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    find Author "何少茹" 2 results
    • Diagnosis and Management of Chylothorax in Children after Congenital Heart Surgery

      ObjectiveTo investigate the clinical characteristics, diagnosis and management of postoperative chylothorax after congenital cardiac surgery in infants and children. MethodsWe retrospectively analyzed clinical data of 79 postoperative patients with chylothorax after congenital cardiac surgery in Guangdong General Hospital between January 2006 and December 2013.There were 54 males and 25 females at age ranged 8 days to 14 years. ResultsThe prevalence of postoperative chylothorax was 0.6% (79/12 067). A total of 75 (94.9%) patients were cured. And 71 patients (89.9%) were cured by conservative treatment. While 4(5.1%) patients received operative treatment, including 3 patients undergoing ligation of thoracic duct, 1 patient undergoing lymphatic ablation. There were 4 (5.1%) patients failed to treat, including 1(1.3%) abandoned, 3 (mortality of 3.8%) deaths in hospital for low cardiac output syndrome, cardiac arrest and severe anastomotic stenosis after transposition of conducting arteries(TGA), tetralogy of Fallot(TOF) and total anomalous pulmonary venous connection(TAPVC) operation respectively. Hospitalization time ranged 10 to 108 (39.3±19.4) d. There was no recurrence of chylothorax within 6 months to 8 years of following-up. ConclusionThe key to prevention of chylothorax is to improve the surgical technology. Conservative management of chylothorax will be successful in most cases, but surgical treatment ought to be considered if the conservative management is unsuccessful.

      Release date:2016-10-02 04:56 Export PDF Favorites Scan
    • 高頻振蕩通氣成功救治腺病毒感染致小兒嚴重急性呼吸窘迫綜合征合并氣漏一例

      目的探討高頻振蕩通氣(HFOV)在小兒重度急性呼吸窘迫綜合征(ARDS)合并氣漏中的應用價值及安全性。 方法結合1例腺病毒感染致重度ARDS合并大量氣胸患兒的臨床資料及國內外相關文獻, 評價早期HFOV在兒童重度ARDS綜合治療中的價值。 結果患兒機械通氣前動脈血PaO2/FiO2為41 mm Hg, 氧合指數(OI)為35, 動脈血PaCO2為72 mm Hg, SaO2為10%。放置胸腔引流管, 約2 h換用HFOV, 在咪達唑侖、芬太尼基礎上加用維庫溴銨以保證人機的協調性。患兒氣漏逐漸穩定吸收, PaO2/FiO2逐日升高, OI逐日下降, PaCO2維持在50~60 mm Hg。開始運用HFOV時患兒心率增快, 血壓進行性下降, 經生理鹽水、白蛋白擴容以及去甲腎上腺素、多巴胺升壓后穩定。共使用HFOV治療7 d, 常規頻率機械通氣2 d, 住院10 d后轉出兒科重癥監護室, 一共住院3周, 痊愈出院。 結論早期應用HFOV對改善大量氣漏的重度ARDS患兒的通氣和氧合有益, 但HFOV對血流動力學有影響。

      Release date:2016-10-02 04:55 Export PDF Favorites Scan
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