Coron Artery Dis: 心梗后心脏破裂知多少?阜外医院和上海仁济医院比较

2020-03-26 中国循环杂志 中国循环杂志

心梗后心脏破裂虽少见但凶险,发生率究竟有多少?

心梗后心脏破裂虽少见但凶险,发生率究竟有多少?

上海胸科医院江立生等研究发现,2004年1月至2015年12月期间连续就诊的4190例STEMI患者中,有75例(1.8%)发生了心脏破裂。其中42例游离壁破裂,33例室间隔穿孔。

心脏破裂发生平均时间为症状发生后(4.41±3.48)天 ,波动范围在4 h~17 d。

阜外医院李佳等对7 315 例急性心梗患者资料发现,心脏破裂的发生率为1.13%,2008~2017年期间不同年份心脏破裂发生率相似。33例(0.68%)发生游离壁破裂,50 例(0.45%)发生室间隔穿孔。

游离壁破裂的发生时间(3.3±2.6)天,室间隔穿孔时间为(4.1±3.6)天。

但仅 2 例(6.1%)游离壁破裂患者成功接受外科手术治疗,而25 例(50%)室间隔穿孔患者成功接受外科手术治疗。

美国心脏病学会建议:除非患者不愿接受手术治疗或有手术禁忌,否则应对室间隔缺损的患者进行急诊手术。

阜外医院心外科还对2005年至2015年10年间心梗合并室间隔缺损患者进行修补术的患者77例进行了总结,结果仅死亡3例。

原始出处:
Hao Z, Ma J, Dai J, et al. A real-world analysis of cardiac rupture on incidence, risk factors and in-hospital outcomes in 4190 ST-elevation myocardial infarction patients from 2004 to 2015 . Coron Artery Dis. 2020 Mar 12.

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    2020-05-06 lfyang
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    2020-10-02 budeshao
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  6. [GetPortalCommentsPageByObjectIdResponse(id=2013247, encodeId=b70e201324e6e, content=<a href='/topic/show?id=7d69598468' target=_blank style='color:#2F92EE;'>#Dis#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5984, encryptionId=7d69598468, topicName=Dis)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c689267, createdName=cmj8wellington, createdTime=Fri Oct 16 10:38:23 CST 2020, time=2020-10-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1816160, encodeId=5789181616061, content=<a href='/topic/show?id=fc4e9e348b6' target=_blank style='color:#2F92EE;'>#阜外医#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97348, encryptionId=fc4e9e348b6, topicName=阜外医)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c97a2500111, createdName=thinkibmz_44722594, createdTime=Sat Jun 06 16:38:23 CST 2020, time=2020-06-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2053422, encodeId=f7492053422e9, content=<a href='/topic/show?id=93255105e89' target=_blank style='color:#2F92EE;'>#心梗后#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=51057, encryptionId=93255105e89, topicName=心梗后)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=43cb463, createdName=lfyang, createdTime=Wed May 06 13:38:23 CST 2020, time=2020-05-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1751724, encodeId=bb491e5172482, content=<a href='/topic/show?id=5e8b2e8739' target=_blank style='color:#2F92EE;'>#Artery#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2787, encryptionId=5e8b2e8739, topicName=Artery)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=842136396965, createdName=budeshao, createdTime=Fri Oct 02 16:38:23 CST 2020, time=2020-10-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1293755, encodeId=286a1293e5513, content=<a href='/topic/show?id=4c6e9e34931' target=_blank style='color:#2F92EE;'>#阜外医院#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97349, encryptionId=4c6e9e34931, topicName=阜外医院)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8942242, createdName=jj000001, createdTime=Sat Mar 28 01:38:23 CST 2020, time=2020-03-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1357456, encodeId=6159135e4562a, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=15, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Sat Mar 28 01:38:23 CST 2020, time=2020-03-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1441018, encodeId=d5f1144101849, content=<a href='/topic/show?id=9776252499c' target=_blank style='color:#2F92EE;'>#仁济医院#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=25249, encryptionId=9776252499c, topicName=仁济医院)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2ca24772092, createdName=12498a49m61暂无昵称, createdTime=Sat Mar 28 01:38:23 CST 2020, time=2020-03-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1623122, encodeId=45e2162312277, content=<a href='/topic/show?id=09c751628fe' target=_blank style='color:#2F92EE;'>#心脏破裂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=51628, encryptionId=09c751628fe, topicName=心脏破裂)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=bee920492824, createdName=liye789132258, createdTime=Sat Mar 28 01:38:23 CST 2020, time=2020-03-28, status=1, ipAttribution=)]
    2020-03-28 zhaojie88
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