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find Keyword "心脏病" 407 results
  • Open heart operation on neonates with critical congenital heart disease 推荐 CAJ下载 PDF

    Objective To summarize the experience of open heart operation on neonates with critical and complex congenital heart diseases and evaluate the methods of perioperative management. Methods From May 2001 to January 2003, 12 patients of neonates with congenital heart diseases underwent emergency operation. Their operating ages ranged from 6 to 30 days, the body weights were 2.8 to 4.5 kg. Their diagnoses included D-transposition of the great arteries in 4 cases, ventricular septal defect with atrial septal defect in 5 cases, complete atrioventricular septal defect, obstructed supracardiac total anomalous pulmonary venous drainage and cardiac rhabdomyomas in 1 case respectively. 12 cases were operated under moderate or deep hypothermic cardiopulmonary bypass. Results All cases were observed in ICU for 2-11 days and discharged 7-19 days after operation. The postoperative complications included low cardiac output, mediastinal infection, respiratory distress syndrome, systemic capillary leak syndrome and acute renal failure. All cases were cured and the follow-up (from 6 months to 2 years) showed satisfactory outcome. Conclusion A particular cardiopulmonary bypass and proper perioperative management is very important to ensure the successful outcome. Peritoneal dialysis is an effective and safe method for treating acute renal failure after cardiac operation in neonates.

    Release date:2016-08-30 06:27 Export PDF Favorites Scan
  • 慢性肺原性心脏病患者的人文关怀护理

    目的:研究对慢性肺原性心脏病实施人文关怀护理的效果。方法:根据单日和双日住院区分,选择我院呼吸科2008年10~12月的单日住院的慢性肺心病住院患者38例作为对照组, 2008年10~12月的双日住院的慢性肺心病住院患者39例作为实验组,对照组实施常规护理,实验组在常规护理的基础上实施人文关怀护理,。采用自行设计的问卷调查表调查两组患者对护理工作的满意度,并将两组患者的满意度评分分数进行t检验。结果:实验组肺心病患者对工作的满意度评分分数为(53.36±3.17)分,对照组肺心病患者对护理工作的满意度评分分数为(47.47±3.90)分,t=7.28,Plt;0.01,差异有统计学意义。结论: 人文关怀护理使慢性肺原性心脏病患者对护理工作的满意度得到提升,有利于提高肺心病老年人的生命质量和构建和谐护患关系。

    Release date:2016-09-08 10:04 Export PDF Favorites Scan
  • 小儿先天性心瓣膜病的外科治疗

    目的 探讨小儿先天性心瓣膜病手术治疗的方法,并总结其经验.方法 45例先天性心瓣膜病患儿实施主动脉瓣修复成形术4例,二尖瓣综合成形术31例,二尖瓣置换术、三尖瓣置换术和主动脉瓣环扩大瓣膜置换术各1例,三尖瓣综合成形术9例次.外科技术包括瓣叶或交界折叠(悬吊)成形,瓣环环缩,置Carpentier环,升主动脉加宽换瓣,瓣叶楔形切除及瓣下结构畸形修复等,同期矫治其它心内畸形.结果 1例术后死于重度低心排血量综合征,其余44例顺利恢复.二维超声心动图示5例有轻度二尖瓣反流,1例有轻度三尖瓣反流,随访5个月~8年,效果稳定.结论 采用综合成形技术,保留自身瓣膜是小儿先天性心瓣膜病外科治疗的首选方法,具有效果确切,术后心功能好,并发症少,无需长期抗凝及不影响生长发育等优点.

    Release date:2016-08-30 06:35 Export PDF Favorites Scan
  • 先天性心脏病继发感染性心内膜炎的外科治疗

    目的 总结先天性心脏病继发感染性心内膜炎41例外科治疗的经验。方法 手术均在体外循环下进行畸形矫正和赘生物清除。室间隔缺损(VSD)直接缝合16例,补片修补10例;动脉导管未闭(PDA)均采用直视缝合法。同期行肺动脉瓣成形术5例,三尖瓣置换术2例,主动脉瓣置换术12例,主动脉瓣和二尖瓣置换术2例。结果 1例急诊VSD修补同时行主动脉瓣置换术,术后并发脑栓塞死亡;其余患者均痊愈出院。随访35例,随访时间3~102个月,无1例死亡和心内膜炎复发。结论 正确把握手术时机和使用有效抗生素是提高治愈率的关键,应强调对先天性心脏畸形的早期治疗,以防止严重并发症。

