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find Author "姜静" 2 results
  • Incomplete left main coronary obstruction after transcatheter aortic valve replacement for severe aortic stenosis: a case report

    An 84-year-old severe aortic stenosis patient admitted with acute heart failure was reported. Transcatheter aortic valve replacement (TAVR) was proposed. The patient was at high risk of the left coronary artery occlusion in preoperative and intraoperative evaluation. Coronary artery protection was performed by pre-embedded coronary artery guide wire and stent during the TAVR. The left coronary artery was partially blocked by valve leaflet after 23 mm self-expanding aortic valve was released. Coronary revascularization was not performed as the coronary blood flow was not affected. However, the patient suffered acute myocardial infarction with hypotension on the third day after TAVR. Emergency angiography showed that left coronary artery was more blocked than before and the condition improved after left main coronary stent implantation. This case suggested that aggressive coronary revascularization should be considered for high risk of coronary artery obstruction during TAVR, especially for partial obstruction of coronary artery.

    Release date:2020-10-26 03:00 Export PDF Favorites Scan
  • 体位约束带用于椎管内麻醉穿刺的临床效果观察

    目的观察椎管内麻醉穿刺时使用体位约束带的临床效果。 方法将2013年1月-2014年6月行脊椎麻醉(腰麻)-硬膜外联合麻醉手术的90例患者随机分为约束带组和常规组,每组各45例。取常规腰椎穿刺体位(侧卧、头低、弯腰、屈膝向腹部),若一侧下肢骨折或活动受限者则屈膝健侧,患肢取自然舒适位。常规组摆好体位后,常规消毒铺单,用1%利多卡因3~5 mL局部麻醉,在腰椎2-4间隙行腰麻-硬膜外联合麻醉;约束带组摆好体位后,用约束带固定好体位,选择穿刺间隙及其他操作同常规组。 结果常规组腰椎麻醉穿刺时间为(17±3)min,约束带组为(8±3)min,两组比较差异有统计学意义(P < 0.05)。常规组中有15例患者腰椎麻醉穿刺≥2次,约束带组腰椎麻醉穿刺均为1次,两组比较差异有统计学意义(P < 0.05)。常规组发生术后腰痛5例(11.1%),约束带组发生术后腰痛1例(2.2%),两组比较差异有统计学意义(P < 0.05)。两组患者均无较多出血、局部血肿发生。常规组患者满意率为44%,约束带组患者满意率为93%,两组比较差异有统计学意义(P < 0.05)。 结论行椎管内麻醉时使用体位约束带可缩短操作时间、减轻患者术后腰痛以及提高患者满意度,使操作简单易行,值得临床推广。

    Release date:2016-10-28 02:02 Export PDF Favorites Scan
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