急性心肌梗死并发室间隔穿孔患者的手术时机与评价

室间隔穿孔是急性心肌梗死少见的并发症,却会迅速发生心力衰竭、心源性休克等并发症,预后极差。外科手术治疗是改善预后的根本措施,而手术时机的选择至关重要。其基本指导原则为：部分心肌梗死患者发生室间隔穿孔后会迅速出现双心室功能衰竭和/或心源性休克,经药物等保守治疗循环功能不能维持,又不能耐受外科手术,将会很快死亡,病死率很高;对该类已经失去了手术机会的患者,不宜施行手术治疗;对少数穿孔较小、能平稳控制病情的患者,严格把握手术指征后可给予药物和保守治疗1～4周后再行手术治疗,一旦无法确保病情稳定时,应及时改为急诊手术治疗;其余患者无论处于何种状态,均应立即行外科手术治疗

Evaluation and Timing of Surgery for Patients with Acute Myocardial Infarction Complicated with Ventricular Septal Rupture

Ventricular septal rupture is a rare complication of acute myocardial infarction,but it can easily lead to such complications as acute heart failure and cardiac shock with sinister prognosis.Surgical treatment is a fundamental measure to improve the prognosis,and the selection of operation time is a key factor.The basic guiding principles of operation timing are as follows.Those patients who have acute heart failure and/or cardiac shock soon after the onset of ventricular septal rupture,and can not be contr...