首页 > 最新文献

Chinese Journal of Thoracic and Cardiovaescular Surgery最新文献

英文 中文
Clinicopathology observation of primary pulmonary sarcomatold carcinoma: 15 cases 原发性肺肉瘤癌15例临床病理观察
Pub Date : 2019-11-25 DOI: 10.3760/CMA.J.ISSN.1001-4497.2019.11.003
Yangyang Sun, Xiaoli Zhou, W. Gu, Gengfang Wang, Wei Gao
Objective To investigate the clinical pathological feature of primary pulmonary sarcomatold carcinoma and to make a further understandine of the disease. Methods Data including clinical manifesation, pathological findings, molecular detection and immunophenotyping with pathologically confirmed primary pulmonary sarcomatold carcinoma was retrospectively analyzed. Results 15 patients with PPSC were identified(13 men and 2 women, age ranged 56-76 years, median age 66 years). The tumor were located in the left lobus superior(8 cases), lobus inferior(6 cases), and the right lobus medius(1 case). The main clinical symptoms was cough, sputum, bloody sputum, chest pain. Among the 13 males, 10 had smoking history of more than 30 years, and 2 females had no smoking history. All cases presented with a spheroid solid lung mass. All tumor showed mild enhancement similar to that of the surrounding musculature after contrast enhancement, and inhomogeneous central low-attenuation areas were seen in 15 patients. Pathological pattern: 6 cases spindle cell carcinoma, 4 cases pleomorphic carcinoma, 2 cases giant cells carcinoma, 2 cases carcinosarcoma, 1 case pulmonary blastoma. The tumors were composed of both carcinomatous and sarcomatous elements. Immunohistochemistry showed that CK was all positive, EMA was positive in 7, VIM was positive in 10 of 15 cases.10 patients were tested for common related genes of lung cancer, 4 patients had MET14 jump mutation, EGFR L858R gene mutation occurred in 3 cases, KARS G13D gene mutation in 2 cases, and BRAF V600E mutation in 1 case. All 15 patients underwent lobectomy, 13 underwent adjuvant chemotherapy, and 6 underwent local radiotherapy. Postoperative follow-up was 8 to 50 months, 3 cases were lost, and 4 cases were survival 3 years after the surgery. Conclusion Pulmonary sarcomatold carcinoma is a rare histologic subtype of non-small cell lung cancer. Compared with other NSCLC, there is no special clinical and imageing characteristics. Its definite diagnosis relies on postoperative pathological analysis and immunohistochemical staining, and PSC needs to be diatinguished from a variely of disease. PPSC is more aggressive and poor prognosis. Key words: Sarcomatold carcinoma; Lung neoplasma; Spindle cell carcinoma; Pathological characteristics
目的探讨原发性肺肉瘤癌的临床病理特点,提高对该病的认识。方法回顾性分析经病理证实的原发性肺肉瘤癌的临床表现、病理表现、分子检测及免疫分型等资料。结果15例PPSC患者(男13例,女2例,年龄56 ~ 76岁,中位年龄66岁)。肿瘤位于左侧叶上(8例)、叶下(6例)和右侧叶中(1例)。临床主要表现为咳嗽、咳痰、痰血、胸痛。13例男性中有10例吸烟史超过30年,2例女性无吸烟史。所有病例均表现为球状实性肺肿块。所有肿瘤增强后均表现出与周围肌肉组织相似的轻度增强,15例患者可见不均匀的中央低衰减区。病理类型:梭形细胞癌6例,多形性癌4例,巨细胞癌2例,癌肉瘤2例,肺母细胞瘤1例。肿瘤由癌性和肉瘤性成分组成。免疫组化结果显示,15例患者中CK全部阳性,EMA 7例阳性,VIM 10例阳性。10例患者进行肺癌常见相关基因检测,其中MET14跳跃突变4例,EGFR L858R基因突变3例,KARS G13D基因突变2例,BRAF V600E基因突变1例。15例患者均行肺叶切除术,13例行辅助化疗,6例行局部放疗。术后随访8 ~ 50个月,失联3例,术后3年存活4例。结论肺肉瘤癌是一种罕见的非小细胞肺癌的组织学亚型。与其他非小细胞肺癌相比,无特殊的临床和影像学特征。其明确诊断依赖于术后病理分析和免疫组织化学染色,PSC需要与多种疾病相鉴别。PPSC侵袭性更强,预后差。关键词:肉瘤细胞癌;肺赘生物;梭形细胞癌;病理特点
{"title":"Clinicopathology observation of primary pulmonary sarcomatold carcinoma: 15 cases","authors":"Yangyang Sun, Xiaoli Zhou, W. Gu, Gengfang Wang, Wei Gao","doi":"10.3760/CMA.J.ISSN.1001-4497.2019.11.003","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-4497.2019.11.003","url":null,"abstract":"Objective \u0000To investigate the clinical pathological feature of primary pulmonary sarcomatold carcinoma and to make a further understandine of the disease. \u0000 \u0000 \u0000Methods \u0000Data including clinical manifesation, pathological findings, molecular detection and immunophenotyping with pathologically confirmed primary pulmonary sarcomatold carcinoma was retrospectively analyzed. \u0000 \u0000 \u0000Results \u000015 patients with PPSC were identified(13 men and 2 women, age ranged 56-76 years, median age 66 years). The tumor were located in the left lobus superior(8 cases), lobus inferior(6 cases), and the right lobus medius(1 case). The main clinical symptoms was cough, sputum, bloody sputum, chest pain. Among the 13 males, 10 had smoking history of more than 30 years, and 2 females had no smoking history. All cases presented with a spheroid solid lung mass. All tumor showed mild enhancement similar to that of the surrounding musculature after contrast enhancement, and inhomogeneous central low-attenuation areas were seen in 15 patients. Pathological pattern: 6 cases spindle cell carcinoma, 4 cases pleomorphic carcinoma, 2 cases giant cells carcinoma, 2 cases carcinosarcoma, 1 case pulmonary blastoma. The tumors were composed of both carcinomatous and sarcomatous elements. Immunohistochemistry showed that CK was all positive, EMA was positive in 7, VIM was positive in 10 of 15 cases.10 patients were tested for common related genes of lung cancer, 4 patients had MET14 jump mutation, EGFR L858R gene mutation occurred