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心脏再同步化治疗后超反应并放射性皮肤损伤1例报道

A case report of hyperreaction complicated with radiation skin injury after cardiac resynchronization therapy

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【作者】 李明哲左铁成李阳

【Author】 LI Mingzhe;ZUO Tiecheng;LI Yang;Department Ⅱ of Cardiovascular Internal Medicine, Siping Central People’s Hospital in Jilin Province;Department of Cardiovascular Internal Medicine, the First Hospital of China Medical University;

【通讯作者】 李阳;

【机构】 吉林省四平市中心人民医院心血管内二科中国医科大学附属第一医院心血管内科

【摘要】 1例诊断为心功能Ⅳ级纽约心脏病协会(New York heart association,NYHA)分级、完全性左束支传导阻滞的女性患者,在强心、利尿、扩管、改善心室重构等药物治疗基础上,接受心脏再同步化治疗(CRT)。术后心电图QRS波群时限由165 ms缩短至130 ms。随访3年,心脏超声显示:左心房内径(Left atrial diameter,LAD)由47 mm缩小至31 mm,左室舒张末内径(Left ventricular end diastolic diameter,LVEDd)由66 mm缩小至43 mm,左室射血分数(Left ventricular ejection fraction,LVEF)由14%升高至66%。患者日常活动无心悸、气短。术后2周发现患者右侧背部皮肤大面积放射性损伤,经清除坏死皮肤,凡士林油纱布包扎,定期换药等治疗后,放射性皮肤损伤逐渐愈合。

【Abstract】 A female patient, with complete left bundle branch block, diagnosed as New York Heart Association(NYHA) grade Ⅳ and was treated with cardiac resynchronization therapy(CRT) on the basis of cardiac strengthen, diuretic therapy, cardiovascular expanding and improvement of ventricular remodeling. The QRS complex duration of ECG was shortened from 165 ms to 130 ms after operation. It was shown by the follow-up for 3 years that left atrial diameter(LAD) was decreased from 47 mm to 31 mm, left ventricular end diastolic diameter(LVEDd) was decreased from 66 mm to 43 mm, and left ventricular ejection fraction(LVEF) was increased from 14% to 66%. There were no palpitations and shortness of breath in patients’ daily activities. Two weeks after operation, a large area of radiation injury was discovered on the right back skin of the patient. After necrotic skin was removed, petrolatum gauze was bandaged, and dressing was changed regularly, the radiation induced skin injury was healed gradually after treatment.

  • 【文献出处】 中国现代医生 ,China Modern Doctor , 编辑部邮箱 ,2020年34期
  • 【分类号】R541.6
  • 【下载频次】15
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