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find Author "侍晔" 2 results
  • 孙氏手术处理急性 A 型主动脉夹层合并灌注不良综合征的近期结果

    目的探讨孙氏手术处理急性 A 型主动脉夹层合并灌注不良综合征的临床效果。 方法2014 年 1 月至 2017 年 12 月期间南京医科大学第二附属医院连续收治 A 型主动脉夹层合并灌注不良综合征患者 30 例,其中男 24 例、女 6 例,平均年龄(52.87±12.76)岁。所有患者在深低温停循环,顺行性选择性脑灌注下或经上腔静脉逆行性脑灌注下行四分支人工血管全主动脉弓置换加支架象鼻人工血管植入术(孙氏手术),近端行 Bentall 手术 18 例,单纯升主动脉置换 10 例。同期行冠状动脉旁路移植术 3 例。 结果全组平均体外循环时间(196.4±23.5)min,主动脉阻断时间(93.2±8.4)min,深低温停循环时间(24.8±6.3)min。住院死亡 5 例。术后随访 3~42(24.0±13.0)个月,随访率 100.0%,死亡 2 例。 结论A 型主动脉夹层合并灌注不良综合征明显增加了手术风险,但通过孙氏手术能够获得较满意的结果。

    Release date:2019-05-28 09:28 Export PDF Favorites Scan
  • Comparative study of fluorescence and inflation-deflation methods in defining the intersegmental plane in thoracoscopic anatomical lung segmentectomy

    ObjectiveTo analyze the feasibility, advantages and disadvantages of the fluorescence method and the inflation-deflation method in defining the intersegmental plane during thoracoscopic lung segmental resection.MethodsFrom February to October 2018, 60 patients underwent thoracoscopic anatomical segmentectomy in Thoracic Surgery Department of Nanjing Chest Hospital, with 28 males and 32 females, aged from 25 to 82 years. Three-dimension computed tomography bronchography and angiography was used to reconstruct pulmonary vessels, bronchus and virtual intersegmental plane. Among them, 20 patients used the fluorescence method to define the intersegmental plane, and the other 40 patients used the traditional inflation-deflation method to define the intersegmental plane.ResultsFluorescent injection of indocyanine green (ICG) showed a clear intersegmental line with a duration sufficient to complete the label. With the fluorescence method, the intersegmental plane occurrence time was significantly shortened (10.75±3.78 s vs. 988.00±314.24 s, P<0.001) and had satisfactory repeatability. The lungs did not need to be inflated, which was convenient for the operation. And the operation time was shortened (108.75±31.28 min vs 138.00±32.47 min, P=0.002). No obvious ICG injection-related concurrency symptoms was found.ConclusionCompared with the traditional inflation-deflation method, the fluorescence method can display the intersegmental line quickly, accurately and clearly, reduce the difficulty of surgery, shorten the operation time, and provide reliable technical support for thoracoscopic anatomical segmentectomy. The fluorescence is a safe and effective method that is worthy of clinical application.

    Release date:2019-08-12 03:01 Export PDF Favorites Scan
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