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find Author "魏蜀亮" 5 results
  • 胸骨、肋骨嗜酸性肉芽肿16例的外科治疗

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  • Expression Change and Its Implication of Cell Adhesion Molecules CD11b/CD18, sPselectin in Perioperative Period of Cardiopulmonary Bypass

    Abstract: Objective To observe the significance of the changes of cell adhesion molecules (CAM) CD11b/CD18 and sPselectin during the perioperative period of open heart surgery under cardiopulmonary bypass (CPB), and investigate the roles of CD11b/CD18 and sPselectin in systemic inflammatory response triggered by CPB. Methods Thirty patients including 18 males and 12 females, age ranged from 29 to 55 years (45.3±8.1 years) having undergone valvular replacement for rheumatic heart disease in our hospital were selected as the subjects of this research. After anesthesia induction, radial arterial blood sample was collected at six different time points including the time prior to skin incision, and 30 min, 1 h, 6 h, 12 h and 24 h following the start of CPB. The expression levels of CD11b/CD18 were tested by flow cytometry, and concentration of sP-selectin in the plasma was measured with enzymelinked immunosorbent assay(ELISA). Results The expression of CD11b/CD18 was elevated at 30min after CPB, and it reached the peak (581.44±215.26) at 6 h after CPB with significant differences (Plt;0.05). Its expression started to drop at 12 h after CPB, but it was still higher than the expression level before CPB. The expression returned under the level before CPB at 24 h after CPB with insignificance differences (Pgt;0.05). The expression of sPselectin in the peripheral blood started to rise evidently at 30 min after CPB, reaching the peak (51.44±10.06 ng/ml) with significant differences (Plt;0.05). Its expression level decreased at 12 h after CPB and fell back below the level before CPB with insignificant differences (Pgt;0.05). Conclusion CPB can cause the expression of CD11b/CD18 and sPselectin to rise in the peripheral blood, which may play an important role in the systemic inflammatory response triggered by CPB.

    Release date:2016-08-30 06:02 Export PDF Favorites Scan
  • 女性重症肌无力患者的外科治疗与围术期处理

    摘要: 目的 总结女性重症肌无力(MG)患者的外科治疗及围术期处理经验。 方法 回顾性分析1979年1月至2007年12月收治的186例(包括川北医学院附属医院胸心血管外科41例,南方医科大学附属南方医院胸心血管外科145例)MG女性患者的临床资料,年龄5~64岁,平均年龄43.9岁。按Osserman临床分型,小儿MG45例,成人MG141例,其中眼肌型25例,轻度全身型63例,中度全身型29例,急性暴发型19例,晚期严重型5例。合并胸腺瘤166例,按Masaoka分期 I期40例,Ⅱ期69例,Ⅲ期44例,Ⅳ期13例。152例患者经胸骨正中切口径路手术,行胸腺切除,纵隔淋巴结清扫术;34例胸腺无明显增生经颈部横切口行单纯胸腺切除术。 结果 全组无手术死亡。围术期发生MG危象22例,经相应的处理治愈。术后随访12个月以上165例,失访21例。痊愈30例(18.18%)、基本痊愈28例(16.97%)、显效60例(36.36%)、好转25例(15.15%)、无效22例(13.33%)。Ⅰ型、Ⅱa 型、Ⅱb 型、Ⅲ型和Ⅳ型有效率分别为100.00%、93.10%、90.00%、77.27%和53.85%。 结论 女性MG患者经胸腺切除术治疗效果良好;加强围术期处理,合理使用抗胆碱酯酶药物和激素,可减少各种MG危象的发生。

    Release date:2016-08-30 06:03 Export PDF Favorites Scan
  • 经冠状静脉窦持续低流量逆行灌注在双瓣膜置换术中的应用

    目的 总结冷晶体氧合血心脏停搏液经冠状静脉窦持续低流量逆行灌注在二尖瓣和主动脉瓣双瓣膜置换术中的应用经验。方法 将64例患者常规插管建立体外循环,降温至32 ℃时阻断升主动脉,先经主动脉根部或冠状动脉开口顺行灌注4 ℃冷晶体心脏停搏液(15~20 ml/kg),心脏停搏后经冠状静脉窦持续低流量(70~150 ml/min)逆行灌注1∶4冷晶体氧合血心脏停搏液,于心内直视下行双瓣膜置换术。 结果 开放主动脉后,53例(828%)患者心脏自动复跳,11例(17.2%)电击复跳,均顺利停机拔管。术后发生低心排血量综合征3例,严重室性心律失常3例,死亡2例,其余患者9~13 d出院,无并发症发生。随访56例(87.5%),随访时间5个月~2.5年,患者临床症状消失,活动能力明显改善,无晚期死亡;复查超声心动图提示人工机械瓣活动良好,无瓣周漏。 结论 冷晶体氧合血心脏停搏液经冠状静脉窦持续低流量逆行灌注具有良好的心肌保护效果。

    Release date:2016-08-30 06:05 Export PDF Favorites Scan
  • 室间隔缺损的另一类型——左室右房通道一例

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