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巨大冠状动脉瘤的直径至少是正常冠状动脉的4倍以上,是普通冠状动脉瘤的2~3倍以上。该病在临床上非常罕见,根据目前临床报道它的发病率不足0.3%。与普通冠状动脉瘤一样,冠状动脉粥样硬化是该病的主要发病原因。在该病的患者中,大多数是无症状的,而有些患者近期会出现与心脏有关的临床急症,远期会出现血栓并形成栓塞,瘘管并形成破裂。外科矫治是目前该病首选的治疗方法,而介入治疗未来将会成为该病的重要治疗方式。本文就巨大的冠状动脉瘤诊断、临床表现和治疗等方面进行综述。
The diameter of a huge coronary aneurysm is at least 4 times more than that of a normal coronary artery, which is 2 to 3 times more than that of an ordinary coronary artery aneurysm. The disease is clinically very rare, its incidence is less than 0.3% according to the current clinical reports. Like common coronary aneurysms, coronary atherosclerosis is the main cause of the disease. Most of the patients with this disease are asymptomatic, while some patients may have clinical emergency related to the heart in the near future. In the future, thrombosis will occur and embolism, fistula and rupture will be formed. Surgical treatment is the preferred treatment of the disease, and intervention in the future will become an important treatment of the disease. This article reviews the diagnosis, clinical manifestation and treatment of huge coronary aneurysm.