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find Author "唐白云" 3 results
  • 心瓣膜置换术同期双极射频消融治疗心房颤动

    目的 总结心内直视下射频消融改良迷宫手术治疗心房颤动(AF)的临床经验,探讨该手术方法的效果。方法 2007年12月至2008年2月在心内直视手术下同期采用射频消融改良迷宫手术治疗AF患者11例,男3例,女8例;年龄22~65岁,平均年龄40.36岁。术前诊断为风湿性心脏病二尖瓣狭窄11例,合并关闭不全5例,左心房血栓3例。采用Atricure双极射频消融系统,按照迷宫手术线路分别经房间沟路径行心内膜射频消融术,同期完成相应的心脏手术。 结果 手术均顺利完成,射频消融手术时间22~50 min,平均30.55min。术后无死亡患者,术后当天有7例(63.64%)转为窦性心律。11例患者均顺利出院。出院后随访1个月以上,10例(9091%)转为窦性心律。结论 心内直视下射频消融改良迷宫手术治疗AF简单、有效,短期临床效果明显。

    Release date:2016-08-30 05:59 Export PDF Favorites Scan
  • 心内直视术后长时间应用呼吸机支持的原因与防治

    目的 探讨心内直视术后的患者长时间应用呼吸机的原因及其防治方法。方法 将30例心内直视术后的患者分为两组,不能脱离呼吸机组(n=19)和二次插管组(n=11),两组患者应用呼吸机均超过3天,从术前心功能、心胸比率、体外循环、主动脉阻断时间和术后并发症等方面对两组进行了原因分析和比较。结果 心内直视术后需长时间应用呼吸机原因与术前心功能、心胸比率、体外循环和主动脉阻断时间、术后并发心、肺、脑、多器官功能衰竭等有密切关系。不能脱离呼吸机组患者术后主要发生心、脑及多器官功能衰竭等并发症,14例痊愈,5例死亡。二次插管组主要合并心脏和呼吸系统并发症,全部治愈。结论 术前心、肺功能准备充分,尽可能缩短体外循环和主动脉阻断时间,预防和综合治疗心、肺、脑等重要脏器并发症及合理应用呼吸机支持治疗,对促进患者的早日康复具有重要意义。

    Release date:2016-08-30 06:33 Export PDF Favorites Scan
  • Clinical Application of Combined Treatment with Probiotics and Lactulose after Open Heart Surgery under Cardiopulmonary Bypass: A Control Study

    Objectives To investigate the effect of the combined treatment with probiotics and lactulose of gastrointestinal function and postoperative infection after open cardiac surgery. Methods We retrospectively analyzed the clinical data of 264 patients underwent cardiopulmonary bypass in our hospital between August 2013 and June 2014. There were 129 males and 135 females at the mean age of 53.06±10.97 years. We divided those patients into a treatment group and a control group. In the treatment group, there were 58 males and 63 females at the mean age of 52.29±14.31 years. They took probiotics and lactulose from the first day to the seventh day after operation. In the control group, there were 71 males and 72 females at the mean age of 52.29±14.31 years. They didn’t take probiotics or lactulose after the surgery. Procalcitonin (PCT) and lipopolysaccharides (LPS) concentrations were measured before operation, at 24 hours postoperatively, at 72 hours and on the seventh day. We recorded the condition of postoperative infection, gastrointestinal disorders and relative informations. Results The PCT and LPS concentrations in the treatment group after 72 hours postoperatively were statistically lower than those of the control group (1.04±5.39 ng/ml vs. 3.51±4.28 ng/ml, P=0.04; 11.28±4.34 EU/ml vs. 21.59±7.34 EU/ml, P=0.03). The PCT and LPS concentrations in the treatment group were also statistically lower than those of the control group on the 7th day postoperatively (0.17±2.79 ng/ml vs. 1.98±4.62 ng/ml,P=0.04; 6.74±6.38 EU/ml vs. 15.96±4.61 EU/ml, P=0.01). The ICU stay time (43.25±14.36 h vs. 63.47±24.46 h, P=0.01) and postoperative hospital stay time (15.07±4.52 d vs. 21.08±6.49 d, P=0.02) were significantly less in the treatment group than those in the control group. The morbidity of infection and the morbidity of gastrointestinal disorders of the treatment group were statistically less than those of the control group (1.65% vs. 5.59%, P=0.00; 2.48% vs. 6.99%, P<0.001), and there was no statistical difference in mortality between the two groups (1.65% vs. 2.10%, P=0.12). Conclusions The combined treatment with probiotics and lactulose can improve the postoperative inflammatory reaction, gastrointestinal function, and reduce the morbidity of infection.

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