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二尖瓣狹窄的治療

SHIJIAN:2016-09-27 00:00:00

人氣:

BIANJI:WANGYOUZHENGLI

標簽:內科 二尖瓣狹窄 

導讀:風濕熱是臨床上二尖瓣狹窄最常見病因。是急性風濕熱引起心臟炎后所遺留的以瓣膜病為主的心臟病,為慢性風濕性心臟病,其中累及二尖瓣的占95%~98%,其中單純二尖瓣病變占70&#

  FENGSHIRESHILINCHUANGSHANGERJIANBANXIAZHAIZUICHANGJIANBINGYIN。SHIJIXINGFENGSHIREYINQIXINZANGYANHOUSUOYILIUDEYIBANMOBINGWEIZHUDEXINZANGBING,WEIMANXINGFENGSHIXINGXINZANGBING,QIZHONGLEIJIERJIANBANDEZHAN95%~98%,QIZHONGDANCHUNERJIANBANBINGBIANZHAN70%~80%,ERJIANBANHEBINGZHUDONGMOBANBINGBIANZHAN20%~30%;DUOYUERJIANBANHUOZHUDONGMOBANBINGBIANHEBINGCUNZAI。JINNIANLAI,YOUYUJIAQIANGLEDUIFENGSHIREDEFANGZHI,FENGSHIXINGXINZANGBANMOBINGFABINGLVMINGXIANXIAJIANG。

  ERJIANBANXIAZHAIDEZHILIAOFANGFATONGCHANGYOUYIXIAJIZHONG:

  一、藥物治療

  BAOKUOYUFANGFENGSHIREFUFA,FANGZHIGANRANYIJIHEBINGZHENGDEZHILIAO。

  1、心力衰竭

  ZUNXUNXINSHUAIZHILIAODEYIBANYUANZE,LINIAO、QIANGXIN、KUOXUEGUANZHILIAO。JIXINGFEISHUIZHONGSHIBIMIANSHIYONGKUOZHANGXIAODONGMOWEIZHUDEKUOXUEGUANYAO。

  2、心房顫動

  ZHILIAOYUANZEWEIKONGZHIXINSHILV,ZHENGQUHUIFUDOUXINGXINLV,YUFANGXUESHUANSHUANSAI。

  (1)JIXINGFAZUOBANKUAISHILV:XUELIUDONGLIXUEWENDINGZHE,KEJINGZHUXIDILANJIANGXINSHILVKONGZHIZAI100/FENZHONGYIXIA。WUXIAO,KEJINGZHUANDIANTONG、XINLVPING、βSHOUTIZUZHIJI(MEIDUOXINAN、AISILUOER)HUOGAIJIEKANGJI(WEILAPAMI、DIERLIUZHUO;JIXINGFAZUOBANFEISHUIZHONG、XIUKE、XINJIAOTONGHUOHUNJUESHI,YINGLIJIDIANFULV。

幸运飞艇会亏吗  (2)MANXINGXINFANGZHANDONG:BINGCHENG<1NIAN,ZUOFANGNEIJING<60mm,WUBINGTAIDOUFANGJIEZONGHEZHENGHUOGAODUFANGSHICHUANDAOZUZHIZHE,KEKAOLVXINGYAOWU(CHANGYONGZHUANFUYAOWUYOUKUINIDING、ANDIANTONG)HUODIANFULVSHUZHUANFUDOUXINGXINLV。FULVQIANYINGZUOCHAOSHENGJIANCHAYIPAICHUXINFANGNEIFUBIXUESHUAN。ZHUANFUCHENGGONGHOUYONGANDIANTONGHUOKUINIDINGWEICHIDOUXINGXINLV。BUYIZHUANFUZHE,KOUFUDIGAOXINHUOLIANYONGDIERLIUCAO、BEITALEKE、ANXIANXINANJIANGXINSHILVKONGZHIZAIJINGXISHI70/FENZHONGZUOYOU。

