發(fā)布時(shí)間：2018-08-31 14:37

【摘要】：背景與目的：心肌橋作為一種獨(dú)立的冠狀動(dòng)脈病變,可以引起多種心血管系統(tǒng)疾病甚至心源性猝死等不良心血管事件。針對藥物控制不滿意的心肌橋患者,可以考慮行內(nèi)科介入和外科手術(shù)治療。但近些年的研究表明,內(nèi)科介入治療心肌橋往往無法取得較為滿意的治療效果。而外科治療心肌橋的手段主要有心肌松解術(shù)和冠狀動(dòng)脈旁路移植術(shù)。本文總結(jié)并分析心肌橋的臨床特點(diǎn),探討冠狀動(dòng)脈旁路移植術(shù)治療心肌橋的臨床療效。方法：選取2008年6月至2014年4月于安徽醫(yī)科大學(xué)第一附屬醫(yī)院心臟外科行冠狀動(dòng)脈旁路移植術(shù)治療的冠狀動(dòng)脈心肌橋患者共28例,男13例,女15例。所有病患者術(shù)前常規(guī)行冠狀動(dòng)脈造影檢查,均提示前降支心肌橋,收縮期狹窄70%～95%,其中單純心肌橋11例,合并瓣膜病4例,合并先天性心臟病5例,合并冠心病8例。非體外循環(huán)不停跳下完成冠脈搭橋術(shù)18例,體外循環(huán)心臟停跳下完成10例；其中前降支選取左乳內(nèi)動(dòng)脈血管橋23例,大隱靜脈橋5例。結(jié)果：1例因術(shù)后再發(fā)心梗死亡,1例出院6月內(nèi)再發(fā)心絞痛,服藥控制良好,其余26例冠狀動(dòng)脈心肌橋行外科治療獲成功,患者心絞痛等癥狀明顯改善,心電圖提示心肌缺血明顯改善,室壁運(yùn)動(dòng)改善有20例,21例術(shù)后3-6個(gè)月復(fù)查冠狀動(dòng)脈CT,均未發(fā)現(xiàn)橋血管狹窄。結(jié)論：對于心肌橋收縮期狹窄70%及有臨床癥狀的患者,冠狀動(dòng)脈旁路移植術(shù)是可靠有效的。
[Abstract]:Background & AIM: as an independent coronary artery disease, myocardial bridge can cause a variety of cardiovascular diseases, including sudden cardiac death and other adverse cardiovascular events. Medical intervention and surgical treatment may be considered for patients with myocardial bridge who are not satisfied with drug control. However, recent studies have shown that interventional treatment of myocardial bridge is often unable to achieve satisfactory results. The surgical treatment of myocardial bridge mainly consists of myocardial release and coronary artery bypass grafting. This article summarizes and analyzes the clinical features of myocardial bridge, and discusses the clinical effect of coronary artery bypass grafting (CABG) in the treatment of myocardial bridge. Methods: from June 2008 to April 2014, 28 patients (13 males and 15 females) underwent coronary artery bypass grafting (CABG) in the Department of Cardiac surgery, first affiliated Hospital of Anhui Medical University. All the patients were examined by coronary angiography before operation. The results showed that the anterior descending branch of myocardial bridge was 70 and 95%, including 11 cases of simple myocardial bridge, 4 cases of valvular disease, 5 cases of congenital heart disease and 8 cases of coronary heart disease. Coronary artery bypass grafting was performed in 18 cases and cardiopulmonary bypass in 10 cases, including 23 cases of left internal mammary artery graft and 5 cases of great saphenous vein graft. Results one patient died of recurrent myocardial infarction and one patient died of recurrent angina pectoris within 6 months of discharge. The medication was well controlled. The remaining 26 cases had successful surgical treatment of myocardial bridge of coronary artery, and the symptoms of angina pectoris were obviously improved. Electrocardiogram showed that myocardial ischemia was obviously improved and ventricular wall motion was improved in 20 cases. Coronary artery stenosis was not found in 20 cases after 3 to 6 months of coronary artery CT,. Conclusion: coronary artery bypass grafting is reliable and effective for 70% of patients with myocardial bridge stenosis and with clinical symptoms.
【學(xué)位授予單位】：安徽醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R654.2

【參考文獻(xiàn)】

相關(guān)期刊論文 前2條

1 王健,錢菊英,周月明,祝X≈，

本文編號：2215290