【摘要】：血管內溶血是心臟瓣膜術后并發(fā)癥之一。隨著醫(yī)學技術發(fā)展,嚴重瓣膜相關血管內溶血發(fā)生率顯著降低,但亞臨床溶血仍普遍存在。該并發(fā)癥主要發(fā)生機制為瓣膜術后局部結構改變,導致非生理性血流形成,剪應力增高,引發(fā)紅細胞破碎、血管性血友病因子減少,血小板功能異常。溶血的發(fā)生及嚴重程度受人工瓣膜、手術操作和原發(fā)病等多方面因素影響。早期主要原因為瓣膜設計缺陷和質量問題,現(xiàn)階段以手術操作并發(fā)癥所致為主�；颊咄瑫r具有瓣膜功能異常和血管內溶血相關臨床表現(xiàn),治療以糾正原發(fā)病為主,結合患者情況個體化用藥,嚴重者考慮再次手術。近年來,介入下瓣膜置換術和瓣周漏修補術在世界范圍內逐漸開展,相關研究及證據資料有限,值得進一步關注。
[Abstract]:Intravascular hemolysis is one of the complications after cardiac valve operation. With the development of medical technology, the incidence of severe valvular related intravascular hemolysis decreased significantly, but subclinical hemolysis was still prevalent. The main mechanism of this complication is that the local structure changes after valve operation, resulting in the formation of non-physiological blood flow, the increase of shear stress, the fragmentation of red blood cells, the decrease of von Willebrand factor, and the abnormal platelet function. The occurrence and severity of hemolysis are affected by prosthetic valves, surgical procedures and primary diseases. The main causes in the early stage were valve design defects and quality problems. Patients also have valve dysfunction and intravascular hemolysis related clinical manifestations, the main treatment is to correct the primary disease, combined with the individual use of patients, serious cases consider reoperation. In recent years, interventional valvular replacement and perivalvular leakage repair have been carried out all over the world.
【作者單位】： 中國醫(yī)學科學院北京協(xié)和醫(yī)學院北京協(xié)和醫(yī)院麻醉科;
【分類號】：R654.2

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本文編號：2272107