in 3 cases, KARS G13D gene mutation in 2 cases, and BRAF V600E mutation in 1 case. All 15 patients underwent lobectomy, 13 underwent adjuvant chemotherapy, and 6 underwent local radiotherapy. Postoperative follow-up was 8 to 50 months, 3 cases were lost, and 4 cases were survival 3 years after the surgery. \u0000 \u0000 \u0000Conclusion \u0000Pulmonary sarcomatold carcinoma is a rare histologic subtype of non-small cell lung cancer. Compared with other NSCLC, there is no special clinical and imageing characteristics. Its definite diagnosis relies on postoperative pathological analysis and immunohistochemical staining, and PSC needs to be diatinguished from a variely of disease. PPSC is more aggressive and poor prognosis. \u0000 \u0000 \u0000Key words: \u0000Sarcomatold carcinoma; Lung neoplasma; Spindle cell carcinoma; Pathological characteristics","PeriodicalId":10181,"journal":{"name":"Chinese Journal of Thoracic and Cardiovaescular Surgery","volume":"33 1","pages":"649-654"},"PeriodicalIF":0.0,"publicationDate":"2019-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87409978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Hepatoid adenocarcinoma of the lung: one case report 肺肝样腺癌1例报告
Pub Date : 2019-11-25 DOI: 10.3760/CMA.J.ISSN.1001-4497.2019.11.014
Qianjiang Ding, Q. Deng, K. Li, Yu-hong Pan
肺肝样腺癌是指癌细胞具有肝细胞样分化、有类似肝细胞癌的形态特征、免疫组化AFP呈阳性表达的肺腺癌,临床罕见。本例52岁男性患者,体检发现右肺上叶肿块、AFP升高。2018年11月行胸腔镜辅助小切口右肺上叶癌根治+胸膜粘连松解术,清扫纵隔淋巴结。术后病理检查示肺原发肝样腺癌,结节大小约7.0 cm×6.0 cm×4.5 cm,紧贴肺膜,未见明确脉管癌栓及神经侵犯,支气管切缘(-),周围肺组织(-)。
肺肝样腺癌是指癌细胞具有肝细胞样分化、有类似肝细胞癌的形态特征、免疫组化AFP呈阳性表达的肺腺癌,临床罕见。本例52岁男性患者,体检发现右肺上叶肿块、AFP升高。2018年11月行胸腔镜辅助小切口右肺上叶癌根治+胸膜粘连松解术,清扫纵隔淋巴结。术后病理检查示肺原发肝样腺癌,结节大小约7.0 cm×6.0 cm×4.5 cm,紧贴肺膜,未见明确脉管癌栓及神经侵犯,支气管切缘(-),周围肺组织(-)。
{"title":"Hepatoid adenocarcinoma of the lung: one case report","authors":"Qianjiang Ding, Q. Deng, K. Li, Yu-hong Pan","doi":"10.3760/CMA.J.ISSN.1001-4497.2019.11.014","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-4497.2019.11.014","url":null,"abstract":"肺肝样腺癌是指癌细胞具有肝细胞样分化、有类似肝细胞癌的形态特征、免疫组化AFP呈阳性表达的肺腺癌,临床罕见。本例52岁男性患者,体检发现右肺上叶肿块、AFP升高。2018年11月行胸腔镜辅助小切口右肺上叶癌根治+胸膜粘连松解术,清扫纵隔淋巴结。术后病理检查示肺原发肝样腺癌,结节大小约7.0 cm×6.0 cm×4.5 cm,紧贴肺膜,未见明确脉管癌栓及神经侵犯,支气管切缘(-),周围肺组织(-)。","PeriodicalId":10181,"journal":{"name":"Chinese Journal of Thoracic and Cardiovaescular Surgery","volume":"100 1","pages":"700-701"},"PeriodicalIF":0.0,"publicationDate":"2019-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73376096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Initial results of the second order chordal-cutting procedure for chronic ischemic mitral regurgitation 慢性缺血性二尖瓣反流的二级索切断手术的初步结果
Pub Date : 2019-11-25 DOI: 10.3760/CMA.J.ISSN.1001-4497.2019.11.008
Han Qingqi, Xu Zhiyun
Objective To discuss and evaluate the safty and outcome of the second order chordal-cutting. Methods From Aug 2015 to Mar 2017, 9 chronic IMR patients underwent chordal-cutting procedure, in addition to myocardial revascularization and undersized mitral annuloplasty. The indication was the presence of increased tethering of the anterior leaflet, with a bending angle (BA)<145° and the coaptation depth (CD) less than 10 mm. Pre- and post-procedure clinical data including left ventricular ejection fraction(LVEF), mitral regurgitation grade, New York Heart Association (NYHA) class and dimension of the left ventricle were compared. Results There was no perioperative death. No patient was lost to follow-up. MR grade decreased from 2.89 ± 0.60 preoperatively to 0.56 ± 0.70 postoperatively. The New York Heart Association class decreased from 2.78 ± 0.70 preoperatively to 1.33 ± 0.50 postoperatively. The BA increased from (136.22 ± 4.55)°preoperatively to (174.22 ± 3.15)°postoperatively. The coaptation depth decreased from (8.59 ± 0.46) mm preoperatively to (1.54 ± 0.68) mm postoperatively. LVEF increased from 0.49±0.07 preoperatively to 0.57±0.05 postoperatively. The diastolic and systolic diameters of left ventricle decreased from (62.78 ± 5.24 )mm to (53.67 ± 2.99)mm and( 44.11 ± 4.62)mm to( 37.22 ± 3.27)mm, respectively. Conclusion In selected chronic IMR patients with a BA<145° and coaptation depth less than 10 mm, second order chordal-cutting can be a good surgical option, and is related to less MR return or persistence, improved LVEF, and lower New York Heart Association class. Key words: Chronic ischemic mitral regurgitation; Second order chordal-cutting procedure; Surgery
目的探讨和评价二级索切术的安全性和效果。方法2015年8月至2017年3月,9例慢性IMR患者除行心肌血运重建术和小二尖瓣成形术外,还行脊髓切断术。指征为前小叶系索增加,弯曲角度(BA)<145°,覆盖深度(CD)小于10 mm。比较手术前后的临床数据,包括左心室射血分数(LVEF)、二尖瓣反流分级、纽约心脏协会(NYHA)分级和左心室尺寸。结果无围手术期死亡。无患者失访。MR评分由术前的2.89±0.60降至术后的0.56±0.70。纽约心脏协会评分从术前的2.78±0.70降至术后的1.33±0.50。BA由术前(136.22±4.55)°增加至术后(174.22±3.15)°。覆盖深度由术前(8.59±0.46)mm降至术后(1.54±0.68)mm。LVEF由术前的0.49±0.07增加到术后的0.57±0.05。左室舒张直径由(62.78±5.24)mm降至(53.67±2.99)mm,收缩直径由(44.11±4.62)mm降至(37.22±3.27)mm。结论在选择性的BA<145°、适应深度小于10 mm的慢性IMR患者中,二级脊髓切断术是一种较好的手术选择,与MR复归率或持久性较低、LVEF改善、纽约心脏协会分级较低有关。关键词:慢性缺血性二尖瓣反流;二级切弦程序;手术
