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find Keyword "冠状动脉搭桥术" 3 results
  • 无创正压通气治疗冠状动脉搭桥术后急性左心衰竭的疗效观察

    【摘要】 目的 观察早期无创正压通气对冠状动脉搭桥术后急性左心衰竭所致严重低氧血症的治疗效果。方法 40 例冠状动脉搭桥术后发生急性左心衰竭的患者随机分为两组。对照组( n =20) : 予以面罩吸氧、强心、利尿、扩血管等治疗; 治疗组( n = 20) : 在对照组基础上予以无创面罩正压通气。测定动脉血pH、PaO2、SaO2、PaCO2 , 观察血压、心率、呼吸及临床症状, 并进行相关分析。结果 治疗组在治疗后30 min 开始改善, 在1、3、6 h 时的改善明显优于对照组, 表现在pH、PaO2、PaCO2 、心率、呼吸频率、SaO2 方面( P lt;0. 05) ; 在纠正低PaO2 方面, 治疗组早期即表现出优越性。治疗组急性左心衰竭开始缓解的时间较对照组明显缩短( P lt;0. 01) 。结论 对于冠状动脉搭桥术后急性左心衰竭的冠心病患者, 在抗心衰治疗的同时短期使用无创正压通气可以较快纠正机体缺氧状况, 改善心功能, 缩短急性左心衰竭病程。

    Release date:2016-08-30 11:55 Export PDF Favorites Scan
  • Evaluation of the Treatment Effect of Off-pump Coronary Artery Bypass Surgery and Summary of the Nursing Care in the Treatment

    ObjectiveTo investigate the clinical efficacy of off-pump coronary artery bypass grafting, and summarize the experience of nursing care in the treatment. MethodsWe retrospectively analyzed the clinical data of 25 patients undergoing off-pump coronary artery bypass surgery between January 2010 and December 2012. The therapeutic effect of the surgical method and the care management measures were summarized and analyzed. ResultsAll the operations were successful without any deaths. The Mean operation time was (209.85±38.41) miniutes; Blood infusion volume averaged (1 311.23±423.70) mL; Drainage volume was (491.98±142.46) mL; The mean ICU monitoring time was (4.22±1.23) days; Hospitalization lasted for (10.10±1.89) days; And the mean number of bypass was 4.00±0.51. Two patients had high temperature and coughing after surgery, and were cured through intravenous dripping and atomization sputum suction. Two had slight injury infection and were controlled with antibiotics. Two could not endure the pain which was relieved by sauteralgyl. One patient with thoracic pain due to neural stimulation was relieved by glycerin trinitrate. ConclusionThe off-pump coronary artery bypass surgery is advantageous in having less trauma, less bleeding, shorter hospital stay and lower hospital costs. The preoperative, intraoperative and postoperative care should be prepared to ensure the smooth implementation of the surgery and improve therapeutic effect.

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  • Numerical study on the mechanical coupling of external vascular stent and vein graft in coronary artery bypass surgery

    External support stent is a potential means for restricting the deformation and reducing wall stress of the vein graft, thereby improving the long-term patency of the graft in coronary artery bypass surgery. However, there still lacks a theoretical reference for choosing the size of stent based on the diameter of graft. Taking the VEST (venous external support) stent currently used in the clinical practice as the object of study, we constructed three models of VEST stents with different diameters and coupled them respectively to a model of the great saphenous vein graft, and numerically simulated the expansion-contraction process of the vein graft under the constraint of the stents to quantitatively evaluate the influence of stent size on the radial deformation and wall stress of the vein graft. The results showed that while the stent with a small diameter had a high restrictive effect in comparison with larger stents, it led to more severe concentration of wall stress and sharper changes in radial deformation along the axis of the graft, which may have adverse influence on the graft. In order to solve the aforementioned problems, we ameliorated the design of the stent by means of changing the cross-sectional shape of the thick and thin alloy wires from circle into rectangle and square, respectively, while keeping the cross-sectional areas of alloy wires and stent topology unchanged. Further numerical simulations demonstrated that the ameliorated stent evidently reduced the degrees of wall stress concentration and abrupt changes in radial deformation, which may help improve the biomechanical environment of the graft while maintaining the restrictive role of the stent.

    Release date:2021-02-08 06:54 Export PDF Favorites Scan
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