晚发性心脏机械瓣膜功能障碍诊断与治疗

Clinical Diagnosis and Treatment of Delayed Mechanical Valve Prosthesis Dysfunction

目的；对晚发性机械瓣膜功能障碍的诊断和治疗进行探讨。方法：回顾1996—01～2004—03诊断为机械瓣膜置换术后功能障碍患者16例（男6例，女10例）的临床资料。结果：超声彩色心动图（UCG）示所有患者存在机械瓣膜开启障碍。15例瓣口有效面积下降，8例人工机械瓣膜上有血栓声像。再次换瓣手术7例，5例为急诊手术，死亡1例；溶栓治疗6例，死亡3例；未行治疗的3例均已死亡。结论：超声彩色心动图有助于人工机械瓣膜功能障碍的诊断，手术和溶栓疗法是目前治疗的主要方法，但手术应为首选。

Objective ：To discuss the diagnosis and treatment of delayed mechanical valve prosthesis dysfunction. Methods ：Clinical data of 16 patients （6 males, 10 females） with delayed dysfunction of mechanical valve prosthesis were retrospectively analyzed. Results： All patients were found mechanical valve prosthesis by Eehocardiography（UCG）. 15 cases showed reduced effective areas at valve orifice. 8 eases presented acoustic images of thrombosis. 7 eases received second walve replacements,including 5 emergence operations and 1 death. 6 cases received treatment of thrombolysis in which 3 died. The untreated 3 cases all died. Conclusions：Echoeariography is very important and useful for diagnosis of mechanical valve prosthesis dysfunction. Operation and thrombolytie are the two efficacious therapies, but operation is of the first choice.