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find Author "杨一峰" 5 results
  • 先天性心脏病合并气道异常的围术期处理

    摘要: 目的 提高对先天性心脏病合并气道异常的认识,总结围术期处理经验。 方法 对中南大学湘雅二医院2006年1月至2008年1月收治的5例先天性心脏病合并气道异常患者的临床资料进行回顾性分析,其中男3例,女2例;年龄5个月~9岁,平均年龄27个月。气道异常包括:左主支气管狭窄2例,右侧气管化支气管、气管轻度软化和左主支气管狭窄、长段先天性气管狭窄各1例。行先天性心脏病矫治术加左主支气管成形术1例,仅行先天性心脏病矫治术3例,放弃手术治疗1例。 结果 围术期死亡1例,为先天性心脏病合并右侧气管化支气管,术后发生右肺上叶不张、肺部感染和呼吸衰竭死亡。1例先天性心脏病合并左主支气管狭窄,同期行左主支气管成形术后顺利出院;随访2年健康。1例行先天性心脏病矫治术后撤离呼吸机困难,发现合并先天性左主支气管狭窄伴轻度气管软化,经内科处理撤离呼吸机后仍有喘憋;随访6个月患者发育好,喘憋未再发作。1例混合型室间隔缺损致心脏扩大、肺动脉扩张压迫左主支气管导致狭窄,行先天性心脏病矫治术后左主支气管压迫症状缓解;随访1年健康。1例合并长段气管狭窄,家属放弃手术。 结论 先天性心脏病合并气道异常临床上很少见。应提高对该病的认识,做到术前确诊;采用最佳的手术方法,尽量与先天性心脏病同期手术纠治;术后加强呼吸道管理,以获得最佳的疗效。

    Release date:2016-08-30 06:03 Export PDF Favorites Scan
  • 成人法洛四联症的外科治疗

    目的 总结成人法洛四联症的外科手术治疗经验。 方法 回顾性分析2000年1月~2006年3月71例成人法洛四联症患者手术治疗的临床资料,69例在低温体外循环下行法洛四联症根治术,其中55例采用跨瓣环补片加宽右心室流出道及肺动脉,14例仅行右心室流出道扩大补片;2例于非体外循环下行双向腔肺分流术。 结果 住院期间死亡率2.8%(2/71),死亡原因为:低心排血量综合征1例, 低心排血量综合征、多器官功能衰竭1例。其余患者并发低心排血量综合征3例,肺部感染2例,肺不张1例,胸腔积液17例,气胸1例,乳糜胸1例,均治愈出院。随访2 个月~6年(36.5±19.0个月),术后复查发现小的室间隔缺损残余漏4例,无1例晚期死亡。心功能分级(NYHA)Ⅰ级63例,Ⅱ级6例。 结论 彻底矫正畸形,加强心肌保护、避免发生低心排血量综合征,加强术后管理,成人法洛四联症均可取得良好的

    Release date:2016-08-30 06:16 Export PDF Favorites Scan
  • 漏斗胸合并先天性心脏病同期外科治疗体会

    目的总结漏斗胸合并先天性心脏病同期外科治疗的经验。方法回顾性分析5例漏斗胸合并先天性心脏病患者同期手术治疗的临床资料,其中3例采用带腹直肌蒂的胸骨翻转术矫治漏斗胸,1例采用保留双侧胸廓内动脉及腹直肌蒂的胸骨翻转术矫治漏斗胸,另1例采用胸骨抬举术矫治漏斗胸。结果5例患者均治愈出院,随访3~44个月,胸骨稳定性好,外观满意,心脏畸形矫正满意,心功能良好,均为Ⅰ级(NYHA)。结论同期矫正漏斗胸及心内畸形是一种安全可行的治疗方案,节约医疗费用,避免或减少了分期手术及麻醉的风险,减轻了患者痛苦。

    Release date:2016-08-30 06:23 Export PDF Favorites Scan
  • Effects of Modified Ultrafiltration on Blood Rheology in Infants after Open Cardiac Surgery

    Abstract:Objective To evaluate the effects of modified uhrafihration (MUF)on blood rheology in infants after open cardiac surgery. Methods According to admission number, 22 infants of body weight less than 10 kilograms with ventricular septal defect (VSD) and pulmonary hypertension (PH) were divided into control group (10 infants, the mantissa of their admission number was odd number) and experimental group (12 infants, the mantissa of their admission number was even number). Cases in control group didn't undergo MUF at the end of cardiopulmonary bypass (CPB), while cases in experimental group underwent MUF; the flow rate of MUF ranged from 10 ml/min · kg to 15 ml/min · kg. MUF lasting for 10-15 minutes. Blood samples were repeatedly collected as following time: before operation, at the end of CPB, 15 minutes after CPB or the end of MUF, 2, 24 h after operation. Blood sample of 2. 5 ml was collected from the radial artery with hepathrom test-tube. The changes of relative indexes of the blood rheology were observed by MDK-3200 completely automatic dual pathways blood rheology testing analysator at 37±1 C. Results Hemoglobin, hematocrit, red cell count, blood yielding stress, plasma viscosity, the whole blood viscosity at high shear rate, the whole blood viscosity at middle shear rate and low shear rate, the whole blood reduction viscosity at high shear rate and middle shear rate, the whole blood reduction viscosity at low shear rate and Casson viscosity in experimental group at the end of MUF were significantly higher than those in control group at 15 minutes after CPB (P〈0. 05). There was no significant difference in red cell aggregation index and red cell deformity between two groups at each moment (P 〉 0.05 ). Conclusion Hemoglobin, hematocrit and red cell count are significantly elevated through MUF after CPB. Whole blood viscosity in infants undergone open cardiac surgery after CPB with MUF is higher than those who didn't undergo MUF.

    Release date:2016-08-30 06:23 Export PDF Favorites Scan
  • Turner综合征合并复杂先天性心脏畸形一例

    Release date:2016-08-30 06:08 Export PDF Favorites Scan
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