    Release date:2016-08-30 06:33 Export PDF Favorites Scan
  • 上腔静脉右肺动脉分流术治疗三尖瓣闭锁

    目的 总结上腔静脉右肺动脉分流术治疗三尖瓣闭锁(TA)的临床经验。 方法 2004年10月至2008年4月,采用上腔静脉右肺动脉分流术治疗TA 10例,男8例,女2例 ;年龄2~13岁,平均年龄5.6岁;体重10.0~33.5 kg,平均体重16.4 kg。TA合并大动脉错位(右位心)2例,房室间隔缺损3例,永存左上腔静脉1例。均在常温非体外循环下手术,切断上腔静脉,近端缝合,远端与右肺动脉做端侧吻合;1例合并永存左上腔静脉患者行双侧上腔静脉肺动脉吻合术。 结果 全组无死亡患者,术后末梢血氧饱和度由74%±9%上升至92%±5%。所有患者紫绀明显减轻,顺利出院。随访10例,分别随访6~36个月,血氧饱和度86%±3%,活动能力明显改善。 结论 上腔静脉右肺动脉分流术治疗TA效果满意,是比较理想的术式。

    Release date:2016-08-30 05:59 Export PDF Favorites Scan
  • 婴幼儿体外循环术后机械通气模式的选择

    目的比较先天性心脏病婴幼儿体外循环术后容量控制通气(VCV)、压力控制通气(PCV)和压力调节容量控制通气(PRVC)3种呼吸模式的治疗效果。方法将2003年10月到2005年5月收治的106例婴幼儿先天性心脏病(CHD)患者分为3组,组Ⅰ(42例)为一般CHD患者,组Ⅱ(40例)为复杂CHD患者,组Ⅲ(24例)为伴有肺动脉高压(PH)的CHD患者。根据随机原则选择VCV、PCV、PRVC3种呼吸模式进行支持治疗。记录血流动力学、呼吸力学和血气分析指标并进行统计分析。结果组Ⅱ和组Ⅲ患者PRVC模式可以明显改善血气和降低气道压力,同时对血流动力学无明显影响;3种呼吸模式对组Ⅰ患者差异无统计学意义。结论婴幼儿体外循环术后3种呼吸模式对一般CHD患者无明显差异,对复杂CHD和伴有PH的CHD患者PRVC模式在呼吸力学和血气分析方面优于VCV和PCV模式。

    Release date:2016-08-30 06:23 Export PDF Favorites Scan
  • Surgical Treatment of Complicated Transposition of the Great Arteries by a Modified REV Procedure with Preservation of Native Pulmonary Valve 3 Cases Report and Literature Review

    Objective To introduce a modified REV procedure of complicated transposition of the great arteries (TGA) or double outlet right ventricle (DORV) which was combined with ventrieular septal defect (VSD) and pulmonary valve stenosis(PS). Methods From Sep. 2005 to Feb. 2006, 3 children with complicated transposition of the great arteries underwent a modified REV operation. This modified REV operation was designed on the basis of classical REV procedure to preserve the native pulmonary artery valve and its function. Results Two patients recovered uneventfully but one died after extraeorporeal membrane oxygenator (ECMO) treatment. After 4 and 1 months follow-up respectively, the discharged 2 patients were asymptomatie and the eehoeardiography revealed that the pressure gradient between left ventrieular-main pulmonary were estimated to be 15 and 5mmHg. Conclusion This modified REV operation for preservation of pulmonary artery valve is an ideal procedure to complicated transposition of the great arteries. Advantages and disadvantages of this modified REV procedure were discussed.