{"title":"Initial results of the second order chordal-cutting procedure for chronic ischemic mitral regurgitation","authors":"Han Qingqi, Xu Zhiyun","doi":"10.3760/CMA.J.ISSN.1001-4497.2019.11.008","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-4497.2019.11.008","url":null,"abstract":"Objective \u0000To discuss and evaluate the safty and outcome of the second order chordal-cutting. \u0000 \u0000 \u0000Methods \u0000From Aug 2015 to Mar 2017, 9 chronic IMR patients underwent chordal-cutting procedure, in addition to myocardial revascularization and undersized mitral annuloplasty. The indication was the presence of increased tethering of the anterior leaflet, with a bending angle (BA)<145° and the coaptation depth (CD) less than 10 mm. Pre- and post-procedure clinical data including left ventricular ejection fraction(LVEF), mitral regurgitation grade, New York Heart Association (NYHA) class and dimension of the left ventricle were compared. \u0000 \u0000 \u0000Results \u0000There was no perioperative death. No patient was lost to follow-up. MR grade decreased from 2.89 ± 0.60 preoperatively to 0.56 ± 0.70 postoperatively. The New York Heart Association class decreased from 2.78 ± 0.70 preoperatively to 1.33 ± 0.50 postoperatively. The BA increased from (136.22 ± 4.55)°preoperatively to (174.22 ± 3.15)°postoperatively. The coaptation depth decreased from (8.59 ± 0.46) mm preoperatively to (1.54 ± 0.68) mm postoperatively. LVEF increased from 0.49±0.07 preoperatively to 0.57±0.05 postoperatively. The diastolic and systolic diameters of left ventricle decreased from (62.78 ± 5.24 )mm to (53.67 ± 2.99)mm and( 44.11 ± 4.62)mm to( 37.22 ± 3.27)mm, respectively. \u0000 \u0000 \u0000Conclusion \u0000In selected chronic IMR patients with a BA<145° and coaptation depth less than 10 mm, second order chordal-cutting can be a good surgical option, and is related to less MR return or persistence, improved LVEF, and lower New York Heart Association class. \u0000 \u0000 \u0000Key words: \u0000Chronic ischemic mitral regurgitation; Second order chordal-cutting procedure; Surgery","PeriodicalId":10181,"journal":{"name":"Chinese Journal of Thoracic and Cardiovaescular Surgery","volume":"21 1","pages":"675-679"},"PeriodicalIF":0.0,"publicationDate":"2019-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80135957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Whole process echocardiogram navigated congenital heart disease minimally invasive treatment in 1 164 children patients 全流程超声心动图引导先天性心脏病患儿微创治疗1164例
Pub Date : 2019-11-25 DOI: 10.3760/CMA.J.ISSN.1001-4497.2019.11.013
Minglei Gao, Yuhang Liu, Ye Zhao, P. Wen
回顾性分析2011年1月至2017年12月大连市儿童医院心脏中心应用全程超声导航进行先天性心脏病食管超声心动图导航经胸微创手术,以及经食管超声心动图及经胸超声心动图导航经皮介入治疗的疗效、安全性及经验。全组1 164例,封堵、扩张及支架置入成功1 161例,合并主动脉瓣脱垂高位室间隔缺损转为体外循环下心内直视手术3例。全组无手术即刻及近期并发症。随访6~83个月,未见迟发房室传导阻滞、心脏磨蚀等远期并发症,患儿心肺功能及生长发育均恢复正常。全程超声导航先天性心脏病微创治疗效果良好,安全性高,可获得满意疗效,值得临床推广。
回顾性分析2011年1月至2017年12月大连市儿童医院心脏中心应用全程超声导航进行先天性心脏病食管超声心动图导航经胸微创手术,以及经食管超声心动图及经胸超声心动图导航经皮介入治疗的疗效、安全性及经验。全组1 164例,封堵、扩张及支架置入成功1 161例,合并主动脉瓣脱垂高位室间隔缺损转为体外循环下心内直视手术3例。全组无手术即刻及近期并发症。随访6~83个月,未见迟发房室传导阻滞、心脏磨蚀等远期并发症,患儿心肺功能及生长发育均恢复正常。全程超声导航先天性心脏病微创治疗效果良好,安全性高,可获得满意疗效,值得临床推广。
{"title":"Whole process echocardiogram navigated congenital heart disease minimally invasive treatment in 1 164 children patients","authors":"Minglei Gao, Yuhang Liu, Ye Zhao, P. Wen","doi":"10.3760/CMA.J.ISSN.1001-4497.2019.11.013","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-4497.2019.11.013","url":null,"abstract":"回顾性分析2011年1月至2017年12月大连市儿童医院心脏中心应用全程超声导航进行先天性心脏病食管超声心动图导航经胸微创手术,以及经食管超声心动图及经胸超声心动图导航经皮介入治疗的疗效、安全性及经验。全组1 164例,封堵、扩张及支架置入成功1 161例,合并主动脉瓣脱垂高位室间隔缺损转为体外循环下心内直视手术3例。全组无手术即刻及近期并发症。随访6~83个月,未见迟发房室传导阻滞、心脏磨蚀等远期并发症,患儿心肺功能及生长发育均恢复正常。全程超声导航先天性心脏病微创治疗效果良好,安全性高,可获得满意疗效,值得临床推广。","PeriodicalId":10181,"journal":{"name":"Chinese Journal of Thoracic and Cardiovaescular Surgery","volume":"275 1","pages":"696-699"},"PeriodicalIF":0.0,"publicationDate":"2019-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86733591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Surgical treatment of Stanford A intramural hematoma Stanford A型颅内血肿的外科治疗
Pub Date : 2019-11-25 DOI: 10.3760/CMA.J.ISSN.1001-4497.2019.11.010
Ning-ning Liu, Jin-dong Li, Long-fei Wang, Zi-hua Zhou, Jun Wang, Yong-min Liu, Junming Zhu, Li-Zhong Sun
Objective To summarize experience and result in surgical treatment of Stanford type A intramural hematoma. Methods 60 patients with Stanford type A intramural hematoma were operated from February 2015 to August 2017. Surgery was indicated in complicated cases with penetrating ulcer or ulcer-like projection in ascending aorta, maximum aorta diameter≥50 mm, progressive maximum aortic wall thickness≥10 mm, pericardial or pleural effusion, persistent or recurrent pain. Aortic valve regurgitation. In our group, 46 patients recieved ascending aorta replacement+ Sun' s procedure. 6 patients recieved Bentall+ Sun' s procedure. 4 patients recieved asceding aorta+ hemiarch replacement. 2 patients recieved Bentall+ hemiarch replacement. 