Zhonghua wai ke za zhi [Chinese journal of surgery]
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Zhonghua Wai Ke Za Zhi · Aug 1997
[Diagnosis and surgical management of 22 patients with congenital coronary artery fistula].
Twenty-two patients underwent surgical treatment of coronary artery fistulas. The right coronary artery was the most common vessel of origin (68.2%), and the most frequent drainage site was the right ventricle (45.4%). ⋯ The absence of operative mortality and severe postoperative complication provide clear indications for surgical treatment. In view of currently improved and standardized techniques of extracorporeal circulation, we believe that it should be employed routinely.
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Zhonghua Wai Ke Za Zhi · Jul 1997
Clinical Trial Controlled Clinical Trial[Quantitative electroencephalogram monitoring the depth of anesthesia during skin incision].
We investigated the EEG parameter changes of skin incision during different depth of sevoflurane/nitrous oxide analgesia. 65 ASA physical status I patients (aged 34 +/- 12 yr) scheduled for elective abdominal surgery were studied. The tracheal of each patient was intubated and the lungs were ventilated. Patients were randomly assigned to one of three groups. ⋯ There were no difference of hemodynamics among the three groups. Patients who moved at incision also had significantly higher SEF, BIS leveles compared to non-movers (P < 0.01). Quantitative EEG determinants were correlated well with the end-tidal sevoflurane concentration and were a useful predictor of patient movement in response to skin incision during sevoflurane/nitrous oxide anesthesia.
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Zhonghua Wai Ke Za Zhi · Jul 1997
[Clinical study of systemic inflammatory response syndrome and multiple organ dysfunction syndrome in critically patients].
We defined the epidemiology of systemic inflammatory response syndrome (SIRS) and multiple organ dysfunction syndrome (MODS) in critically ill patients, and evaluated the procession from SIRS to MODS and the therapeutic strategies. 230 patients were studied prospectively until discharge or death. On admission, the morbidity rate of SIRS was 71.3%. ⋯ In SIRS patients with non-infectious SIRS, sepsis and septic shock, the morbidity rates of MODS were 22.8%, 61.1% and 85.7%, and the mortality rates were 11.4%, 30.6% and 50.0% respectively. The outcome of critically ill patients may be improved if SIRS is early diagnosed and the body inflammatory response is reglulated properly.
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In 80 patients with thoracic aortic aneurysm were treated in our hospital, 62 were males and 18 females. Their age ranged from 20 to 73 years. The aneurysm lesions involved ascending aorta in 45 patients (Marfan's syndrome), aortic isthmus segment in 3, descending aortic aneurysm in 26, and thoraco-abdominal aneurysm in 3. ⋯ In this series of patients, Marfan's syndrome and dissecting aneurysm were the predominant pathological lesion. Since acute rupture of dissecting aneurysm is the main cause of death, surgical treatment should be immediate after the diagnosis is established. In the chronic dissecting aneurysm, early surgical treatment also should be considered.
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Fifty-two patients entered ICU after heart operation with cardiopulmonary bypass. These patients with ventilation atracurium (ATC) were given 3 micrograms-6 micrograms/kg/min for 5-48 hours. No complications happened. ⋯ The time of effect is short and there is no cumulation effect. There is no vagal or ganglionic blocking activity, so ATC does not influence circulation and myocardial function. Maintenance relaxation keeps ventilation steady and oxygen supply normal.