晚发性心脏机械瓣膜功能障碍诊断与治疗

目的；对晚发性机械瓣膜功能障碍的诊断和治疗进行探讨。方法：回顾1996—01～2004—03诊断为机械瓣膜置换术后功能障碍患者16例（男6例，女10例）的临床资料。结果：超声彩色心动图（UCG）示所有患者存在机械瓣膜开启障碍。15例瓣口有效面积下降，8例人工机械瓣膜上有血栓声像。再次换瓣手术7例，5例为急诊手术，死亡1例；溶栓治疗6例，死亡3例；未行治疗的3例均已死亡。结论：超声彩色心动图有助于人工机械瓣膜功能障碍的诊断，手术和溶栓疗法是目前治疗的主要方法，但手术应为首选。

Clinical Diagnosis and Treatment of Delayed Mechanical Valve Prosthesis Dysfunction

Objective:To discuss the diagnosis and treatment of delayed mechanical valve prosthesis dysfunction.Methods:Clinical data of 16 patients(6 males,10 females) with delayed dysfunction of mechanical valve prosthesis were retrospectively analyzed.Results:All patients were found mechanical valve prosthesis by Echocardiography(UCG).15 cases showed reduced effective areas at valve orifice.8 cases presented acoustic images of thrombosis.7 cases received second valve replacements,including 5 emergence operations and 1 death.6 cases received treatment of thrombolysis in which 3 died.The untreated 3 cases all died.Conclusions:Echocariography is very important and useful for diagnosis of mechanical valve prosthesis dysfunction.Operation and thrombolytic are the two efficacious therapies,but operation is of the first choice.