2 patients recieved asceding aorta replacement. Results In the whole group, there was 1(1.7%)operative death because of multiple organ failure after operation. Hyoxemiaoccured in 5(8.3%) patients, 2(3.3%) patients occurred new renal failure and required CRRT treatment, cerebrovascular complication occurred in 1 (1.7%)patient, re-sternotomy due to bleeeding occured in 1 (1.7%)patient and paraplegia occured in 1(1.7%) patient after operation. but they recoved quickly after proper treatment. During follow up period, there were 4 cases need reintervention, including TEVAR for type B dissection at 3 months and distal stent-graft new entry at 1 year. Two other reinterventions were performed for endoleak by interventional occlusion. During the follow-up, hematoma absorption rates after treatment 1、3 and 6 months were 68.6%, 84.7% and 94.8%. Conclusion Given the dynamic evolution of acute type A IMH pre-operative accurate indications and the proper surgical strategy maybe the keys for success. Key words: Aortic intramural hematoma; Surgical procedures; Cardiopulmonary bypass; Sun's procedure
目的总结Stanford A型颅内血肿的手术治疗经验和效果。方法2015年2月~ 2017年8月对60例Stanford A型颅内血肿患者进行手术治疗。升主动脉穿透性溃疡或溃疡样突出,主动脉最大直径≥50mm,主动脉最大进行性壁厚≥10mm,心包或胸膜积液,持续或反复疼痛的复杂病例需行手术治疗。主动脉瓣反流。本组46例患者行升主动脉置换术+ Sun手术。6例患者接受Bentall+ Sun手术。4例患者行升主动脉+血腹置换术。2例患者行Bentall+血弓置换。2例行升主动脉置换术。结果全组术后多脏器功能衰竭死亡1例(1.7%)。5例(8.3%)患者出现低氧血症,2例(3.3%)患者出现新发肾功能衰竭并需CRRT治疗,1例(1.7%)患者出现脑血管并发症,1例(1.7%)患者因出血而再次开胸,1例(1.7%)患者术后出现截瘫。但经过适当治疗后,他们很快恢复了健康。在随访期间,有4例需要再干预,包括3个月时因B型夹层进行TEVAR手术,1年时远端支架新入路。另外2例介入闭塞治疗内漏。随访中,治疗1、3、6个月血肿吸收率分别为68.6%、84.7%、94.8%。结论鉴于急性A型IMH的动态演变,术前准确的适应证和合理的手术策略可能是成功的关键。关键词:主动脉壁内血肿;外科手术;心肺旁路;太阳的过程
{"title":"Surgical treatment of Stanford A intramural hematoma","authors":"Ning-ning Liu, Jin-dong Li, Long-fei Wang, Zi-hua Zhou, Jun Wang, Yong-min Liu, Junming Zhu, Li-Zhong Sun","doi":"10.3760/CMA.J.ISSN.1001-4497.2019.11.010","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-4497.2019.11.010","url":null,"abstract":"Objective \u0000To summarize experience and result in surgical treatment of Stanford type A intramural hematoma. \u0000 \u0000 \u0000Methods \u000060 patients with Stanford type A intramural hematoma were operated from February 2015 to August 2017. Surgery was indicated in complicated cases with penetrating ulcer or ulcer-like projection in ascending aorta, maximum aorta diameter≥50 mm, progressive maximum aortic wall thickness≥10 mm, pericardial or pleural effusion, persistent or recurrent pain. Aortic valve regurgitation. In our group, 46 patients recieved ascending aorta replacement+ Sun' s procedure. 6 patients recieved Bentall+ Sun' s procedure. 4 patients recieved asceding aorta+ hemiarch replacement. 2 patients recieved Bentall+ hemiarch replacement. 2 patients recieved asceding aorta replacement. \u0000 \u0000 \u0000Results \u0000In the whole group, there was 1(1.7%)operative death because of multiple organ failure after operation. Hyoxemiaoccured in 5(8.3%) patients, 2(3.3%) patients occurred new renal failure and required CRRT treatment, cerebrovascular complication occurred in 1 (1.7%)patient, re-sternotomy due to bleeeding occured in 1 (1.7%)patient and paraplegia occured in 1(1.7%) patient after operation. but they recoved quickly after proper treatment. During follow up period, there were 4 cases need reintervention, including TEVAR for type B dissection at 3 months and distal stent-graft new entry at 1 year. Two other reinterventions were performed for endoleak by interventional occlusion. During the follow-up, hematoma absorption rates after treatment 1、3 and 6 months were 68.6%, 84.7% and 94.8%. \u0000 \u0000 \u0000Conclusion \u0000Given the dynamic evolution of acute type A IMH pre-operative accurate indications and the proper surgical strategy maybe the keys for success. \u0000 \u0000 \u0000Key words: \u0000Aortic intramural hematoma; Surgical procedures; Cardiopulmonary bypass; Sun's procedure","PeriodicalId":10181,"journal":{"name":"Chinese Journal of Thoracic and Cardiovaescular Surgery","volume":"1 1","pages":"684-687"},"PeriodicalIF":0.0,"publicationDate":"2019-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87615202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Retrospective study of right axillary and femoral artery cannulation in Sun’s operation 孙手术中右腋窝和股动脉插管的回顾性研究
Pub Date : 2019-11-25 DOI: 10.3760/CMA.J.ISSN.1001-4497.2019.11.009
Kaiyue Jin, H. Qiao, Xiaonan Li, Yingen Feng, Lin Li, Yong-min Liu, Junming Zhu, Li-Zhong Sun
Objective Summarize the anatomical features of the aortic dissection of right axillary and femoral artery cannulation in Sun's surgery. Exploring whether right axillary and femoral artery cannulation can reduce the incidence of organ malperfusion and improve patient prognosis. Methods From January 2015 to December 2017, 181 cases with aortic dissection were treated in Beijing Anzhen Hospital affiliated to Capital Medical University, Beijing Great Blood Vessel Research and Treatment Center, 122 patients were enrolled in the right axillary and femoral artery cannulation group, and 59 patients in control group were enrolled. Retrospective analysis the data of two groups, intraoperative, and postoperative univariate were compared between the two groups. Results A total of 17 patients died in the postoperative group, with 9 (7.38%) in the combined perfusion group and 8 (13.56%) in the control group, P=0.181. Among the complications of the two groups, 18 patients(14.75%) in combined perfusion group had renal insufficiency and 17 patients (28.81%) in the control group, P= 0.025. 0 case had stransient spinal cord injury in combined perfusion group , 3 cases(5.08%) in control group , P=0.033. Conclusion Right axillary and femoral artery cannulation can reduce the incidence of complications of postoperative organ dysfunction and improve patient prognosis. Key words: Stanford A aortic dissection; Right axillary and femoral artery cannulation; Organ malperfusion
