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find Author "廖崇先" 5 results
  • 心得安对肥厚心肌的保护作用

    目的 探讨心脏外科围手术期心得安预处理对肥厚心肌的保护作用。 方法  36只 SD大鼠 ,采用随机数字表分为正常心肌组、肥厚心肌组和心得安组 ,腹主动脉缩窄制备大鼠心肌肥厚模型 ,采用离体工作心脏灌流模型 ,观察心脏自动复跳情况、心肌酶释放量的动态变化、心肌组织中丙二醛 ( MDA)含量和心肌超微结构改变。 结果与肥厚心肌组比较 ,心得安组心脏自动复跳时间短 ,4种心肌酶释放量明显减少 ,上升幅度较缓 ,MDA含量低 ( Plt;0 .0 1) ,心肌超微结构显示心肌细胞损伤较轻。 结论 术前用心得安预处理可缩短心脏手术后心脏自动复跳时间 ,减少肥厚心肌缺血 -再灌注时心肌酶的释放 ,提高氧自由基清除能力 ,较好地保护心肌超微结构形态 ,对肥厚心肌具有保护作用。

    Release date:2016-08-30 06:27 Export PDF Favorites Scan
  • 合并心脏恶病质瓣膜病的外科治疗

    目的 为提高合并心脏恶病质瓣膜病患者外科治疗的成功率,探讨其围术期处理的特点。方法 符合心脏恶病质综合征诊断标准的21例心瓣膜病患者接受了手术治疗,其中二尖瓣置换术14例,主动脉瓣及二尖瓣置换术7例,同时三尖瓣成形术16例。结果 发生并发症13例,分别为低心排血量综合征、室性心律失常和多器官功能衰竭等;死亡6例,主要死亡原因为多器官功能衰竭。结论 合并心脏恶病质瓣膜病患者的外科治疗应注意围术期处理;术中应重视三尖瓣功能纠正及左、右心房折叠;术后注意低心排血量的治疗,积极防治多器官功能衰竭,加强营养支持。

    Release date:2016-08-30 06:33 Export PDF Favorites Scan
  • 胸骨正中小切口行主动脉瓣置换术

    目的 总结32例经胸骨正中小切口置换主动脉瓣的临床经验。 方法 采用胸骨正中上段小切口,切口下缘在第3肋间中点水平,上方在第2肋间上缘处与正中线成70°夹角斜向左侧,切口长度约8~9cm,沿肌层表面向中线和胸骨柄上缘潜行分离,锯开部分胸骨至第3肋间中点,并在此处横断两侧胸骨。主动脉瓣置换术采用间断缝合法。 结果 本组无死亡。与同期81例常规正中切口置换主动脉瓣者比较,升主动脉阻断时间、术后呼吸机辅助时间无差异;而心包引流量明显减少,术后住院时间明显缩短(P<0.05)。 结论 经胸骨正中小切口置换主动脉瓣安全、创伤小、疗效好。

    Release date:2016-08-30 06:33 Export PDF Favorites Scan
  • MODIFICATION OF HERON’S TECHNIQUE FOR CERVICAL HETEROTOPIC CARDIAC XENOTRANSPLANTATION

    Objective To improve the Heron’s technique for heterotopic cardiac transplantation in rats by cuff vessel anastomosis in some aspectsand successfully establish the simplified model of cervical cardiac xenotransplantation from guinea pigs donor to SD rats recipients. Methods The donors were 64 male guinea pigs, whose weight ranged from 250 to 350 g; the recipients were 64 male SD rats, whose weight ranged from 300 to 350 g.The guinea pigs donor’s ascending aorta and pulmonary artery were anastomosed to SD rats recipient’s right common carotid artery and external jugular vein respectively with a self-made “sleeve” anastomosis. The modified cuff technique of heterotopic grafting is described in detail. Results 64 consecutive successful transplantations have been performed by single surgeon were done with negligible operative risk. No anastomosis leakage nor vessel obstruction. The total time of surgical procedure were 45 to 60 minutes. The new technique allowed vascular anastomoses to be completed in 2 to 5 minutes. The total cold ischemia time for donor heart was 14 minutes in average. Conclusion This modified Heron’s technique was a simple, economical, practicable,reliable and high reproducible model can be operated by surgeons with minimal training in microvascular surgery, and be applied to various transplantation immunological studies. 

    Release date:2016-09-01 09:29 Export PDF Favorites Scan
  • Risk Factors Analysis of Ventilator-Associated Pneumonia in Adult Patients Undergoing Heart Surgery with Cardiopulmonary Bypass

    Objective To analyze the risk factors for ventilator-associated pneumonia( VAP) in adult patients undergoing cardiac surgery with cardiopulmonary bypass ( CPB) . Methods A total of 127 consecutive adult patients who received postoperative ventilation for more than 48 hours between January 2002 and June 2008 in the cardiac surgical intensive care unit( CSICU) were included in this study. The patients were assigned into a VAPgroup( n =64) and a control group( n = 63) . Pre-, intra-, and postoperative factors were collected and analyzed between two groups, and the multivariate analysis( logistic regression)were used to identify the risk factors of VAP. Results The overall incidence of VAP was 5.1%. The mortality of VAP was 28. 1% . Compared to the control group, the patients in the VAP group had longer duration of cardiopulmonary bypass time, ventilation time, more blood products usage and the duration of stay in CSICU( P lt; 0. 001) , higher morbidity of low cardiac output syndrome and tracheotomy( P lt; 0. 01) and higher rate of aortic surgery and mortality( P lt; 0. 05) . The preoperative left ventricular ejection fraction ( LVEF) and postoperative oxygenation index( PaO2 /FiO2 ) were lower in the VAP group than those of the control group( P lt; 0. 001) . Five variables were found to be significantly related to the development of VAP by multivariate analysis: CPB time gt; 120 min( OR = 6. 352, P = 0. 000) ; PaO2 /FiO2 lt; 300 mm Hg( OR =3. 642, P = 0. 017) , transfusion of blood products ≥1500 mL( OR = 5. 083, P = 0. 039) , ventilation time≥5 days( OR = 9. 074, P = 0. 047) and tracheotomy( OR = 19. 899, P = 0. 021) . A total of 102 pathogens were obtained by sputum culture in 64 VAP patients. There were 62( 60. 8% ) cases of gram negative bacilli, 19 cases( 18. 6% ) of gram positive cocci and 21( 20. 6% ) cases of eumycetes. Conclusion This study shows that the cardiopulmonary bypass time, ventilation time, hypoxemia, blood products transfusion and tracheotomy are risk factors most likely associated with VAP development.

    Release date:2016-09-14 11:23 Export PDF Favorites Scan
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