| 朱梅,李晗.右冠状动脉 -左心室瘘并发感染性心内膜炎、脑梗死、脑出血 1例[J].安徽医药,2026,30(7):1367-1370. |
| 右冠状动脉 -左心室瘘并发感染性心内膜炎、脑梗死、脑出血 1例 |
| Right coronary artery-left ventricular fistula with infective endocarditis, cerebral infarction and cerebral hemorrhage: a case report |
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| DOI：10.3969/j.issn.1009-6469.2026.07.019 |
| 中文关键词: 冠状动脉瘘 感染性心内膜炎 脑出血 脑梗死 脑动脉瘤 |
| 英文关键词: Coronary artery fistula Infective endocarditis Cerebral hemorrhage Cerebral infarctionis Cerebral aneurysm |
| 基金项目:贵州省优秀青年科技人才项目(黔科合平台人才〔 2019〕5662)；贵州省科技计划项目(黔科合基础〔2018〕1097)； |
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| 中文摘要: |
| 目的总结冠状动脉瘘并发感染性心内膜炎、脑梗死、脑出血诊疗经验。方法回顾性分析 1例 15岁女性病人临床资料。女， 15岁，因“记忆力下降 10余天，右侧肢体无力 18 h”入院。诉 10余天前有记忆力下降、遗忘等症状。病人神志嗜睡，右侧肢体无力，右侧肢体肌力 0级，伴言语含混，右下肢 Babinski征阳性。结合病人病史、体征、辅助检查诊断。予抗感染、抗氧化、改善脑代谢等对症支持治疗。结果病人神志清楚，言语清晰，右侧肢体肌力 4级，好转出院。病人拒绝冠状动脉瘘管封堵，行脑动脉瘤栓塞术后随访至今，无再发感染性心内膜炎，无胸闷、气促不适，日常生活能自理。结论冠状动脉瘘并发感染性心内膜炎、脑梗死、脑出血病人，发现冠状动脉瘘并及时封堵能避免不良预后。 |
| 英文摘要: |
| Objective To summarize the diagnosis and treatment experience of coronary artery aneurysm complicated with infectiveendocarditis, cerebral infarction, and cerebral hemorrhage.Methods A retrospective analysis was conducted on the clinical data of a 15-year-old female patient. A 15-year-old female patient was admitted due to "memory loss for over 10 days and right limb weaknessfor 18 hours". Symptoms such as memory loss and forgetfulness were reported more than 10 days ago. The patient was mentally drowsy,with weakness in the right limb, muscle strength of the right limb at level 0, accompanied by slurred speech, and positive Babbitt signin the right lower limb. Diagnosis was made based on the patient's medical history, physical signs, and auxiliary examinations. Symp-tomatic supportive treatment such as anti infection, antioxidant, and improvement of brain metabolism was provided.Results The pa-tient was conscious, spoke clearly, and had a muscle strength of level 4 in the right limb. The patient improved and was discharged. Thepatient refused to occlude the coronary artery fistula and underwent cerebral aneurysm embolization. Follow up has been conducted sofar, and there has been no recurrence of infective endocarditis, chest tightness, shortness of breath discomfort, and daily life manage.ment.Conclusions Patients with coronary artery fistula complicated by infective endocarditis, cerebral infarction, and cerebral hemor-rhage. Timely detection and closure of coronary artery fistula can avoid adverse prognosis. |
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