Zhonghua wai ke za zhi [Chinese journal of surgery]
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Zhonghua Wai Ke Za Zhi · Mar 1991
[Hypoxaemia during transportation of patients after anesthesia and upper abdomen surgery].
The incidence of hypoxaemia was studied in 100 patients breathing room air during their transportation from the operating room to the recovery room. Hypoxaemia (SaO2 less than 90%) occurred in 24 (24%) patients. ⋯ The causes of hypoxaemia are discussed. Quick transportation and oxygen supply were recommended.
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Zhonghua Wai Ke Za Zhi · Mar 1991
[Effects of fasting and infusion of acid-base balance, electrolyte and plasma glucose level in children during operation].
We studied the effects of fasting and infusion different fluid on acid-base balance, electrolyte and plasma glucose level in 50 children during operation. After whole night fasting, 26 of 44 children (59.1%) were found to have metabolic acidosis, and 5 of 42 children (11.9%) have hypokalemia. The serum K+ level of 30 of 42 children (71.4%) and the serum Na+ level of 6 of 48 children (12.5%) were lower than normal. ⋯ The effects of infusing deferent fluids on acid-base balance, electrolytes and plasma glucose level were compared. The results showed that in patients infusing 10% dextrose with Ringer's solution or 5% Dextrose with normal saline, the plasma glucose level, electrolytes maintained at the normal level or acidosis corrected significantly. It is suggested that 10% dextrose with Ringer's solution and 5% dextrose with normal saline are infused during operation for children.
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Zhonghua Wai Ke Za Zhi · Mar 1991
[Internal fixation of fractured ribs with Kirschner wires for serious traumatic chest instability].
Internal fixation of fractured ribs with kirschner wires was done in 14 patients with serious traumatic chest wall instability. Four of these patients had fracture of prothorax ribs, and 10 fracture of lateral thorax ribs. ⋯ It is an ideal treatment for serious traumatic chest wall instability. In this paper, operative opportunity, indication and the main technical points of surgery are discussed.
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8 patients with postoperative chylothorax were reported: 7 after resection of esophageal carcinoma, 1 after radical correction of tetralogy of Fallot. 1 case was treated conservatively and 7 by ligation of thoracic duct after rethoracotomy. All the cases recovered. The factors causing postoperative chylothorax, the principles of treatment, and the role of prophylactic ligation of thoracic duct were discussed. The authors point out that, the mechanisms of postoperative chylothorax after open heart surgery by sternotomy may be: (1) injury of perithymotic and anterior mediastinal lymph ducts; (2) injury of thoracic duct through posterior wall of pericardium; and (3) effect of hypertension of systemic veins on flow of thoracic duct.
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From January 1954 to December 1987, 42 cases with open thoracoabdominal injuries were surgically treated. The causes of trauma were gun shot in 11, stabbing in 28, and buffalo horn injury in 3 cases. 24 cases were complicated with shock and 29 cases had more than two thoracoabdominal organs injured. 3 patients died postoperatively, an operative mortality rate of 7.1%. The authors discussed the problems of nomenclature, diagnosis and treatment and emphasized that: (1) open wound with thoracic and abdominal cavities and diaphragm involved simultaneously should be called open thoraco-abdominal injury; (2) surgical treatment is often delayed if diagnosis depends solely on X-ray examination; (3) operative approach should be carefully selected according to circumstances.