Objective To summarize the clinical outcome and strategy of re-operation on adult and older children patients with congenital heart disease. Methods We retrospectively analyzed the clinical data of 339 patients underwent re-operation in our hospital from January 2010 to December 2014. There were 214 males and 125 females at the mean age of 21.6±12.4 years. According to the pathophysiological result and the difficulty level of operation, patients were divided into a simple re-operation group (n=186) and a complex re-operation group (n=153) . We compared the clinical outcomes of two groups. Results In the simple re-operation group, the rate of mortality was zero and the rate of complications was 5.9%. There was 1 patient of interoperative right atrium injury, 1 patient of extensive hemorrhage, 5 patients of postoperative secondary thoracotomy, 1 patient of hemodialysis, 3 patients of severe infection, and 2 patients of Ⅲ degree atrioventricular blockage. In the complex re-operation group, the rate of mortality was 3.3% and the rate of complication was 30.1%. There were 2 patients of intraoperative coronary artery lesion, 2 patients of aortic injury, 1 patient of pulmonary artery injury, 6 patients of extensive bleeding, 8 patients of postoperative secondary thoracotomy, 13 patients of hemodialysis, 12 patients of severe infection, 5 patients of nervous system complications, 4 patients of Ⅲ degree atrioventricular blockage. Extracorporeal membrane oxygenation (ECMO) applied in 4 patients. Conciusion Complex re-operation is still the influential factor of mortality and complications for patients with congenital heart disease and we should take measures to aviod the mortality and complications.
ObjectiveTo investigate the prevalence of chronic obstructive pulmonary disease (COPD) and related risk factors in two districts and five counties in Jiaxing city of Zhejiang province. MethodsWe randomly selected people over the age of 40 in 10 communities of two districts and five counties in Jiaxing city by cluster sampling and random sampling to investigate the prevalence of COPD from January 2013 to December 2013. All included patients received pulmonary function test at the same time. ResultsA total of 1 256 cases of adults over the age of 40 were included, among which, 1 056 cases with complete data and qualified for pulmonary function test. There were 410 males with mean age of 58.74±11.62, and 646 females with mean age of 59.45±11.72. The overall prevalence of COPD was 13.60%. Male and female prevalence rates were 13.90% and 13.41%, respectively. Divided by age, the prevalence of the age of 40 to 50 was 3.38%, the age of 51 to 60 was 9.57%, the age of 61 to 70 was 19.15%, and the age of above 70 was 29.35%. The results of multivariate logistic regression analysis showed that the main risk factors of COPD were smoking, passive smoking, history of dust exposure, chronic respiratory disease history and age. ConclusionThe total prevalence of COPD in Jiaxing area is high, and the female prevalence rate is especially higher than the national average level, which is the epidemiological characteristic of this area. Because the risk factors of COPD are complex, an integrated control strategy should be adopted.