成人及儿童心脏憩室临床分析尤士杰1姚民1杨跃进1李琳1高润霖1乔树宾1秦学文1姚康宝1陈纪林1徐义枢1陈在嘉1摘要目的:探讨成人与儿童心脏憩室的临床特点。方法:将经心脏造影或手术证实为心脏憩室的9例患者临床资料进行回顾性分析。结果:�4例成人患者(成人组)皆因并发冠心病在冠状动脉及左室造影检查时被偶然发现。5例儿童患者(儿童组)中4例因并存其他严重先天性心脏畸形而施行外科矫治手术时被确诊,另1例经左室造影证实。�成人组平均憩室瘤体径为20～48(36.3±11.8)mm,憩室颈径为10～17(14.0±2.9)mm;儿童组平均憩室瘤体径25～80(42.0±22.0)mm,憩室颈径为4～12(8.6±3.9)mm。�成人组均为孤立性左室肌型憩室,无与憩室有关的并发症,未行手术治疗;儿童组中仅1例为孤立性左室肌型憩室,其余4例均根据其并存的心脏畸形类型分别接受了憩室缝合术和房、室间隔修补术、三尖瓣成形术、二尖瓣置换术或动脉导管结扎术等治疗。结论:成人与儿童心脏憩室的临床特点有许多不同之处。关键词先天性心脏憩室憩室缝合术左心室造影AnalysisoftheclinicalfeaturesofcongenitalcardiacdiverticuluminadultsandchildrenYOUShi-jieYAOMinYANGYue-jinLILingGAORun-linQIAOShu-binQINXue-wenYAOKang-baoCHENGJi-linXUYi-shuCHENZai-jia(CardiovascularInstituteandFuwaiHeartHospital,ChineseAcademyofMedicalSciencesandPekingUnionMedicalCollege,Beijing100037)AbstractObjective:Inordertoelucidatedifferentclinicalfeaturesbetweenadultsandchildrenwiththecongenitalcardiacdiverticulum.Method:Theclinicalcharactersofninecaseswithcongenitalcardiacdiverticulumconfirmedbytheventriculographyorsurgicaloperationinourhospitalwereanalyzedretrospectively.Therewere4adultcases,theiraverageagewere(59.3±7.6)years(50～68years);and5childrencases,theiraverageagewere(6.5±4.4)years(2.5～14years).Result:�Fourcaseswithleftventriculardiverticuluminadultswereallincidentallydiscoveredandconfirmedbyleftventriculographyunderwentfordifferentioncoronaryheartdiseasediagnosis.Fivecasesinchildrenwereconfirmedbysurgicaloperationduringcorrectedoperationforotherseverecongenitalheartmalformation.�Theaveragediameterofthediverticulumwere(36.3±11.8)mm(20～48mm),theneckofdiverticulumwere(14.0±2.9)mm(10～17mm)in4adults.Theaveragediameterofthediverticulumwere(42.0±22.0)mm(25～80mm),theneckofdiverticulumwere(8.6±3.9)mm(4～12mm)in5children.�Allthediverticulumwereisolateralleftventricularmusculardiverticulumin4adults,andthepatientshadnocomplainesrelatedtothediverticulum,andwerenotoperated.Only1casewiththediverticulumwasisolateralleftventricularmusculardiverticuluminchildren,otherchildrenwiththediverticulum(1casewithbioverticularmusuculardiverticulum,2casewithrightventricularmusculardiverticulum,1casewithleftatrialfibrousdiverticulum)wereunderwentsurgeryaccordingtothetypesofcongenitalheartanomalestheirdiverticulumsweresuturedatthesametime.Conclusion:Thereweremanydifferentclinicalfeaturesbetweentheadultsandthechildrenwithcongenitalcardiacdiverticulum.KeywordsCongenitalcardiacdiverticulumDiverticulosuturaLeftventriculography心脏憩室是一种极为罕见的先天性心脏畸形,文献报道甚少。现将我院确诊的9例的临床特点回顾性分析如下。1临床资料1.1对象选择我院1983年3月～1999年3月期间收治的心脏憩室患者9例,分为成人组4例,均为男性,年龄50～68(59.3±7.6)岁;儿童组5例,其中男4例,女1例,年龄2.5～14(6.5±4.4)岁。1中国医学科学院中国协和医科大学心血管病研究所阜外心血管病医院冠心病研究室(北京,100037)1.2临床特点及伴发其他心脏疾患情况成人组均未并发其他先天性心脏畸形,2例有陈旧性心肌梗死史,2例有心绞痛史,心电图可见相应导联异常Q波和(或)ST-T改变。儿童组5例患者均可闻及心脏杂音和心...
