急性心肌梗死并发左心室游离壁破裂18例的临床特点.docVIP

精品论文 参考文献 急性心肌梗死并发左心室游离壁破裂18例的临床特点 郭士金（山东医学高等专科学校诊断学教研室 276002） 【摘要】目的 探讨急性心肌梗死后并发左心室游离壁破裂的临床特点，提高高危患者的早期识别能力预防并减少其发生。方法 回顾2002年6月至2012年10月18例急性心肌梗死并发心室游离壁破裂患者的临床资料并对其进一步总结分析。结果 本组患者均为老年患者，平均年龄63.5岁，女性患者12例，16例有高血压病史，12例发生于初次心肌梗死后，15例发生于大面积梗死，发生于急性心肌梗死后24小时内7例，3～7天6例，2例行急诊手术后存活8天及15天，其余16例均于发病后立即死亡。结论 急性心肌梗死后并发左心室游离壁破裂死亡率高、易发于老年女性、高血压者常见、多发生于初次心肌梗死、大面积心肌梗死较易发生、多发生在前降支供血区域等为其主要临床特点。 【关键词】急性心肌梗死 游离壁破裂 诱发因素 再灌注 【中图分类号】R54 【文献标识码】A 【文章编号】2095-1752（2013）13-0131-02 【Abstract】Objective To investigate the clinical features of acute myocardial infarction complicated by left ventricular free wall rupture, to improve the early identification of high-risk patients to prevent and reduce its occurrence. Methods A retrospective from 2002 to 2012 Oct. 18 patients with acute myocardial infarction complicated by ventricular free wall rupture in patients with clinical data and further sum analysis.Results All the patients were elderly patients, average age 63.5 years, 12 cases of female patients, 16 patients had a history of hypertension, 12 cases occurred in the initial myocardial infarction, 15 cases occurred in a large area of infarction occurred after acute myocardial infarction 24hours in 7 cases, 3 to 7 days in 6 cases, 2 cases of emergency surgery survival after 8 days and 15 days, and the remaining 16 cases are immediately after the onset of death. Conclusion Acute myocardial infarction complicated by left ventricular free wall rupture the mortality rate is high, easy to occur in older women, high blood pressure is common, occurred in the initial myocardial infarction, myocardial infarction are more prone to a large area, occurred at LAD blood supply to the area its main clinical features. 心脏游离壁破裂是急性心肌梗死最致命、最常见的并发症[1]，心室游离壁破裂时，病死率高达100%。回顾18例急性心肌梗死并发左心室游离壁破裂的临床资料，分析其临床特点。 1、资料与方法 1.1 一般资料 2002年6月至2012年10月我院治疗急性心肌梗死并发心室游离壁破裂患者18例，其中男6例，女12例，年龄55～ 82岁，平均63.5岁。既往有高血压病史者16例，冠心病病史者12例，