摘要
对左房血栓脑梗塞病人行瓣膜置换术进行临床研究。方法４５例左房血栓病人，其中２０例有脑梗塞史（脑梗塞组），另外２５例无脑梗塞（对照组），进行比较。结果（１）两组术后２４ｈ多巴胺用量、呼吸机辅助时间和死亡率，差别无显著性（Ｐ＞０．０５）。（２）脑梗塞组二尖瓣口面积、左室射血系数和新鲜血栓发生率均大于对照组（Ｐ＜０．０５）；左房内径脑梗塞组小于对照组（Ｐ＜０．０５）。结论（１）脑梗塞后病人能安全进行瓣膜置换术，其危险性及手术并发症并不特别增加。手术时机须视病人具体情况而定。（２）二尖瓣口中度狭窄，左房中等扩大，左室收缩功能正常及左房有新鲜血栓的病人更易发生脑梗塞，应积极手术治疗。
Objective\ To investigate the cardiac valve replacment in the patients with left atrial thrombus and cerebral embolism.\ Methods\ 45 patients with left atrial thrombus were devided into two groups:cerebral embolism(CE group,n=20) and control group(n=25),according to whether they had cerebral embolic history.\ Their clinical data was analysed and compared.\ Results\ (1)The dosage of dopamine during the first 24 hours after operation,the ventilatory support time and the mortality had no significant statistical difference between two groups(P>0.05).\ (2)The area of mitral valve orifice,the ejection fraction(EF) of left ventricle and the incidence of fresh thrombus in left atrium in CE group were larger than those in control group(P<0.05).\ The inner diameter of left atrium in CE group was shorter than that in control group(P<0.05).\ Conclusion\ (1)The patients with cerebral embolism can sustain cardiac valve replacement safely.\ The risk and complications about operation doesn′t increase.\ The opportunity for valve replacement must be decided according to the patient′s condition.\ (2)The patients with moderate mitral valve stenosis,mild enlarged left atrium,near normal contractive function of left ventricle and fresh thrombus in left atirum tend to suffer from cerebral embolization more than the patients in control group,so they need operative interference as soon as possible.
出处
《福建医科大学学报》
1997年第2期173-175,共3页
Journal of Fujian Medical University
关键词
脑梗塞
左房血栓
心瓣膜置换术
cerebral embolism
left atrial thrombus
cardiac valve replacement
