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    find Author "李德才" 3 results
    • 供者脾細胞和環磷酰胺聯合預處理對移植心臟存活的作用

      目的 誘導同種異體心臟移植的免疫耐受,為心臟移植的抗排斥反應治療提供依據.方法 采用供者脾細胞和環磷酰胺聯合預處理受者,誘導受者對移植心臟的免疫耐受,然后行大鼠頸部心臟移植術.將實驗動物分成5組.對照組:受者不作任何預處理;組1:預處理第2天用環磷酰胺50~80mg/kg預處理受者;組2:預處理當天用供者5~10×107個脾細胞預處理受者;組3:受者不作任何預處理,手術當天開始用環孢菌素A 10mg/kg,每2天1次,共8~10次,腹腔內注入;組4:預處理當天用供者脾細胞5~10×107個和第2天環磷酰胺50~80mg/kg聯合預處理受者.結果 各組移植心臟的存活時間明顯不同,5組移植心臟的存活時間差異有顯著性(Plt;0.01).供者脾細胞和環磷酰胺預處理受者的移植心臟存活時間明顯延長.結論 供者脾細胞和環磷酰胺聯合預處理,可誘導受者對移植心臟的免疫耐受.

      Release date:2016-08-30 06:35 Export PDF Favorites Scan
    • Cone Reconstruction for Tricuspid Valve in 19 Patients with Ebstein's Anomaly: A Clinical Analysis

      Objective We sought to review our experience of cone reconstruction for tricuspid valve repair and to evaluate this therapeutic approach for patients with Ebstein's anomaly, to report early clinical outcomes. Method We retrospectively analyzed the clinical data of 19 consecutive patients underwent cone reconstruction technique in our hospital between December 2011 and June 2014 year. There were 8 males and 11 females at mean age 24 years(ranged from 3 months to 53 years). Six patients were diagnosed by electrocardiography or electrophysiology examination, including 4 patients with B type Wolff-Parkinson-White syndrome and atrial fibrillation, 2 patients with paroxysmal supraventricular tachycardia. Results There was one patient of severe cyanosis hospital death for low cardiac output syndrome depending on cardiopulmonary bypass. The remaining patients were recovered smoothly. Atrial fibrillation associated with frequent ventricular premature, restoration of sinus rhythm with lidocaine and amiodarone occurred in one patient. Early postoperative echocardiograms showed good ventricular morphology and reduction in tricuspid regurgitation (TR) grade. Eleven patients were with mild regurgitation and 7 patients without or with trace amounts of regurgitation. All patients were followed up for 5-30 months. And postoperative cardiac function recovered to gradeⅠin 10 patients and gradeⅡ in 8 patients. None of patients needed re-operation. Conclusions The cone reconstruction technique shows low in-hospital mortality and complication rate, reducing TR, restoring right ventricular function, allowing reverse remodeling of the heart. Early postoperative follow-up shows improvement in patients' clinical outcome and low incidence of re-operation.

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    • 心上聯合徑路治療嬰幼兒心上型完全性肺靜脈異位引流 47 例

      目的總結嬰幼兒心上型完全性肺靜脈異位引流的早期診斷和應用心上聯合徑路手術治療經驗。方法2011 年 9 月至 2017 年 9 月,我院共完成 47 例嬰幼兒心上型完全性肺靜脈異位引流的手術治療,其中男 34 例、女 13 例,年齡 3 d~1 歲,平均年齡(3.5±2.6)個月,平均體質量 2.7~8.0(4.9±1.2)kg。患者均由超聲心動圖確診。所有患者均在全身麻醉中度低溫體外循環下行矯治術,均采用左心房頂部切口,心上聯合徑路行手術治療。結果全組手術順利,術后死亡 2 例,圍手術期死亡率 4.3%。隨訪 45 例,隨訪時間 6 個月~6 年,隨訪期均行心電圖、心臟超聲、胸部 X 線片檢查。所有患兒心電圖示竇性節律,心影較術前明顯縮小,肺充血消失,心功能明顯好轉,吻合口血流速度正常。結論嬰幼兒心上型完全性肺靜脈異位引流病情危重,早期診斷、心上聯合徑路手術效果良好。手術成功的關鍵在于吻合口足夠大,充分利用左心耳擴大吻合口,避免術后肺靜脈回流梗阻。

      Release date:2019-03-01 05:23 Export PDF Favorites Scan
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  • 松坂南