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目的:分析风湿性心脏病二尖瓣狭窄合并左心房血栓形成的诊断和治疗。方法:74例风湿性心脏病二尖瓣狭窄合并左心房血栓形成患者均行经胸与经食管超声心动图检查,口服华法林抗凝治疗,INR达标后行经皮二尖瓣球囊成形术。结果:所有患者均检出血栓形成,口服华法林治疗6个月后,73例患者INR达标,顺利行经皮二尖瓣球囊成形术,随访期间均无严重不良反应。结论经胸与经食管超声心动图检查和口服华法林进行抗凝治疗是风湿性心脏病二尖瓣狭窄合并左心房血栓形成患者的有效诊断和治疗方法。
Objective: To analyze the diagnosis and treatment of rheumatic mitral stenosis with left atrial thrombosis. Methods: Totally 74 patients with rheumatic mitral stenosis and left atrial thrombosis underwent transthoracic and transesophageal echocardiography, and received warfarin anticoagulation therapy. Percutaneous balloon mitral valvuloplasty was performed after INR was achieved. Thrombosis was detected in all patients. After 6 months of oral warfarin therapy, INR was achieved in 73 patients and successful percutaneous balloon mitral valvuloplasty was performed without serious adverse reactions during follow-up. Conclusion Transthoracic and transesophageal echocardiography and oral warfarin anticoagulant therapy is an effective diagnosis and treatment of patients with rheumatic mitral stenosis and left atrial thrombosis.