目的总结孙手术中右腋窝及股动脉插管主动脉夹层的解剖特点。探讨右腋窝和股动脉插管是否能降低器官灌注不良的发生率,改善患者预后。方法选取2015年1月至2017年12月首都医科大学附属北京安贞医院、北京大血管研究与治疗中心收治的181例主动脉夹层患者,其中右腋窝及股动脉插管组122例,对照组59例。回顾性分析两组资料,比较两组术中、术后单变量资料。结果术后组共死亡17例,其中联合灌注组死亡9例(7.38%),对照组死亡8例(13.56%),P=0.181。两组并发症中,联合灌注组18例(14.75%)出现肾功能不全,对照组17例(28.81%)出现肾功能不全,P= 0.025。联合灌注组发生短暂性脊髓损伤0例,对照组3例(5.08%),P=0.033。结论右腋窝和股动脉插管可减少术后脏器功能障碍并发症的发生,改善患者预后。关键词:Stanford A主动脉夹层;右腋窝和股动脉插管;器官malperfusion
{"title":"Retrospective study of right axillary and femoral artery cannulation in Sun’s operation","authors":"Kaiyue Jin, H. Qiao, Xiaonan Li, Yingen Feng, Lin Li, Yong-min Liu, Junming Zhu, Li-Zhong Sun","doi":"10.3760/CMA.J.ISSN.1001-4497.2019.11.009","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-4497.2019.11.009","url":null,"abstract":"Objective Summarize the anatomical features of the aortic dissection of right axillary and femoral artery cannulation in Sun's surgery. Exploring whether right axillary and femoral artery cannulation can reduce the incidence of organ malperfusion and improve patient prognosis. Methods From January 2015 to December 2017, 181 cases with aortic dissection were treated in Beijing Anzhen Hospital affiliated to Capital Medical University, Beijing Great Blood Vessel Research and Treatment Center, 122 patients were enrolled in the right axillary and femoral artery cannulation group, and 59 patients in control group were enrolled. Retrospective analysis the data of two groups, intraoperative, and postoperative univariate were compared between the two groups. Results A total of 17 patients died in the postoperative group, with 9 (7.38%) in the combined perfusion group and 8 (13.56%) in the control group, P=0.181. Among the complications of the two groups, 18 patients(14.75%) in combined perfusion group had renal insufficiency and 17 patients (28.81%) in the control group, P= 0.025. 0 case had stransient spinal cord injury in combined perfusion group , 3 cases(5.08%) in control group , P=0.033. Conclusion Right axillary and femoral artery cannulation can reduce the incidence of complications of postoperative organ dysfunction and improve patient prognosis. Key words: Stanford A aortic dissection; Right axillary and femoral artery cannulation; Organ malperfusion","PeriodicalId":10181,"journal":{"name":"Chinese Journal of Thoracic and Cardiovaescular Surgery","volume":"3 1","pages":"680-683"},"PeriodicalIF":0.0,"publicationDate":"2019-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73041355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Immune indicators analysis in 282 patients of thymoma with autoimmune diseases 282例胸腺瘤合并自身免疫性疾病的免疫指标分析
Pub Date : 2019-11-25 DOI: 10.3760/CMA.J.ISSN.1001-4497.2019.11.004
Yuan Chen, Peng Zhang, Jian Li
Objective To compare the difference of immune indices and T lymphocyte subsets in patients with simple thymoma, thymoma combined with myasthenia gravis or other autoimmune diseases, analyze the immune characteristics of patients with thymoma combined with or without autoimmune diseases. Methods Retrospective analyze thymoma surgical cases in cardiothoracic surgery of Tianjin Medical University General Hospital from January 2014 to December 2018. A total of 282 patients with thymoma were included in the analysis, including 66 patients with simple thymoma, 188 patients with myasthenia gravis, and 28 patients with other autoimmune diseases. Patients were grouped by combining with MG or autoimmune diseases. Age, sex, pathological type, immune indexes (including IgG, IgA, IgM, IgE, C3, C4, CRP, circulating immune complexes, anti-nuclear antibodies), T cell subsets (including CD4+ T cells, CD8+ T cells, Th1, Th2, Th17 and Treg) were analyzed. Results The results showed that thymoma with autoimmune diseases and antinuclear antibodies positive were more likely to occur in female patients. Types B1, B2 and B3 thymomas were more likely to be associated with MG. Immune index analysis showed that IgG increased (P=0.008) and C3 decreased (P=0.007) significantly in patients of thymoma with MG or autoimmune diseases, they were the most significant immune indicators. CRP content in thymoma with MG was significantly lower than that in simple thymoma (P=0.004). the content of circulating immune complexes was higher in patients of thymoma with autoimmune diseases (P=0.03). IgG, IgE and circulating immune complexes increased