    Release date:2016-08-30 06:23 Export PDF Favorites Scan
  • Surgical Treatment for Unruptured Aneurysm of the Sinus of Valsalva

    ObjectiveTo summarize surgical treatment experience on unruptured aneurysm of the sinus of Valsalva (SVA). MethodsClinical data of 33 patients with unruptured SVA underwent surgical repair at Fu wai Hospital between February 2007 and January 2012 were retrospectively analyzed. There were 27 males and 6 females with their mean age of 28.5±13.5 years (ranged from 4.5 to 58.0 years). The unruptured SVA originated in the right coronary sinus in 29 cases (87.8%), in non-coronary in 2 cases (6.1%) and in left coronary sinus in 2 cases (6.1%). There were 29 cases with ventricular septal defect and 20 cases with aortic valve insufficiency (AI). ResultsOnly 52.8% of unruptured SVA were correctly diagnosed by echocardiography preoperatively. All unruptured SVA received active surgical management, with no early death after operation. Thirty patients (90.9%) were followed up for 22 to 81 months (mean 42.9±18.8 months) and in NYHA classⅠorⅡ. None SVA recurrence occurred. Postoperative AI could be improved better by using the repair route only through the chamber of right ventricle for patients with unruptured SVA originated in right coronary sinus. ConclusionFor unruptured SVA patients who associated with other kinds of cardiovascular lesions, active surgical repair for unruptured SVA can achieve satisfactory results.

    Release date:2016-10-02 04:56 Export PDF Favorites Scan
  • Analysis of risk factors for surgical treatment of congenital pulmonary venous stenosis combined with congenital heart disease

    ObjectiveTo explore risk factors associated with mortality and restenosis after the surgery for congenital pulmonary venous stenosis (CPVS) combined with congenital heart disease.MethodsFrom May 2007 to August 2019, 58 patients received surgical relief of CPVS combined with congenital heart disease, including 24 males and 34 females, aged 17.2±26.3 months, weighing 8.8±8.2 kg. Endpoints were death and restenosis, and the risk factors were analyzed. A univariate and multivariate risk analyses were performed.ResultsPreoperative pulmonary venous stenosis severity score (PVSSS) was 4.5±2.7. Average pulmonary vein counts with CPVS was 1.9±1.0. There were 2 (3.4%) early deaths. The mean follow-up time was 2-145 (49.8±40.0) months. The 1-, 2-, 3- and 5-year overall survival rates were 86.7%, 81.3%, 78.5% and 73.6%, respectively, and the pulmonary venous restenosis-free rates were 79.6%, 68.5%, 68.5% and 68.5%, respectively. Preterm birth was an independent risk factor for mortality. The pulmonary venous peak flow rate ≥1.2 m/s at discharge was an independent risk factor for mortality and restenosis.ConclusionThe prognosis of CPVS is still poor. Postoperative residual stenosis at discharge is an independent risk factor for death and restenosis.

    Release date:2021-12-27 11:31 Export PDF Favorites Scan
  • Research on the Mutation and Expression of Nkx2.5 in Right Ventricular Outflow Tract Myocardial of Congenital Heart Disease Patients with Diminutive Pulmonary Blood

    ObjectiveTo observe the mutation and expression of Nkx2.5 in congenital heart disease patients with diminutive pulmonary blood. We preliminarily explored the association between Nkx2.5 gene and pathogenesis of congenital heart disease patients with diminutive pulmonary blood. MethodsFifty six patients of congenital heart disease with diminutive pulmonary blood in the first affiliated hospital of Bengbu medical college and Anhui province children, s hospital between May 2012 and May 2014 were as an experimental group. Sixty three patients of ventricular septal defect were as a control group. In the trial group, there were 30 males and 26 females averagely aged 5.82± 4.23 years ranking from 6 months to 14 years. In the control group, there were 36 males and 27 females averagely aged 6.93± 4.56 years ranking from 6 months to 14 years. Before operation, peripheral venous blood of all the patients were collected. We used polymerase chain reaction combined with DNA sequencing technology to detect Nkx2.5 gene exon sequence and to analyze the association between Nkx2.5 gene mutation and congenital heart disease with diminutive pulmonary blood. And we got some hypertrophic myocardial tissue from right ventricular outflow tract in the operation, whose size was 0.5× 0.5× 0.5 cubic centimeter. And we extracted myocardial tissue RNA. The expression changes of Nkx2.5 gene mRNA were detected by real-time fluorescence quantitative polymerase chain reaction technique. ResultsThere was no mutations tested out in the peripheral venous blood in both two groups. The expression of mRNA in Nkx2.5 gene of the trial group was lower than that in the control group with a statistical difference. ConclusionNkx2.5 gene mutation may be associated with multiple factors. The occurrence of congenital heart disease with diminutive pulmonary blood may be related with a decline of Nkx2.5 gene expression in the myocardial tissue.

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