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患有家族性心肌病的产妇剖宫产的麻醉注意事项。

Anesthetic considerations for cesarean section in the parturient with familial cardiomyopathy.

作者信息

Wood W L, Kuczkowski K M, Beal B R

机构信息

Department of Anesthesiology, University of California San Diego, San Diego, California, USA.

出版信息

Acta Anaesthesiol Belg. 2008;59(2):87-9.

Abstract

Dilated cardiomyopathy (DCM) is a heart muscle disease characterized by ventricular dilatation and impaired systolic cardiac function. DCM is defined by the presence of: a) fractional myocardial shortening less then 25% (> 2 SD) and/or ejection fraction less than 45% (> 2 SD); and b) left ventricular end diastolic diameter (LVEDD) greater than 117% excluding any known cause of myocardial disease. Familial dilated cardiomyopathy (FDC) accounts for 20-48% of all DCM cases, and is defined by the presence of two or more affected relatives with DCM meeting the above diagnostic criteria or a relative of a DCM patient with unexplained sudden death before the age of 35 years. We herein present the first reported case in the literature of a parturient with FDC undergoing urgent Cesarean section (secondary to worsening cardiac function) and briefly highlight anesthetic considerations for parturients with this heart condition.

摘要

扩张型心肌病(DCM)是一种以心室扩张和收缩期心脏功能受损为特征的心肌疾病。DCM的定义为:a)心肌缩短分数小于25%(>2个标准差)和/或射血分数小于45%(>2个标准差);b)左心室舒张末期内径(LVEDD)大于117%,且排除任何已知的心肌疾病病因。家族性扩张型心肌病(FDC)占所有DCM病例的20 - 48%,其定义为有两名或更多符合上述诊断标准的患有DCM的亲属,或一名DCM患者的亲属在35岁之前发生不明原因的猝死。我们在此报告文献中首例患有FDC的产妇接受紧急剖宫产(继发于心脏功能恶化)的病例,并简要强调患有这种心脏疾病的产妇的麻醉注意事项。

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