significantly (P<0.05) and C3 decreased significantly (P=0.03) in thymoma patients with anti-nuclear antibody positive. T lymphocyte subsets analysis showed that CD4+ T lymphocyte, CD8+ T lymphocyte, CD4+ /CD8+ , Th1 cell and Th2 cell had no statistical significance. Thymoma patients with MG and autoimmune disease had higher Th17 content and higher Th17/Treg ratio, while Treg cells content decreased. Conclusion Women with thymoma were more likely to have autoimmune diseases and type B thymoma was more likely to have MG. The most significant immune indices were IgG and C3. The increase of IgG and the decrease of complement C3 were related to the type of immune diseases. The increase of Th17 cells and the decrease of Treg cells were related to the thymoma with autoimmune diseases. Key words: Thymoma; Autoimmune diseases; Myasthenia gravis; T lymphocyte subsets
目的比较单纯性胸腺瘤、胸腺瘤合并重症肌无力及其他自身免疫性疾病患者免疫指标及T淋巴细胞亚群的差异,分析胸腺瘤合并或不合并自身免疫性疾病患者的免疫特征。方法回顾性分析2014年1月至2018年12月天津医科大学总医院心胸外科胸腺瘤手术病例。共纳入282例胸腺瘤患者,其中单纯性胸腺瘤66例,重症肌无力188例,其他自身免疫性疾病28例。患者根据合并MG或自身免疫性疾病进行分组。分析患者年龄、性别、病理类型、免疫指标(IgG、IgA、IgM、IgE、C3、C4、CRP、循环免疫复合物、抗核抗体)、T细胞亚群(CD4+ T细胞、CD8+ T细胞、Th1、Th2、Th17、Treg)。结果胸腺瘤合并自身免疫性疾病及抗核抗体阳性者多见于女性患者。B1、B2和B3型胸腺瘤更可能与MG相关。免疫指标分析显示,胸腺瘤合并MG或自身免疫性疾病患者IgG显著升高(P=0.008), C3显著降低(P=0.007),是最重要的免疫指标。胸腺瘤合并MG组CRP含量显著低于单纯性胸腺瘤组(P=0.004)。胸腺瘤合并自身免疫性疾病患者循环免疫复合物含量较高(P=0.03)。抗核抗体阳性胸腺瘤患者IgG、IgE及循环免疫复合物显著升高(P<0.05), C3显著降低(P=0.03)。T淋巴细胞亚群分析显示CD4+ T淋巴细胞、CD8+ T淋巴细胞、CD4+ /CD8+、Th1细胞、Th2细胞差异无统计学意义。胸腺瘤合并MG和自身免疫性疾病患者Th17含量较高,Th17/Treg比值较高,Treg细胞含量降低。结论女性胸腺瘤合并自身免疫性疾病的可能性较大,B型胸腺瘤合并MG的可能性较大。免疫指标以IgG和C3最为显著。IgG升高、补体C3降低与免疫性疾病的类型有关。Th17细胞的增加和Treg细胞的减少与胸腺瘤合并自身免疫性疾病有关。关键词:胸腺瘤;自身免疫性疾病;重症肌无力;T淋巴细胞亚群
{"title":"Immune indicators analysis in 282 patients of thymoma with autoimmune diseases","authors":"Yuan Chen, Peng Zhang, Jian Li","doi":"10.3760/CMA.J.ISSN.1001-4497.2019.11.004","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-4497.2019.11.004","url":null,"abstract":"Objective \u0000To compare the difference of immune indices and T lymphocyte subsets in patients with simple thymoma, thymoma combined with myasthenia gravis or other autoimmune diseases, analyze the immune characteristics of patients with thymoma combined with or without autoimmune diseases. \u0000 \u0000 \u0000Methods \u0000Retrospective analyze thymoma surgical cases in cardiothoracic surgery of Tianjin Medical University General Hospital from January 2014 to December 2018. A total of 282 patients with thymoma were included in the analysis, including 66 patients with simple thymoma, 188 patients with myasthenia gravis, and 28 patients with other autoimmune diseases. Patients were grouped by combining with MG or autoimmune diseases. Age, sex, pathological type, immune indexes (including IgG, IgA, IgM, IgE, C3, C4, CRP, circulating immune complexes, anti-nuclear antibodies), T cell subsets (including CD4+ T cells, CD8+ T cells, Th1, Th2, Th17 and Treg) were analyzed. \u0000 \u0000 \u0000Results \u0000The results showed that thymoma with autoimmune diseases and antinuclear antibodies positive were more likely to occur in female patients. Types B1, B2 and B3 thymomas were more likely to be associated with MG. Immune index analysis showed that IgG increased (P=0.008) and C3 decreased (P=0.007) significantly in patients of thymoma with MG or autoimmune diseases, they were the most significant immune indicators. CRP content in thymoma with MG was significantly lower than that in simple thymoma (P=0.004). the content of circulating immune complexes was higher in patients of thymoma with autoimmune diseases (P=0.03). IgG, IgE and circulating immune complexes increased significantly (P<0.05) and C3 decreased significantly (P=0.03) in thymoma patients with anti-nuclear antibody positive. T lymphocyte subsets analysis showed that CD4+ T lymphocyte, CD8+ T lymphocyte, CD4+ /CD8+ , Th1 cell and Th2 cell had no statistical significance. Thymoma patients with MG and autoimmune disease had higher Th17 content and higher Th17/Treg ratio, while Treg cells content decreased. \u0000 \u0000 \u0000Conclusion \u0000Women with thymoma were more likely to have autoimmune diseases and type B thymoma was more likely to have MG. The most significant immune indices were IgG and C3. The increase of IgG and the decrease of complement C3 were related to the type of immune diseases. The increase of Th17 cells and the decrease of Treg cells were related to the thymoma with autoimmune diseases. \u0000 \u0000 \u0000Key words: \u0000Thymoma; Autoimmune diseases; Myasthenia gravis; T lymphocyte subsets","PeriodicalId":10181,"journal":{"name":"Chinese Journal of Thoracic and Cardiovaescular Surgery","volume":"28 1","pages":"655-658"},"PeriodicalIF":0.0,"publicationDate":"2019-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91531492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Sternal suspension technique in treatment of pectus excavatum after open repair of congenital heart disease 胸骨悬吊技术治疗先天性心脏病开放性修补术后漏斗胸
Pub Date : 2019-11-25 DOI: 10.3760/CMA.J.ISSN.1001-4497.2019.11.002
