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find Author "王凤林" 3 results
  • 应用超声波评价冠状动脉旁路移植术患者脑缺血并发症的危险因素

    目的 为减少冠状动脉旁路移植术(CABG)患者术后脑缺血并发症的发生,评价其危险因素. 方法 术前对连续施行CABG的65例患者常规行双功能彩色多普勒血流图象(CDFI)和经颅多普勒(TCD)检查,观察颈动脉和颅内动脉形态学和血流动力学指标的改变(包括颈动脉内膜厚度、斑块的发生、血管狭窄率等). 结果 CDFI检测异常57例(87.7%);颈内动脉狭窄gt;50%13例,其中单侧狭窄50%~69% 6例,双侧狭窄50%~69% 2例,双侧狭窄70%~99% 1例,一侧颈内动脉闭塞、一侧狭窄gt;50% 4例.TCD发现颅内动脉单支狭窄8例,多支狭窄25例.术后死亡2例(3.1%),围术期心肌梗死2 例.冠状动脉3支病变患者颈动脉内膜增厚和多发性斑块发生率明显高于2支病变患者(χ2=4.37, 8.56;P=0.034, 0.013). 结论 术前行CDFI和TCD检查对颈动脉和颅内动脉硬化病变是一种可行的无创筛选方法,对减少CABG患者脑缺血并发症,提高冠心病的外科治疗水平很有价值.

    Release date:2016-08-30 06:30 Export PDF Favorites Scan
  • SURGICAL TREATMENT OF CAROTID STENOSIS

    Objective To summarize cl inical experience of carotid endarterectomy (CEA) in treating severe carotid stenosis. Methods Between October 1998 and January 2010, 215 patients with carotid stenosis were treated with CEA. There were 140 males and 75 females with an average age of 66 years (range, 51-88 years). Transient ischemic attack (TIA) occurred in127 cases, and 31 cases had history of cerebral infarction. All cases were diagnosed definitely by selective angiography and/or CT angiography, and stenosis degree was more than 80%; contralateral carotid artery was also involved in 45 cases. Ninty-six cases were found to have coronary artery stenosis by coronary angiography. CEA and coronary artery bypass grafting were performed simultaneously in 25 cases. Peripheral arterial disease was found in 43 cases and treated at the same time. Results A total of 155 patients were followed up 6-72 months. The cl inical symptom significantly alleviated in 148 cases postoperatively. Two cases had compl ication of cerebral hemorrhage within 1 week postoperatively; one died and the other was resumed after the conservative treatment. One case had hypoglossal nerve injury. Four cases had injuring marginal mandibular branch of the facial nerve, and no special treatment was given. Restenosis was found in 25 patients, and the stenosis degree was less than 25%; moreover, the patients had no TIA. One case died of heart attack at 3 years of follow-up period. Conclusion CEA is an effective and safe method for treating severe carotid stenosis.

    Release date:2016-08-31 05:49 Export PDF Favorites Scan
  • Clinical Study of Long-term Patency Rate of Great Saphenous Veins Transplanted by Coronary Artery Bypass Grafting

    ObjectiveTo summarize the experience of 4 patients with a great saphenous venous graft patency after 15 years of postoperitive great saphenous venous sequential aortic coronary artery bypass grafting. MethodWe retrospectively analyzed the clinical data of 4 patients accepted great saphenous vein aortic coronary artery bypass graft under moderate hypothermia cardiopulmonary bypass from November 1989 to December 1992 year. There were 3 males and 1 female with a mean age of 48.3 years ranging from 40-58 years. We harvested great saphenous vein under groin 45-50 cm. The proximal and distal anastomoses were performed with parachute technique under two clamps technique. Coronary artery bypass graft was performed by two sequential grafts routinely. Aspirin was given through nasal tube 6 hours after operation. The risk factors of arteriosclerosis were controlled by patients themselves after discharge. ResultFour patients received coronary angiography in 15, 16, 18, and 21 years after surgery and the grafts and both proximal and distal anastomoses were patent. The patients lived about 20 years without angina. Conclusioncarefully dealing with the vein graft, taking sequential bypass grafting to guarantee parabolic curve and meticulous anastomosis are preconditional and necessary for long-term patency.

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