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find Author "蒲虹" 5 results
  • Value of Combination APACHEII, Ranson with Balthazar CT Scoring System Predicting Prognosis of Severe Acute Pancreatitis

    Objective To explore the value of combination APACHE II, Ranson with BalthazarCT Scoring System predicting the prognosis of severe acute pancreatitis (SAP). Methods The relationship between APACHE II, Ranson, Balthazar CT scoring systems and mortality of severe acute pancreatitis (SAP) patients admitted to the intensive care unit (ICU) of West China Hospital from January 1st, 2007 to December 31st, 2008 was analyzed. Results There was statistical difference between high and low score groups in the APACHE II, Ranson, BalthazarCT scoring systems. Combination APACHE II, Ranson with Balthazar CT scoring system, there was statistical difference between high and low Balthazar CT score group both in APACHE II and Ranson scoring systems. Conclusion APACHE II, Ranson combined with Balthazar scoring systems can be used as a more important clinical reference in evaluating the diagnosis and prognosis of severe acute pancreatitis.

    Release date:2016-09-07 02:10 Export PDF Favorites Scan
  • 重组人脑利钠肽治疗非体外循环冠状动脉旁路移植术后撤呼吸机困难的疗效分析

    目的探讨重组人脑利钠肽(rhBNP)治疗非体外循环冠状动脉旁路移植术(OPCAB)后撤呼吸机困难患者的有效性及安全性。 方法回顾性分析2010年2月至2011年7月四川省人民医院接受OPCAB,术后带机时间超过48 h 20例患者的临床资料,其中男14例、女6例,年龄(64.03±12.71)岁。对20例撤机困难患者在常规治疗的基础上加用重组人脑利钠肽1.5 μg/kg静脉冲击,此后以0.075 μg/(kg· min)持续滴注48~72 h。比较使用重组人脑利钠肽前、后各临床指标的变化。 结果围术期死亡3例(15%),死亡原因:2例发生严重感染,1例家属放弃治疗。5例术后发生急性肾功能衰竭(ARF),其中3例接受持续肾脏替代治疗(CRRT);4例患者术后出现肺部感染。总体带呼吸机时间(4.31±1.95)d,使用重组人脑利钠肽(2.02±0.38)d后脱机。20例患者住ICU时间(6.23±1.87)d,住院时间(26.75±7.82)d。使用重组人脑利钠肽后左心室舒张期末内径(LVEDD)较术前明显缩小,左心室射血分数(LVEF)较术前明显增加;脑利钠肽(BNP)、中心静脉压(CVP)、血钠(Na)较术前明显降低(P<0.05)。17例患者均进行随访,随访时间3~6个月,患者恢复良好。 结论基因重组人脑利钠肽可以扩张血管、降低中心静脉压、排钠利尿、延缓心肌重塑、减轻心脏负荷、增加心脏射血分数、从而改善OPCAB患者的临床结果。

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  • Airway Reconstruction supported by Extracorporeal Membrane Oxygenation

    Objective To explore the feasibility and safety of extracorporeal membrane oxygenation (ECMO) to support the airway reconstruction for the patients with airway obstruction or stenosis who cannot be ventilated routinely. Methods There were 3 patients received trachea reconstruction procedures assisted by ECMO. Among the patients, 2 cases with tracheal neoplasms underwent fibrobrochoscopy treatments, another one with endotracheal stenosis and fistula received tracheoplasty and semi-tracheostomy. Results ECMO can provide enough oxygenation for the patients with airway obstruction or stenosis and more time for advanced therapies. All three patients recovered after interventional surgeries, in whom one case died due to multiple organ failure caused by esophageal carcinoma metastasis after 3 months, and the others survived with dyspnea classification of 2-3 grade. Conclusion ECMO can be a safe and effective approch for the patients who cannot be ventilated conventionally in airway reconstruction.

    Release date:2016-10-02 04:56 Export PDF Favorites Scan
  • Risk factors and therapy stra tegies of acute pulm onary edem a in critically ill patients after the 2008 W enchuan earthquake

    Objective To analyze risk factors and therapy strategies of critically ill patients with acute pulmonary edema(APE)after the 2008 Wenchuan earthquake.Methods Data including the level of hemoglobin,mean arterial pressure(MAP),central venous pressure(CVP),serum albumin as well as complications and liquid balance 1 week,3 days,1 day before onset of APE was collected an d an alyzed retrospectively.Resets Among 142 patients during two months after May 12 earthquake APE was detected in 17 cases for 25 times.The hemoglobin Was (86.04 ±16.31)s/L,MAP was(99.40±17.38)mm Hg,CVP Was (13.64 ±4.09)mm Hg and serum albumin was(27.80±8.10)g/L.Acute renal failure,severe infection,cardiovascular disease and extremity lost were more common in APE patients.Theliquid net intake Was (1 725.05±4 624.84)mL for one week,(1 574.70±2 857.13)mL for 3 days and (368.56±1 589.89)mL for 1 day before the onset of APE.The liquid intake Was significantly higher in young group.APE Was alleviated promptly after integrated therapy in all cases.Conclusions Traumapatients with ARF or extremity lost are prone to be compromised with APE.Severe infection and overburden of liquid may be other predisposing factors.

    Release date:2016-09-14 11:56 Export PDF Favorites Scan
  • Treatment of critically ill patients with gas gangrene resulted in the 2008 W enchuan earthquake

    Objective To investigate the efficacy of interdisciplinary therapy in critically ill patients with gas gangrene in the 2008 W enchuan earthquake.Methods Four critically wounded patients with gas gangrene caused by Wenchuan earthquake were treated by interdisciplinary cooperation.Results Two patients received debridement and decompression were not amputated.Two amputated patients did not received futher amputation.Conclusions Interdisciplinary therapy of critically ill patients with gasgangrene in earthquake could limited the area of tissue necrosis,minimized the necessity of amputation and further amputation.

    Release date:2016-09-14 11:56 Export PDF Favorites Scan
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