west china medical publishers
Author
  • Title
  • Author
  • Keyword
  • Abstract
Advance search
Advance search

Search

find Author "周丹" 20 results
  • 双主动脉弓合并法洛四联症同期矫治一例

    Release date:2016-08-30 06:04 Export PDF Favorites Scan
  • 单纯心内修复矫治法洛四联症115例

    目的 总结采用单纯心内修复的方法对法洛四联症(TOF)患者进行矫治的临床经验,为患者选择个性化的手术方案,尽可能保护右心功能。 方法 2005年1月至2008年7月武汉亚洲心脏病医院心外科对115例TOF患者施行单纯心内修复,其中男72例,女43例;年龄5个月~39岁。在充分疏通右心室流出道、修补室间隔缺损后,直接缝合右心室切口。 结果 无围术期死亡。呼吸机辅助呼吸时间 12.29±8.67 h,住ICU时间35.10±19.80 h。术后发生残余漏2例,因漏口lt;3 mm未作处理;发生一过性Ⅲ度房室传导阻滞1例,因胸腔积液放置胸腔闭式引流管2例,少量心包积液2例,均经药物或相应的治疗后好转。灌注肺二次气管内插管1例,术后二次开胸止血2例,无低心排血量综合征和肾功能不全发生。术后随访103例,随访时间3~39个月,所有患者均恢复良好,紫绀消失,恢复正常生活和工作,心功能分级(NYHA)Ⅰ级97例,Ⅱ级6例。术后3~6个月复查超声心动图提示:肺动脉瓣无反流或仅有轻度反流。结论 TOF的矫治宜选择个性化的手术方案,对单纯漏斗部狭窄、室间隔缺损为嵴下型的患者,采用单纯心内修复方法是可行的,有利于心功能的保护及术后恢复。

    Release date:2016-08-30 06:06 Export PDF Favorites Scan
  • i-STAT便携式血气分析仪在连续性肾脏替代治疗中的应用

    目的 讨论i-STAT便携式血气分析仪在连续性肾脏替代治疗(CRRT)中的应用。 方法 2012年2月-5月,对92例行CRRT治疗患者采用i-STAT便携式血气分析仪监测分析治疗中各参数变化并及时予以调整。 结果 92例患者治疗中酸碱及电解质的失衡得到及时调整,无意外情况发生。 结论 i-STAT便携式血气分析仪在CRRT治疗中能较好的监测患者的血气及电解质,确保CRRT的安全完成。

    Release date:2016-09-07 02:34 Export PDF Favorites Scan
  • PDCA 循环对血液透析护士查对制度培训的效果观察

    目的 探讨 PDCA 循环理论在血液透析查对制度中的应用效果。 方法 2015 年 5 月—7 月,对肾脏内科血液透析中心 48 名护士,运用计划(plan,P)、实施(do,D)、检查(check,C)、处理(action,A)4 个阶段的PDCA循环理论进行查对制度的培训,开展定期与不定期的抽查、考核。并比较培训前(2015 年 2 月—4 月)和培训后(2015 年8 月—10 月)的操作和理论成绩。 结果 48 名护士在培训前对查对制度的理论考核成绩为(93.87±1.49)分,培训后为(99.09±0.63)分,培训前对查对制度的操作考核成绩为(93.87±1.49)分,培训后为(99.78±0.52)分,培训前后查对制度理论与操作考核成绩比较,差异均有统计学意义(P<0.05)。 结论 PDCA 循环理论在血液透析查对制度中的应用有助于提高临床护理质量,减少护理差错及纠纷的发生,改善护患关系。

    Release date:2017-06-22 02:01 Export PDF Favorites Scan
  • Effect of comprehensive nursing on patients with autoimmune encephalitis

    ObjectiveTo explore the effect of comprehensive nursing service in patients with autoimmune encephalitis (AE).Methods32 patients with AE were selected and treated in our hospital from January 2017 to January 2019. There are 16 patients in the observation group and the control group respectively. The observation group received comprehensive nursing service and the control group received routine nursing intervention. Total satisfaction of clinical nursing was compared between the two groups.ResultsCompared with 10 cases (62.50%) in the control group, 15 cases (93.75%) in the observation group had better overall nursing satisfaction, and the difference between the two groups was significant (P<0.05).ConclusionsFor patients with AE, comprehensive nursing service can significantly improve the quality of life of patients, which has clinical application value.

