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find Author "阎军" 3 results
  • 经胸骨正中切口心脏手术后并发乳糜胸的治疗

    摘要: 目的 探讨经胸骨正中切口心脏直视手术后发生乳糜胸的可能机制和治疗经验,以减少术后乳糜胸的发生。 方法 回顾分析1996年10月至2006年1月收治的18例经胸骨正中切口径路行心脏直视手术后发生乳糜胸患者的临床资料,其中男12例,女6例;年龄2个月~79岁,平均年龄144岁。所有患者均采用在禁食基础上的保守治疗,包括胸腔闭式引流、静脉高营养、强心、利尿等综合措施。 结果 住院时间7~130 d,胸腔引流时间4~35 d。全组死亡2例,其中死于心律失常、心搏骤停1例;因肺部感染、再次插管,死于多器官功能衰竭1例。随访14例,随访时间2~10年,失访2例。随访期间无乳糜胸复发或需二次手术者。 结论 经胸骨正中切口径路行心脏直视手术后发生乳糜胸可能与手术时损伤较小的淋巴侧枝有关,采用禁食、胸腔闭式引流、静脉高营养等保守治疗效果满意。

    Release date:2016-08-30 06:01 Export PDF Favorites Scan
  • 法洛四联症术后左心室破裂一例

    Release date:2016-08-30 06:02 Export PDF Favorites Scan
  • Risk Stratification Management of Pediatric Patients with Prolonged Postoperative Recovery after Total Cavopulmonary Connection

    Objective To investigate clinical features and risk factors of prolonged postoperative recovery of pediatric patients in ICU after total cavopulmonary connection(TCPC),provide evidence for risk stratification management strategy, and enhance their postoperative recovery. Methods We conducted a retrospective analysis of clinical data of 81 patients undergoing TCPC in Fu Wai Hospital from January 2010 to July 2012. Three patients who died postoperatively were excluded from analysis. Prolonged postoperative recovery was defined as patients whose postoperative mechanical ventilation time was longer than that of 75% of all the patients. A total of 78 patients were divided into normal recovery group and prolonged recovery group. There were 59 patients in the normal recovery group including 34 male and 25 female patients with their age of 62.5±20.7 months,and 19 patients in the prolonged recovery group including 11 male and 8 female patients with their age of 64.8±29.8 months. Perioperative variables were compared between the two groups. Results The average cardiopulmonary bypass time of all the 81 patients was 107.6±54.1 (33-350) minutes. The average aortic cross-clamping time of 17 patients was 46.4±31.5 (22-143) minutes. Three patients (3.7%) died postoperatively because of severe low cardiac output syndrome and thrombosis in the extracardiac conduit. The mechanical ventilation time and ICU stay were 7.5 hours and 1.6 days respectively in the normal recovery group,which were both significantly prolonged in the prolonged recovery group. Preoperative high hemoglobin level,coexistence of intracardiac anomalies,longer cardiopulmonary bypass time,and non-fenestrated procedure were the main risk factors of prolonged postoperative recovery. Conclusion Early extubation and fast track recovery can be achieved in most of TCPC patients. Risk stratification management strategies may contribute to successful postoperative recovery of critical patients after TCPC.

    Release date:2016-08-30 05:46 Export PDF Favorites Scan
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