Jie Yu, Q. Zeng, Na Zhang, Cheng-hao Chen, Changqi Xu, D. Yan, Dingyi Liu, Qian Zhang, Xu Zhang
Objective To evaluate the efficacy of using sternal suspension technique in correcting pectus excavatum after open repair of congenital heart disease and improve the safety of this technique. Methods A retrospective study was conducted for 8 cases of pectus excavatum treated with sternal suspension procedure after open repair of congenital heart disease from October 2005 to October 2018 in our institution, 5 males and 3 females. The median age of patients was 5.75 years (range 3.75-12.33 years) and the median Haller index was 4.20(range 3.60-5.19). All patients underwent cardiac ultrasound and chest CT scan to evaluate the severity retrosternal adhesions. Results All patients underwent the sternal suspension procedure successfully with a median operation time 55 min (range 30-230 min) and a median blood loss of 2 ml (range 2-120 ml). There was one patient suffered pneumothorax after operation. The patients were followed up for 4 months to 13 years with an excellent and good outcome. Conclusion Sternal suspension technique is a safe and effective procedure for pectus excavatum. To improve the security and reduce the incidence of cardiac injury, sternal suspension technique is a promising alternative for pectus patients with severe adhesion after open repair of congenital heart disease. Key words: Pectus excavatum; Sternal suspension; Nuss procedure; Congenital heart disease
目的评价胸骨悬吊技术在先天性心脏病开放性修补术后纠正漏斗胸的疗效,提高该技术的安全性。方法回顾性分析我院2005年10月至2018年10月先天性心脏病开放性修补术后行胸骨悬吊术治疗漏斗胸8例,其中男5例,女3例。患者的中位年龄为5.75岁(3.75-12.33岁),中位Haller指数为4.20(3.60-5.19)。所有患者均行心脏超声和胸部CT扫描以评估胸骨后粘连的严重程度。结果所有患者均成功完成胸骨悬吊手术,平均手术时间为55分钟(30-230分钟),平均失血量为2毫升(2-120毫升)。术后出现气胸1例。随访4个月至13年,结果良好。结论胸骨悬吊技术是治疗漏斗胸安全有效的手术方法。为了提高安全性,降低心脏损伤的发生率,胸骨悬吊技术是先天性心脏病开放性修复后胸肌严重粘连患者的一种有希望的替代方法。关键词:漏斗胸;胸骨悬挂;主犯过程;先天性心脏病
{"title":"Sternal suspension technique in treatment of pectus excavatum after open repair of congenital heart disease","authors":"Jie Yu, Q. Zeng, Na Zhang, Cheng-hao Chen, Changqi Xu, D. Yan, Dingyi Liu, Qian Zhang, Xu Zhang","doi":"10.3760/CMA.J.ISSN.1001-4497.2019.11.002","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-4497.2019.11.002","url":null,"abstract":"Objective \u0000To evaluate the efficacy of using sternal suspension technique in correcting pectus excavatum after open repair of congenital heart disease and improve the safety of this technique. \u0000 \u0000 \u0000Methods \u0000A retrospective study was conducted for 8 cases of pectus excavatum treated with sternal suspension procedure after open repair of congenital heart disease from October 2005 to October 2018 in our institution, 5 males and 3 females. The median age of patients was 5.75 years (range 3.75-12.33 years) and the median Haller index was 4.20(range 3.60-5.19). All patients underwent cardiac ultrasound and chest CT scan to evaluate the severity retrosternal adhesions. \u0000 \u0000 \u0000Results \u0000All patients underwent the sternal suspension procedure successfully with a median operation time 55 min (range 30-230 min) and a median blood loss of 2 ml (range 2-120 ml). There was one patient suffered pneumothorax after operation. The patients were followed up for 4 months to 13 years with an excellent and good outcome. \u0000 \u0000 \u0000Conclusion \u0000Sternal suspension technique is a safe and effective procedure for pectus excavatum. To improve the security and reduce the incidence of cardiac injury, sternal suspension technique is a promising alternative for pectus patients with severe adhesion after open repair of congenital heart disease. \u0000 \u0000 \u0000Key words: \u0000Pectus excavatum; Sternal suspension; Nuss procedure; Congenital heart disease","PeriodicalId":10181,"journal":{"name":"Chinese Journal of Thoracic and Cardiovaescular Surgery","volume":"3 1","pages":"645-648"},"PeriodicalIF":0.0,"publicationDate":"2019-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91340459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Neurodevelopmental outcomes at eighteen months of age in infants with congenital heart disease 先天性心脏病婴儿18个月大时的神经发育结果
Pub Date : 2019-10-25 DOI: 10.3760/CMA.J.ISSN.1001-4497.2019.10.001
G. Juan, He Shaoru, Sun Yunxia, Liang Suixin, Liu Yumei, Z. Jian, Chen Jimei, Zhong-hai Jin, Yu Yuhui
Objective To analyze the neurodevelopmental outcome and its risk factors in infants with CHD at 18 months of age. Methods Eighteen-month-old infants with CHD at the follow-up clinic of our hospital were selected. The Bayley scales of infant development(BSID) were used to evaluate the levels of mental development(MDI) and psychomotor development(PDI). The clinical features during hospitalization were reviewed, and the risk factors of MDI and PDI were analyzed. Results A total of 116 children with CHD underwent BSID evaluation at 18 months of age. Both the MDI(95.38±22.98) and PDI(87.84±22.57) of the cohort were significantly lower than the average value of the normal population(P<0.05). In infants with cyanotic CHD, the MDI was higher(β=17.218). The longer the length was of the hospital stay, the lower the PDI(β=-0.577). In patients undergoing cardiopulmonary bypass surgery, the PDI was higher(β=11.956). Compared to infants with relatively normal behavior, the PDI of infants with mild behavioral problems was lower(β=-10.605). Conclusion Children with CHD who underwent cardiac surgery have delayed neurodevelopmental outcomes compared with those of healthy children. The outcomes of infants with cyanotic CHD or undergoing cardiopulmonary bypass surgery was better than others. Long hospital stays and mild behavioral problems were risk factors for poor neurodevelopmental outcomes. Key words: Heart surgery; Congenital heart disease; Infants; Neurodevelopment; Outcomes