    Release date:2020-03-20 08:06 Export PDF Favorites Scan
  • Study on the Direct Health Cost of Nonsmall-Cell Lung Cancer

    Objective Review the status of the direct health cost of nonsmall-cell lung cancer , and to put forward policy recommendations. Methods Database including PubMed, Cochrane Library and Chinese BioMed were searched, and studies literatures about the direct health cost of nonsmall-cell lung cancer. Results Twenty two studies were analyzed in this paper including 20 foreign studies. Normally, international researches about direct medical cost of treating the nonsmall-cell lung cancer investigate total cost from the first diagnosis until several years later. The discrepancy in the results could be explained by different payments, treatment patterns and research methods in different countries. The direct medical cost of nonsmall-cell lung cancer is expensive especially the cost of in-patient. It’s increase with the time of therapy. Most of the researches in China about direct medical cost of nonsmall-cell lung cancer focus on per in-patient fees. Conclusion  Facing the increasingly heavy economic burden of nonsmall-cell lung cancer, to lower the incidence of this disease and to reduce the treatment related cost should be taken into account., the prevention of nonsmall-cell lung cancer carcinoma should be enhanced, Such as tobacco control, environment improvement, etc. A proper incentive mechanism should be established.

    Release date:2016-09-07 02:11 Export PDF Favorites Scan
  • The Psychological States and Their Influencing Factors in the Parents of Congenital Defect Neonates Admitted to Intensive Care Unit

    ObjectiveTo investigate the psychological states and their influencing factors in parents of congenital defect neonates admitted to Intensive Care Unit (ICU). MethodsThe self-designed general information questionnaire was used to collect the demographic data, and self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were used to evaluate the states of anxiety and depression of the parents of congenital defect neonates admitted to ICU between June 1 and November 29, 2013. ResultsA total of 152 parents were included in this investigation. The average score of SAS was 39.45±8.53. The average score of SDS was 43.28±10.76. Univariate analysis found that parents with lower educational level, poorer family income, positive family history and countryside residence might have higher score of SAS, while parents with Han nationality, poorer family income and family history would have higher score of SDS. Multivariate analysis discovered that living condition and family history were related to anxiety status. However, depression state was influenced by nationality, family income and family history. ConclusionA considerable number of parents of congenital defect neonates admitted to ICU have anxiety or depression. And nationality, family income, family history and living condition are the major risk factors.

    Release date: Export PDF Favorites Scan
  • Predictive value of STAMP in Health Information System in children with critical congenital heart disease

    ObjectiveTo analyze the perdictive value of Screening Tool for the Assessment of Malnutrition in Pediatrics (STAMP) for malnutrition or postoperative complications in children with critical congenital heart disease (CHD).MethodsA total of 875 children with critical CHD who were hospitalized in West China Hospital, Sichuan University form August 2019 to February 2021, including 442 males and 433 females with a median age of 30 (12, 48) months, were assessed by STAMP in Health Information System. Clinical data of postoperative complications were collected.Results(1) Based on World Health Organization Z-score as gold standard, 24.5% had malnutrition risk, and 34.3% were diagnosed with malnutrition. According to STAMP, the children were with medium malnutrition risk of 37.9% and high malnutrition risk of 62.1%. There was a statistical difference of incidence rate of malnutrition and detection rate of STAMP malnutrition risk in gender, age, ICU stay or length of mechanical ventilation (P<0.05); (2) with the optimal cut-off point of 5.5 in STAMP for malnutrition, the sensitivity, specificity, positive predictive value, negative predictive value and area under the curve (AUC) were 68.3%, 84.3%, 48.1%, 88.3% and 0.82, respectively; (3) 12.0% of the children were with postoperative complications; (4) with the optimal cut-off point of 5.5 in STAMP for postoperative complications, the sensitivity, specificity, positive predictive value, negative predictive value and AUC were 83.8%, 73.1%, 18.8%, 99.1% and 0.85, respectively.ConclusionChildren with critical CHD have a higher incidence of malnutrition risk and postoperative complications. STAMP has a good perdictive value for malnutrition or postoperative complications, however, the sensitivity and specificity of STAMP are affected by the gold standard or the cut-off point.

