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.
ObjectiveTo summarize experience of surgical treatment of ascending aortic aneurysm and analyse related problems.MethodsOne hundred and fourteen (containing 62 cases had aortic dissection) consecutive cases underwent replacement of diseased ascending aorta alone (9 cases) or Bentall operation.ResultsThere were seven operative death (6.14%). The cardiac function, in six of them, was in class Ⅳ(NYHA) preoperatively. Follow up was completed in 107 patients, with a duration of 40±30 months. Eight patients succumbed due to intracranial hemorrhage (3 cases), rupture of abdominal aortic lesion (3 cases), cardiac failure after coronary artery bypass grafting (1 case), and sudden death of unknown cause (1 case),respectively. All 99 long term survivors (86.8%) were in NYHA class Ⅰor Ⅱ.ConclusionThe results indicate that Bentall operation for treating ascending aortic aneurysms and aortic insufficiency, or aortic replacement alone for treating ascending aortic aneurysm gives good functional recovery and an active life for the vast majority of survivors.
Objective To summarize the visual outcome of patients with severe ocular trauma treated with vitreous surgery. Methods Clinical data of 188(191 eyes) with severe ocular trauma treated with vitreous surgery in a period from November 1996 to April 1998 were analysed retrospectively. Results The study included penetrating injury in 56 eyes, foreign bodies in the posterior segment in 70 eyes, blunt injury in 41 eyes , and globe rupture in 24 eyes. Main complications included endophthalmitis in 35 eyes, choroidal bleeding in 20 eyes, retinal detachment in 60 eyes, and vitreous hemorrhage in 97 eyes. Post-opera-tively, out of 188 eyes, except for 3 of patients too young to examine, visual acuity improved in 133(70.7%), including 85(45.2%) with visal acuity 0.02-1.0, 46(24.5%) remained unchanged; and 9(4.8%) had worse vision. Among 34 with no-light-perception, 12 had light-perception or over. Conclusion A majority of severe trauma eyes can be salvaged with considerable visual recovery after adequate and timely vitreous surgery. (Chin J Ocul Fundus Dis,1999,15:4-6)
ObjectiveTo determine the characters of symptomatic pancreatic pseudocyst due to acute pancreatitis and effects of surgical treatment with two kinds of procedure （internal drainage or external drainage）. MethodsOne hundred and fifteen cases hospitalized during recent ten years were retrospectively analyzed.ResultsWe found that necrotic tissue existed in the pseudocyst in most cases and infection might occur in these pseudocyst. Although effect of two kinds of surgery was similar, the clinical course was different. The complications after surgery were fewer in patients underwent internal drainage than that with procedure of external drainage, and average hospital day was 7d in cases with internal drainage and 11d in cases with external one respectively. Surgery of internal drainage used in treatment was not only successful in noninfectious and single pseudocyst, but in infectious or multiple seudocyst.ConclusionInternal drainage should be used in most cases and considered as the first selection in surgery of pseudocyst due to acute pancreatitis.
目的:探討低溫體外循環下心內直視手術的有效配合。 方法:回顧總結200例心內直視術的配合過程,總結其配合方法。 結果:200例手術過程均順利,除7例因嚴重的心律失常及右心衰竭死亡,其余患者生存至今且無相應并發癥發生。結論:手術室護士積極、有效地護理配合為患者的手術成功提供保障。
目的 探討胰腺損傷患者的診斷及處理原則和方法。方法自1994~2005年11年期間我院共收治17例胰腺損傷患者，其中閉合性損傷8例，開放性損傷8例，醫源性損傷1例。分析其臨床特征、手術方式及手術并發癥。本組全部行手術治療，腸系膜上血管左側的損傷以修補、胰體尾切除或加脾切除為主； 胰頭及合并十二指腸的損傷以修補及胃十二指腸、空腸、膽總管等多口造瘺為主； 胰頭毀損傷則行胰十二指腸切除。結果術后發生胰瘺3例，胰腺假性囊腫2例，膈下及腹腔膿腫5例。治愈16例，治愈率為94.1%； 死亡1例，死亡率為5.9%。結論胰腺損傷宜早期診斷并及時手術治療，術中判斷損傷類型、正確選擇手術方式及充分的沖洗引流是治療胰腺損傷，防止或減少并發癥的關鍵。