超声诊断心肌梗死后心肌夹层及室间隔穿孔1例并文献复习  

Ultrasound diagnosis of myocardial dissection and interventricular septal perforation after myocardial infarction:a case report and lite-rature review

作　　者：张晓峰[1] 袁馨 赵璐[2] 苏欣悦 刘泳 ZHANG Xiaofeng;YUAN Xin;ZHAO Lu;SU Xinyue;LIU Yong(Qingdao Fifth People’s Hospital/Qingdao University Affiliated Qingdao Haici Hospital West Campus,Qingdao 266033,China)

机构地区：[1]青岛市第五人民医院/青岛大学附属青岛市海慈医院西院区,山东青岛266033 [2]青岛大学附属青岛市海慈医院/青岛市中医医院

出　　处：《青岛大学学报（医学版）》2024年第1期148-150,共3页Journal of Qingdao University(Medical Sciences)

基　　金：山东省中医药科技项目(M-2022008)。

摘　　要：目的探讨心肌梗死后心肌夹层及室间隔穿孔的超声心动图特点及治疗方法。方法回顾性分析1例心肌梗死后心肌夹层及室间隔穿孔病人的超声心动图表现及外科手术治疗经过。结果病人术前超声心动图提示心尖部心肌夹层合并室间隔穿孔,射血分数39%。经多学科会诊后病人同意外科手术治疗,遂行室间隔穿孔修补术+冠状动脉旁路移植术+主动脉内球囊反搏术。病人病情稳定后出院。结论超声心动图是心肌夹层及室间隔穿孔的首选诊断方法。心肌梗死后心肌夹层合并严重并发症应积极手术治疗。Objective To investigate the echocardiographic characteristics of myocardial dissection and interventricular septal perforation after myocardial infarction and related treatment methods.Methods A retrospective analysis was performed for the echocardiographic manifestations and surgical treatment of one patient with myocardial dissection and interventricular septal perforation after myocardial infarction.Results Preoperative echocardiography showed that the patient had apical myocardial dissection and interventricular septal perforation,with an ejection fraction of 39%.After multidisciplinary consultation,the patient agreed to receive surgical treatment,and then interventricular septal perforation repair,coronary artery bypass grafting,and intra-aortic balloon counterpulsation were performed.The patient was discharged with stable vital signs.Conclusion Echocardiography is the preferred diagnostic method for myocardial dissection and interventricular septal perforation,and surgical treatment should be performed for myocardial dissection with severe complications after myocardial infarction.

关 键 词：心肌梗死 室间隔破裂 超声心动描记术 心脏外科手术 

分 类 号：R542.22[医药卫生—心血管疾病] R541[医药卫生—内科学]