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中新网广州11月28日电 (记者 蔡敏婕)“主动脉瓣狭窄往往病情进展更快,一旦出现症状,患者发生猝死的风险更高。”南方医科大学南方医院心内科主任修建成28日称,患者通常首先出现呼吸困难,这是左心功能不全的早期信号;随后可能因心脏出口受阻、心肌供血不足而引发心绞痛;最危险的是晕厥或眼前发黑,这提示脑供血已严重不足。
令人担忧的是,这些症状常常被误认为是普通的衰老表现,或是与冠心病相混淆。“等到出现明显症状时,病情往往已经发展到相当严重的阶段,许多患者因此错过最佳治疗时机。”修建成特别提醒,“当出现呼吸困难、胸闷、气短、心绞痛等表现时,务必要及时就医检查,真正做到早发现、早治疗。”
修建成指出,对于重度的主动脉瓣狭窄,内科治疗的手段很有限,而外科手术需要开胸、全身麻醉等,对患者身体状况的要求相当高。尤其是高龄患者器官功能普遍衰退,应激与代偿能力较弱,往往因无法承受外科手术带来的风险。
“也正因如此,经导管介入技术应运而生。”修建成指出,介入最大的优势是创伤小,患者康复快,不过,与高危患者相比,临床上中低危患者年龄普遍更轻且合并症较少,未来面临再次换瓣的可能性也会更高。因此,这部分患者的全生命周期管理问题也成为临床重点关注问题。
修建成特别提醒,及早发现瓣膜问题,才能避免心功能发生不可逆损伤,“超声是筛查瓣膜病的第一步。特别是对于65岁以上的老年人这类高危人群,一定要定期进行心脏超声检查”。(完)
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