摘要:目的:探討創傷性感染性假性股動脈瘤的診斷和外科治療的臨床經驗。方法:回顧性分析２１例創傷性感染性假性股動脈瘤的臨床資料,均行瘤體摘除及徹底的清創后,分別采用了血管結扎術和血管修復重建術兩種不同的手術治療方法。結果:血管修復重建術組中３例術后出現血管破裂大出血,要再次手術,１５例行股動脈結扎術,全部保肢成功。結論:瘤體切除加血管移植術是一種理想的方法,但在無條件行血管移植時,股動脈結扎術可做為一種有效的方案,對伴有皮膚缺損者行對側胸臍皮瓣轉移術。Abstract: Objective: 〖WT5”BZ〗To explore the traumatic infected femoral pseudoaneurysm diagnosis and surgical treatment of clinical experience. Methods: Retrospective analysis of 21 cases of traumatic infected femoral pseudoaneurysm of the clinical data were performed and the tumor removed after thorough debridement, respectively vascular ligation and blood vessel repair and reconstruction surgery of two different surgical treatment. Results: The blood vessel repair and reconstruction surgery group, three cases of postoperative bleeding blood vessel ruptures occurred, we must resurgery, 15 routine femoral artery ligation, all of the success of limb salvage. Conclusion: The tumor resection plus vascular graft is an ideal way, but in an unconditional line of vascular grafts, the femoral artery ligation can be used as an effective program for skin defects associated with the contralateral breast underwent umbilical flap transfer of patients.
Objective To investigate the differences in postoperative mortality and identify potential influential factors in patients with a systemic left ventricle (SLV) versus a systemic right ventricle (SRV) following total cavopulmonary connection (TCPC). MethodsWe retrospectively collected data from functional single ventricle patients who underwent TCPC at the Department of Cardiac Surgery, Guangdong Provincial People’s Hospital, between October 2004 and July 2021. The cohort was categorized based on ventricular morphology into two groups: a SLV group and a SRV group. All procedures were performed via a median sternotomy under cardiopulmonary bypass. ResultsA total of 195 patients were included, comprising 108 patients in the SLV group (69 males, 39 females) and 87 in the SRV group (61 males, 26 females). The median age at surgery was 5.7 (IQR, 4.0-11.2) years, and the median body mass index (BMI) was 15.1 (IQR, 13.5-16.2) kg/m2 for the SLV group. For the SRV group, the median age was 5.7 (IQR, 4.1-8.9) years, and the median BMI was 14.7 (IQR, 13.6-15.9) kg/m2. The proportion of patients with situs inversus, heterotaxy syndrome, and moderate or greater atrioventricular valve regurgitation was significantly higher in the SRV group. Patients in the SRV group had a higher rate of fenestration and experienced longer aortic cross-clamp, cardiopulmonary bypass, and operative times, as well as prolonged postoperative hospital stays and chest tube durations. However, there were no statistical differences in early or late mortality between the two groups (P>0.05). Multivariate analysis identified pulmonary vascular resistance, postoperative aspartate aminotransferase, and postoperative creatinine as independent risk factors for mortality, while postoperative percutaneous oxygen saturation and hemoglobin levels were identified as protective factors. Conclusion The post-TCPC survival rate in patients with a SRV is non-inferior to that in patients with a SLV. However, the overall long-term mortality for both groups remains high, warranting close monitoring of the long-term survival outcomes in this patient population.