目的分析18月龄冠心病患儿神经发育结局及其危险因素。方法选择本院随访门诊18月龄冠心病患儿为研究对象。采用贝利婴儿发育量表(Bayley scales of infant development, BSID)评价患儿的心理发展水平(MDI)和精神运动发展水平(PDI)。回顾住院期间的临床特点,分析MDI和PDI的危险因素。结果116例CHD患儿在18月龄时接受了BSID评估。队列MDI(95.38±22.98)、PDI(87.84±22.57)均显著低于正常人群平均值(P<0.05)。青紫型冠心病患儿的MDI较高(β=17.218)。住院时间越长,PDI越低(β=-0.577)。接受体外循环手术的患者PDI较高(β=11.956)。与行为相对正常的婴儿相比,轻度行为问题婴儿的PDI较低(β=-10.605)。结论与健康儿童相比,接受心脏手术的冠心病儿童神经发育预后延迟。青紫型冠心病患儿或行体外循环手术患儿的预后较其他患儿好。长期住院和轻度行为问题是神经发育不良的危险因素。关键词:心脏外科;先天性心脏病;婴儿;神经发育;结果
{"title":"Neurodevelopmental outcomes at eighteen months of age in infants with congenital heart disease","authors":"G. Juan, He Shaoru, Sun Yunxia, Liang Suixin, Liu Yumei, Z. Jian, Chen Jimei, Zhong-hai Jin, Yu Yuhui","doi":"10.3760/CMA.J.ISSN.1001-4497.2019.10.001","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-4497.2019.10.001","url":null,"abstract":"Objective \u0000To analyze the neurodevelopmental outcome and its risk factors in infants with CHD at 18 months of age. \u0000 \u0000 \u0000Methods \u0000Eighteen-month-old infants with CHD at the follow-up clinic of our hospital were selected. The Bayley scales of infant development(BSID) were used to evaluate the levels of mental development(MDI) and psychomotor development(PDI). The clinical features during hospitalization were reviewed, and the risk factors of MDI and PDI were analyzed. \u0000 \u0000 \u0000Results \u0000A total of 116 children with CHD underwent BSID evaluation at 18 months of age. Both the MDI(95.38±22.98) and PDI(87.84±22.57) of the cohort were significantly lower than the average value of the normal population(P<0.05). In infants with cyanotic CHD, the MDI was higher(β=17.218). The longer the length was of the hospital stay, the lower the PDI(β=-0.577). In patients undergoing cardiopulmonary bypass surgery, the PDI was higher(β=11.956). Compared to infants with relatively normal behavior, the PDI of infants with mild behavioral problems was lower(β=-10.605). \u0000 \u0000 \u0000Conclusion \u0000Children with CHD who underwent cardiac surgery have delayed neurodevelopmental outcomes compared with those of healthy children. The outcomes of infants with cyanotic CHD or undergoing cardiopulmonary bypass surgery was better than others. Long hospital stays and mild behavioral problems were risk factors for poor neurodevelopmental outcomes. \u0000 \u0000 \u0000Key words: \u0000Heart surgery; Congenital heart disease; Infants; Neurodevelopment; Outcomes","PeriodicalId":10181,"journal":{"name":"Chinese Journal of Thoracic and Cardiovaescular Surgery","volume":"28 1","pages":"577-582"},"PeriodicalIF":0.0,"publicationDate":"2019-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80449062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Abdominal hemorrhage after aortic valve replacement in 1 case and literature analysis 主动脉瓣置换术后腹部出血1例并文献分析
Pub Date : 2019-10-25 DOI: 10.3760/CMA.J.ISSN.1001-4497.2019.10.012
Bing-xing Tian, Fayu Liang
心脏外科手术后腹部并发症发生率低,而出现腹腔内出血则非常罕见。1例患者因行体外循环下主动脉瓣置换术,术后血压下降明显(32/21 mmHg)(1 mmHg=0.133 kPa),保守治疗效果差。考虑心脏压塞,开胸探查未见出血。随后行腹腔穿刺有不凝血,诊断腹腔出血,剖腹探查见腹腔大量深红色陈旧血,肝脏周围大量凝血块,但未见出血点。推测出血可能与术中下腔静脉插管操作不慎有关。经积极治疗,患者好转出院。提示体外循环心脏外科手术后发生不明原因出血,注意腹腔出血可能,当患者循环不稳定,保守治疗效果差时,应该积极手术干预。
心脏外科手术后腹部并发症发生率低,而出现腹腔内出血则非常罕见。1例患者因行体外循环下主动脉瓣置换术,术后血压下降明显(32/21 mmHg)(1 mmHg=0.133 kPa),保守治疗效果差。考虑心脏压塞,开胸探查未见出血。随后行腹腔穿刺有不凝血,诊断腹腔出血,剖腹探查见腹腔大量深红色陈旧血,肝脏周围大量凝血块,但未见出血点。推测出血可能与术中下腔静脉插管操作不慎有关。经积极治疗,患者好转出院。提示体外循环心脏外科手术后发生不明原因出血,注意腹腔出血可能,当患者循环不稳定,保守治疗效果差时,应该积极手术干预。
{"title":"Abdominal hemorrhage after aortic valve replacement in 1 case and literature analysis","authors":"Bing-xing Tian, Fayu Liang","doi":"10.3760/CMA.J.ISSN.1001-4497.2019.10.012","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-4497.2019.10.012","url":null,"abstract":"心脏外科手术后腹部并发症发生率低,而出现腹腔内出血则非常罕见。1例患者因行体外循环下主动脉瓣置换术,术后血压下降明显(32/21 mmHg)(1 mmHg=0.133 kPa),保守治疗效果差。考虑心脏压塞,开胸探查未见出血。随后行腹腔穿刺有不凝血,诊断腹腔出血,剖腹探查见腹腔大量深红色陈旧血,肝脏周围大量凝血块,但未见出血点。推测出血可能与术中下腔静脉插管操作不慎有关。经积极治疗,患者好转出院。提示体外循环心脏外科手术后发生不明原因出血,注意腹腔出血可能,当患者循环不稳定,保守治疗效果差时,应该积极手术干预。","PeriodicalId":10181,"journal":{"name":"Chinese Journal of Thoracic and Cardiovaescular Surgery","volume":"26 1","pages":"634-635"},"PeriodicalIF":0.0,"publicationDate":"2019-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85579123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Chinese Journal of Thoracic and Cardiovaescular Surgery
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1