附属医院心脏彩超室,河南洛阳471003 [2]河南科技大学第一附属医院心内科,河南洛阳471003 [3]河南科技大学第一附属医院心外科,河南洛阳471003

出　　处：《中国中西医结合影像学杂志》2021年第5期440-442,共3页Chinese Imaging Journal of Integrated Traditional and Western Medicine

基　　金：2019年洛阳市科技计划医疗卫生项目(1920013A)。

摘　　要：目的:探讨超声在急性心肌梗死(AMI)后亚急性左室游离壁破裂(LVWR)中的应用价值。方法:收集19例AMI后临床诊断为亚急性LVWR患者的超声表现及预后转归情况。结果:3例2处心肌破裂患者均于6 h内死亡。16例心肌破裂1处患者中,7例7 d内死亡;4例破裂口处有凝血块覆盖,后心包积液量逐渐减少,预后良好;1例形成假性室壁瘤,预后良好;另4例心包腔内积液量逐渐增加,行外科修补术,2例成功,2例死亡。19例按心包积液回声不同,分为有回声和无回声2组,其死亡率差异无统计学意义(P>0.05)。结论:AMI后亚急性LVWR有一定的超声表现特征,故超声在该疾病的诊断和预后观察中有着重要价值。Objective:To investigate the application of ultrasonography in evaluation of subacute left ventricular wall rupture (LVWR) after acute myocardial infarction (AMI). Methods:The ultrasonic manifestations and prognosis of 19 patients with subacute LVWR after AMI were collected and analyzed. Results:Three patients with two myocardial ruptures died within 6 h of the occurrences. Among the other 16 patients with one myocardial rupture,7 died within 7 d,4 had clot covering at the rupture site with decreasing pericardial effusion and good prognoses,1 developed pseudoaneurysm with a good prognosis,and 2 cases successes and 2 cases failed in surgery for the treatment to increasing pericardial effusion. The 19 patients were divided into two groups based on whether or not there was echo of pericardial effusion in ultrasonography,and there was no significant difference in mortality between the two groups (P>0.05). Conclusions:Subacute LVWR after AMI has certain ultrasonographic features,and ultrasonography has an important value in the diagnosis and prognosis of such disease.

关 键 词：超声检查 心肌梗塞 心脏破裂 诊断 

分 类 号：R542.22[医药卫生—心血管疾病]