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find Author "黄忠耀" 6 results
  • 血管紧张素转换酶抑制剂对心肌再灌注损伤的作用

    心肌再灌注损伤可表现为再灌注性心律失常、心肌顿抑和心肌坏死.研究表明心脏局部的肾素血管紧张素系统和冠状动脉内皮细胞功能失常在心肌再灌注损伤中起重要作用.血管紧张素转换酶抑制剂能抑制转换酶活性,减少血管紧张素Ⅱ的形成,并能作用于激肽酶Ⅱ,抑制缓激肽的降解,后者可促进前列环素和一氧化氮(NO)的产生.近年来血管紧张素转换酶抑制剂被用于防护心肌再灌注损伤,在防护再灌注性心律失常、心肌顿抑和心肌坏死等方面显示了较好的治疗效果.

    Release date:2016-08-30 06:35 Export PDF Favorites Scan
  • 成人心内直视手术后急性肾功能衰竭的治疗

    目的 探讨体外循环心脏手术后发生急性肾功能衰竭的治疗方法及疗效。 方法 回顾性分析2011年1月至2012年7月福建医科大学附属协和医院33例行体外循环心脏手术后发生急性肾功能衰竭患者的临床资料,其中男21例,女12例;年龄25~67 (45.21±7.27) 岁。28例采用床旁连续肾脏替代疗法治疗,5例采用腹膜透析联合间歇床旁连续肾脏替代疗法治疗。对比分析经两种治疗方法患者治疗前、后的尿量、尿素氮、血肌酐、血钾和平均动脉压的变化。 结果 33例患者经床旁连续肾脏替代疗法或腹膜透析联合间歇床旁连续肾脏替代疗法治疗后血钾、血肌酐和尿素氮较治疗前明显降低,平均动脉压治疗6 h后较治疗前升高(P<0.05)。围术期死亡9例,死亡率为27.27%,主要死亡原因为多器官功能衰竭、重症肺部感染合并气道出血、恶性心律失常和消化道出血等。24例患者于治疗后5~14 d尿量恢复正常,肾功能指标正常。随访24例,随访3个月,复查肾功能各项指标均正常。 结论 床旁连续肾脏替代疗法治疗心脏手术后急性肾功能衰竭可获得满意的治疗效果,但应监测电解质及出凝血情况。对有出血倾向及血小板减少症患者采用腹膜透析联合间歇床旁连续肾脏替代治疗,也可获得良好的疗效。

    Release date:2016-08-30 05:46 Export PDF Favorites Scan
  • 急性心肌梗死并发室间隔穿孔急诊手术一例

    Release date:2016-08-30 06:27 Export PDF Favorites Scan
  • 卡托普利对缺血-再灌注鼠心肌一氧化氮及其合酶活性的影响

    目的 研究一氧化氮(NO)和一氧化氮合酶(NOS)在心肌再灌注损伤中的作用,探讨卡托普利(captopril)对缺血-再灌注鼠心肌保护的机制. 方法 采用Langendorff离体鼠心灌流模型,将18只SD大白鼠随机分为3组(每组6只),对照组、缺血-再灌注组、卡托普利组.观察心肌NOS同工酶活性、过氧化物歧化酶活性、丙二醛含量、肌酸激酶含量和冠脉流出液NO的变化. 结果 缺血-再灌注组与对照组比较心肌诱导型NOS(iNOS)活性增高(P<0.001),而心肌原生型NOS(cNOS)活性及总NOS活性显著降低(Plt;0.001,0.05),冠脉流出液NO含量下降(Plt;0.01).卡托普利组再灌注30分钟,心肌iNOS活性低于缺血-再灌注组(Plt;0.01),cNOS活性和总NOS活性高于缺血-再灌注组(Plt;0.01,0.05),再灌注期间冠脉流出液NO水平高于缺血-再灌注组(Plt; 0.01),心肌损伤较缺血-再灌注组减轻. 结论 心肌NOS同工酶活性及NO产生的失常是心肌再灌注损伤的重要机制之一,卡托普利可通过调节心肌NOS同工酶活性,维持正常的NO水平,起到心肌保护作用.

    Release date:2016-08-30 06:32 Export PDF Favorites Scan
  • 左冠状动脉主干严重狭窄行急诊冠状动脉旁路移植术九例

    Release date:2016-08-30 06:34 Export PDF Favorites Scan
  • VASCULAR BYPASS GRAFTING COMBINED WITH ENDOVASCULAR AORTIC REPAIR FOR TREATMENT OFAORTIC DILATATION DISEASE

    Objective To summarize the cl inical experience of vascular bypass grafting combined with endovascularaortic repair (EVAR) for aortic dilatation disease. Methods Between January 2008 and August 2011, 12 patients with aorticdilatation disease were treated with vascular bypass grafting combined with EVAR. Of 12 patients, 11 were male and 1 wasfemale, aged 47-81 years (mean, 65.9 years). All cases were diagnosed through computed tomography angiography (CTA),including 1 case of Stanford type A dissection, 5 cases of Stanford type B dissection, 4 cases of aortic arch aneurysm, and 2 casesof abdominal aortic aneurysm. Eight patients received neck artery bypass grafting before EVAR, and 4 patients underwentfemoral artery bypass grafting after EVAR. Results After operation, pulmonary infection occurred in 3 patients, renalinsufficiency in 2 patients, cerebral infarction in 1 case, decreased hemoglobin and platelets in 7 cases, and poor healing of groinwound in 1 case. Eleven patients were followed up 3-42 months, with an average of 18.6 months. In 1 case undergoing EVARof the thoracic and abdominal aorta, EVAR was performed again because new aneurysms formed at 6 months after operation,and the patient achieved good recovery after 3 months. CTA showed reduced false lumen, thrombosis formation, no endoleak,no deformation or displacement of stent, and anastomotic patency of artificial blood vessels in the other patients at 3, 6, and12 months after operation. Conclusion Vascular bypass grafting combined with EVAR can expand the indications forendovascular repair. It not only provides sufficient anchoring area, but also ensures the blood supply to vital organs, simplifiesthe surgical procedure, and reduces the difficulty of endovascular treatment.

    Release date:2016-08-31 04:23 Export PDF Favorites Scan
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