与心脏肝硬化相关的收缩性心膜炎的外科治疗:一个病例报告
Yudha Klahan Nugraha1, Ummi Maimunah2
1Study Program of Internal Medicine, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia.
International journal of surgery case reports
|June 7, 2024
概括
狭窄性心膜炎可能导致肝脏问题. 成功的心周切除术改善了患者的病情,儿童-图尔科特-普格 (CTP) 和末期肝病模型 (MELD) 评分预测了结果.
科学领域:
- 心脏病学 心脏病学
- 肝病学 肝病学是一种肝病学.
- 心血管外科心血管外科
背景情况:
- 收缩性心膜炎可能会导致由于右侧心力衰竭而引起的血栓性肝病.
- 肝硬化具有显著的死亡风险,强调了术后管理的重要性.
研究的目的:
- 在患有收缩性心膜炎和同时存在肝硬化病的患者中提出成功心膜切除术的案例.
- 要强调使用CTP和MELD得分对这些患者进行风险评估的重要性.
主要方法:
- 评估了一名50岁的男性,呼吸短促,疲劳,有收缩性心周炎病史.
- 诊断工作包括心声回声,心脏CT,腹部超声波和瞬态弹性图.
- 该患者接受了心周切除术,儿童-图尔科特-普格 (CTP) 评分为6,MELD评分为12.
主要成果:
- 手术前发现包括关静脉压升高,肝功能检测异常,左心室缩,右心室衰竭,心周结石化,肝脏充血变化和严重肝纤维化.
- 经过心脏切除术后,患者在2年的随访中经历了显著的症状减轻和功能改善.
结论:
- 心切除术对于患有收缩性心膜炎和补偿性肝硬化 (CTP类A) 的患者来说是一个可行的选择.
- CTP和MELD分数是预测手术后心脏肝硬化患者的预期寿命和手术风险的宝贵工具.
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