    Release date: Export PDF Favorites Scan
  • Association between preoperative anemia and postoperative infection and death in children with acyanotic congenital heart disease undergoing elective cardiac surgery: A retrospective cohort study

    Objective To analyze the relationship between preoperative anemia and postoperative infection and death in children with acyanotic congenital heart disease (CHD) after elective cardiac surgery. Methods Medical records and follow-up data of 3 859 children with acyanotic CHD who underwent elective cardiac surgery in our hospital from 2011 to 2018 were retrospectively collected, including 2 081 males and 1 778 females with a median age of 32.2 (13.7, 61.5) months. The relationship between preoperative anemia and postoperative infection and death within 90 days was analyzed by univariate and multivariate regression analyses. Results Preoperative anemia was found in 325 (8.4%) patients. There were 716 (18.6%) patients of postoperative infection, including 281 (7.3%) patients of confirmed infection and 435 (11.3%) patients of suspected infection. Forty-six (1.2%) patients died within 90 days after the operation. Univariate analysis showed that age, infection history within 3 months before admission, degree of pulmonary hypertension, the risk adjustment in congenital heart surgery-1 (RACHS-1) score, cardiopulmonary bypass (CPB), disease diagnosis, chromosome abnormality, preoperative left ventricular ejection fraction (LVEF)<55% and preoperative anemia were associated with postoperative infection. Age, degree of pulmonary hypertension, RACHS-1 score, CPB, disease diagnosis and preoperative LVEF<55% were associated with postoperative death within 90 days. Logistic regression analysis showed that preoperative anemia was significantly associated with confirmed postoperative infection [OR=1.82, 95%CI (1.18, 2.82), P=0.007], suspected infection [OR=1.60, 95%CI (1.11, 2.30), P=0.012] and total infection [OR=1.64, 95%CI (1.20, 2.24), P=0.002]. The results of modified Poisson regression analysis showed that there was no significant association between preoperative anemia and death within 90 days after the surgery [RR=1.59, 95%CI (0.69, 3.69), P=0.276]. Conclusion Preoperative anemia may be a risk factor for infection after elective cardiac surgery in children with acyanotic congenital heart disease.

    Release date: Export PDF Favorites Scan
  • Surgical Treatment of Tetralogy of Fallot with Anomalous Coronary Artery

    Abstract: Objective To summarize our surgical experience of tetralogy of Fallot(TOF) with anomalous coronary artery(ACA), explore diagnostic method of ACA, and evaluate surgical strategy choices and clinical outcomes of right ventricular outflow tract(RVOT) reconstruction. Methods From January 2004 to January 2010, 29 patients with TOF and ACA underwent total correction in Wuhan Asia Heart Hospital. There were 18 male patients and 11 female patients with their median age of 7 years (5 months to 33 years)and median body weight of 18 (5 to 51) kg at operation. Their preoperative arterial oxygen saturation was 65%-91%. One patient underwent RVOT enlargement and repair of ventricular septal defect via right atrial approach. Three patients underwent RVOT enlargement, repair of ventricular septal defect and main pulmonary artery enlargement using autologous pericardium patch via right atrial approach. Three patients received pulmonary artery translocation (REV) technique. Five patients received double outlet technique. Eleven patients underwent RVOT enlargement via incisions above, below or beside coronary arteries (single patch or two patch technique). Six patients underwent RVOT reconstruction using trans-annular patch after coronary artery bypass grafting. Results  The median cardiopulmonary bypass time was 78 (65-102) min, median aortic crossclamp time was 50(40-82) min, and median operation time was 150 (126-178) min. There was no early death or severe coronary artery injury. Two  patients underwent reexploration because of postoperative bleeding. Two patients had low cardiac output and were both cured with inotropic support. The median follow-up period was 51 (21-83)months and there was no late death during  follow-up. All the patients were in New York Heart Association (NYHA) classⅠduring follow-up, their left ventricular ejection fraction was normal, there was no sign of myocardial ischemia in electrocardiogram, and their arterial oxygen saturation was 96%-99%.Mean early RVOT gradient (△P) was 19 (8-38) mm Hg, and the RVOT gradient (△P) did not increase during follow-up. Conclusion Preoperative diagnosis of ACA in TOF patients can be made by 64-slice multislice compute tomography (64-MSCT). Proper surgical strategy for RVOT reconstruction should be chosen according to the distribution of coronary arteries to achieve satisfactory surgical outcomes.

    Release date:2016-08-30 05:28 Export PDF Favorites Scan
2 pages Previous 1 2 Next

Format

Content