  3、抗凝適應證

  (1)ZUOFANGXUESHUAN

  (2)CENGYOUSHUANSAISHI

  (3)RENGONGJIXIEBANMO

幸运飞艇会亏吗  (4)FANGZHAN。RUWUJINJIZHENG,SHOUXUANHUAFALIN,KONGZHIXUEJIANGNINGXUEMEIYUANSHIJIAN(PT)YANCHANG1.5~2BEI;GUOJIBIAOZHUNHUABILV(INR)2.0-3.0。FULVQIAN3ZHOUHEFULVHOU4ZHOUXUFUYONGHUAFALINKANGNINGZHILIAO。

  二、手術治療

  SHOUSHUXUANZE:ERJIANBANXIAZHAISHOUSHUBAOKUOCHENGXINGSHUJIHUANBANSHOUSHULIANGDALEI,YIBANQINGKUANGXIASHOUXUANCHENGXINGSHU,BINGBIANNANYICHENGXINGHUOCHENGXINGSHOUSHUSHIBAIZHE,KAOLVJINXINGBANMOZHIHUAN。

  1、經皮房間隔穿刺

幸运飞艇会亏吗  ERJIANBANQIUNANGKUOZHANGSHU(PBMV)SHIYINGZHENG

幸运飞艇会亏吗  (1)YOUZHENGZHUANG,XINGONGNENGⅡ、ⅢJI。

  (2)WUZHENGZHUANG,DANFEIDONGMOYASHENGGAO(FEIDONGMOSHOUSUOYAJINGXI>50mmHg,YUNDONG>60mmHg)。

幸运飞艇会亏吗  (3)ZHONGDUXIAZHAI,ERJIANBANKOUMIANJI0.8Cm2≤MVA≤1.5cm2。

  (4)ERJIANBANROURUAN,QIANXIEHUODONGDUHAO,WUYANZHONGZENGHOU,WUBANXIABINGBIAN,CHAOSHENGJIYINGXIANGWUYANZHONGGAIHUA。

  (5)ZUOFANGNEIWUFUBIXUESHUAN。

幸运飞艇会亏吗  (6)WUZHONGZHONGDUERJIANBANFANLIU。

  (7)JINQIWUFENGSHIHUODONG(KANG“O”、XUECHENZHENGCHANG)。

  2、閉式交界分離術

  SHIYINGZHENGTONGJINGPIQIUNANGKUOZHANGSHU,XIANYIBEIQIUNANGKUOZHANGSHUJIZHISHICHENGXINGSHUSUOTIDAI。

  3、直視二尖瓣成形術

  SHIYINGZHENG:XINGONGNENGⅢ~ⅣJI;ZHONG、ZHONGDUXIAZHAI;BANXIEYANZHONGGAIHUA,BINGBIANLEIJIJIANSUOHERUTOUJI;ZUOFANGXUESHUANHUOZAIXIAZHAIDENG,BUSHIYUJINGPIQIUNANGKUOZHANGSHU。SHUHOUZHENGZHUANGHUANJIEQIWEI8~12NIAN,CHANGXUERCISHOUSHUHUANBAN。

  4、瓣膜置換術成形術

  NANYIJIUZHENGERJIANBANJIXINGSHI,XUANZEBANMOZHIHUANSHOUSHU。

  適應證:

  (1)MINGXIANXINSHUAI(NYHAFENJIⅢHUOⅣJI)HUOKENENGCHUXIANWEIJISHENGMINGDEBINGFAZHENG。

幸运飞艇会亏吗  (2)BANMOBINGBIANYANZHONG,RUGAIHUA、BIANXING、WUDANXINGDELOUDOUXINGERJIANBANXIAZHAIJIFENLISHUHOUZAIXIAZHAI。

  (3)HEBINGYANZHONGERJIANBANGUANBIBUQUAN。

溫馨提示:以上內容整理于網絡,僅供參考,如果對您有幫助,留下您的閱讀感言吧!
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