左心房增大导致吞咽困难疑似食管异物1例并文献复习  

Dysphagia due to left atrial enlargement:a case report and literature review

作　　者：宋晴 王晓勇 贾传亮 牟亚魁 宋西成[2] SONG Qing;WANG Xiaoyong;JIA Chuanliang;MOU Yakui;SONG Xicheng(Weifang Medical University,Clinical Medical School,Weifang 261000,Shandong,China;Department of Otorhinolaryngology&Head and Neck Surgery,Yantai Yuhuangding Hospital Affiliated to Qingdao University/Shandong Provincial Clinical Research Center for Otorhinolaryngologic Diseases,Yantai 264000,Shandong,China;Department of Otorhinolaryngology,Yantaishan Hospital of Yantai,Yantai 264000,Shandong,China)

机构地区：[1]潍坊医学院临床医学院,山东潍坊261000 [2]青岛大学附属烟台毓璜顶医院耳鼻咽喉头颈外科/山东省耳鼻喉疾病临床医学研究中心,山东烟台264000 [3]烟台市烟台山医院耳鼻咽喉科,山东烟台264000

出　　处：《山东大学耳鼻喉眼学报》2022年第2期64-67,共4页Journal of Otolaryngology and Ophthalmology of Shandong University

基　　金：山东省自然科学基金(ZR2019PH113);泰山学者工程资助项目(ts20190991)。

摘　　要：目的探讨左心房增大导致吞咽困难病例的临床特点并回顾分析此类患者的诊治经验。方法报道了1例因左心房增大导致吞咽困难患者的临床资料,并检索了近10年由左心房导致吞咽困难的相关报道。总结其临床特点、诊断及治疗方法。结果共纳入15篇文献,包括男7例,女8例,患者主要表现为体质量减轻、呼吸困难和声音嘶哑。胸部CT、上消化道造影和心脏超声是常用的辅助检查。有诊治资料的14例患者中,半数患者采取手术治疗,术后吞咽困难症状改善。结论导致吞咽困难的原因很多,由于左心房增大引起吞咽困难罕见,国内外相关报道较少,多数为个案报道。考虑此类患者年龄较大基础疾病较多,临床医生需要多方面观察、评估,采用最佳治疗方法,具体问题具体分析。Objective To report and review the clinical features and treatment experienceof dysphagia caused by left atrial enlarge⁃ment.Methods We examined a patient presenting with dysphagia for left atrial hypertrophy and searched for relevant reports of patients with dysphagia caused by left atrial enlargement in the past ten years.The clinical characteristics,diagnosis,and treatment of these patients were summarized.Results Fifteen articles comprising seven men and eight women were included.The patients mainly presented with lose weight、dyspnea、voice hoarseness.Chest CT,upper gastrointestinal angiography and ultrasonic cardiogram?are commonly adjunct examination.Of the 14 patients with available data of diagnosis and treatment diagnosis,half underwent surgical treatment and postoperative dysphagia improved.Conclusion Although dysphagia has several etiologies,dysphagia caused by left atrial hypertrophy is rare and only reported in individual cases.Therefore,clinicians need to carefully observation、evaluation and use the best way for the etiologies of dysphagia,especially in older age patients as they are more likely to have under⁃lying chronic disease.

关 键 词：左心房 吞咽困难 风湿性心脏病 二尖瓣反流 食管狭窄 

分 类 号：R766.9[医药卫生—耳鼻咽喉科] R541.2[医药卫生—临床医学]