心肌梗死后室间隔破裂处理现状的评价  

Evaluation of management strategies of ventricular septal rupture after acute myocardial infarction

作　　者：朱鲜阳 ZHU Xian-yang(Department of Congenital Heart Disease,General Hospital,Northern Theater Command,Shenyang 110016,Liaoning,China)

机构地区：[1]中国人民解放军北部战区总医院先心病内科,辽宁沈阳110016

出　　处：《心脏杂志》2021年第4期353-357,共5页Chinese Heart Journal

摘　　要：急性心肌梗死后(acute myocardial infarction,AMI)发生室间隔破裂(ventricular septal rupture,VSR)是一种少见的急危重症。本文通过VSR的临床表现,超声心动图、冠脉和左心室造影诊断,采取药物、机械辅助循环、外科手术和经皮介入治疗,分别比较各种治疗方法的早晚期存活率和病死率,以及远期疗效。患者的血流动力学状态是决定选择治疗时机和方式的重要依据,急诊手术可挽救部分患者生命,在药物和辅助循环下患者病情趋于稳定可以延缓关闭VSR的时间,其病死率、成功率和远期预后均好于发生VSR早期的手术效果。AMI后尽早的血运重建有重要意义,可使VSR发生率降低,心功能改善,病死率降低。Ventricular septal rupture(VSR)after acute myocardial infarction(AMI)is a rare yet urgent complication.In this article,survival rate,mortality rate and long-term outcomes were compared by clinical manifestations,echocardiography,angiography of coronary artery and left ventriculography as well as various treatment methods such as medication,machinery auxiliary circulation,surgery and percutaneous intervention.The hemodynamic status of patients is an important basis to determine the timing and method of treatment.Emergency surgery can save the lives of some patients.The stabilization condition of patients under medication and auxiliary circulation can delay the time of VSR closure.In addition,the mortality rate,success rate and long-term prognosis are better than those of early surgical VSR treatment.Early revascularization after AMI is of great significance,which can reduce the incidence of VSR,improve cardiac functions and reduce mortality.

关 键 词：急性心肌梗死 室间隔破裂 处理 介入治疗 

分 类 号：R541.1[医药卫生—心血管疾病]