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find Author "周华富" 4 results
  • 心瓣膜置换术后患者围术期死亡原因分析

    摘要: 目的 分析心瓣膜置换术后患者围术期死亡的原因,探讨降低围术期病死率的措施。 方法 回顾性分析2004年1月至2009年1月广西医科大学第一附属医院行心瓣膜置换术后死亡的54例患者的临床资料,男28例,女26例;年龄20~65岁(45.5±11.6岁)。全组均在全身麻醉低温体外循环(CPB)下行心瓣膜置换术,其中37例行中低温(26~28 ℃)心脏停搏手术,17例行浅低温(31~33 ℃)心脏不停跳手术。对围术期死亡的原因进行分析。结果 术中死亡15例,手术死亡率1.78%(15/845);其余39例患者的死亡时间为术后3 h~106 d(8.2±17.2 d),死亡原因主要为低心排血量综合征(LCOS)、不能停CPB、心脏及主动脉出血、呼吸功能衰竭、肾功能衰竭、恶性心律失常和多器官功能衰竭等。 结论 选择恰当手术时机、充分术前准备、改善心功能,术中谨慎操作、良好心肌保护、术后加强监护,可提高手术成功率。

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  • 风湿性二尖瓣狭窄心房颤动患者HCN4基因cDNA序列测定及mRNA的表达

    摘要: 目的 通过分析风湿性心脏病二尖瓣狭窄患者心房肌组织超级化激活环核苷酸调控通道基因家族4(HCN4)基因表达与心房颤动发生的关系,为探讨心房颤动发生的机制奠定理论基础。 方法 52例风湿性二尖瓣狭窄患者,根据是否合并心房颤动将其分为两组,实验组:38例,男18例,女20例;年龄26~68岁,平均年龄46.47岁;均合并心房颤动。对照组:14例,男6例,女8例;年龄21~62岁,平均年龄42.93岁;不合并心房颤动。提取并逆转录两组患者心房肌组织中HCN4基因的总核糖核酸(RNA),应用SYBR GreenⅠ荧光染料, 建立检测 HCN4基因信使RNA(mRNA)的实时荧光定量聚合酶链反应 (PCR)法,并对PCR产物测序进行分析。根据标准曲线计算出两组心房肌组织中HCN4基因 mRNA含量,并以HCN4基因mRNA和内参β肌动蛋白(β-actin)含量的比值作为评价HCN4基因mRNA表达水平指标。 结果 测定HCN4基因cDNA 序列同源性为100%。建立的实时荧光定量 PCR方法在103~107拷贝数/μl的标准品梯度稀释范围内r为0.999。实验组HCN4基因mRNA与β-actin含量的相对表达值比值与对照组比较明显升高(1.323±1.226 vs. 0.116±0.192,P<0.05)。 结论 实时荧光定量PCR对HCN4基因mRNA能进行准确定量,HCN4基因的过度转录表达提示其可能参与了调控风湿性二尖瓣狭窄心房颤动的发生过程。

    Release date:2016-08-30 06:01 Export PDF Favorites Scan
  • 大型室间隔缺损伴肺动脉高压的外科治疗

    目的 总结 5 9例大型室间隔缺损 ( VSD)伴肺动脉高压在心脏不停跳下行 VSD修补术的经验。 方法 5 9例大型 VSD伴肺动脉高压患者均在浅低温心脏不停跳下行 VSD修补术。结果手术死亡1例 ,其余患者术后无低心排血量综合征、严重心律失常 ,发现残余漏 4例和III°房室传导阻滞 2例 ,均治愈出院。术后随访未发现残余漏 ,无其他并发症和晚期死亡。 结论 在心脏不停跳下行大型 VSD修补术 ,能更好地保护心肺功能 ,术中能避免残余漏和 °房室传导阻滞的发生 ,临床效果良好。

    Release date:2016-08-30 06:27 Export PDF Favorites Scan
  • EFFECTS OF TYPE 2 DIABETES MELLITUS ON THE STRUCTURE AND OXIDATIVE STRESS IN GREAT SAPHENOUS VEIN GRAFTS

    Objective To compare the condition of the structure and oxidative stress of great saphenous vein grafts between the patients with and without type 2 diabetes mellitus, and to study the mechanisms for providing the theory evidence ofthe protective way for great saphenous vein graft in patients with type 2 diabetes mellitus. Methods The segments of human great saphenous vein graft were collected from 36 patients undergoing coronary artery bypass graft surgery, who were divided into 2 groups, experimental group (17 patients with type 2 diabetes mellitus) and control group (19 patients without type 2 diabetes mell itus). There was no significant difference in age, gender, hypertension, serum creatinine, hyperl ipidemia, smoking, and the number of pathological coronary arteries between 2 groups (P gt; 0.05). Two cm distal great saphenous vein from each patient was obtained. The structure of great saphenous vein was observed by the microscope, and nicotinamide adenine dinucleotide phosphate (NADPH) oxidase enzymatic activity and superoxide anion level were quantified by lucigenin-enhanced chemilumi nescence. Results The NADPH oxidase activity and superoxide anion levels were significantly higher in experimental group [(308.8 ± 33.7) counts/μg and (1 951.71 ± 355.2) counts/(min.mg)] than in control group [(202.7 ± 29.5) counts/μg and (1 230.73 ± 340.5) counts/(min.mg)] (P lt; 0.05). HE staining showed the damage of ultrastructure of great saphenous vein endothel ium in experimental group, including necrosis and exfol iation of endoepithel ial cells, spl itting of the basement membrane, thickened lower layer of the endothelium with vacuoles and deformed vascular smooth muscle cells; however, integrated vessel intima was observed in control group.

    Release date:2016-08-31 05:43 Export PDF Favorites Scan
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