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顺行与逆行性脑灌注对主动脉弓置换术患者脑保护的比较 被引量:5
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作者 李欣 杨珏 +3 位作者 于长江 孙图成 范小平 范瑞新 《岭南心血管病杂志》 2019年第6期665-671,共7页
目的比较主动脉夹层患者在主动脉弓部置换术中使用两种脑灌注方式下脑保护的效果,优化主动脉弓部手术脑保护策略。方法回顾性分析2017年9月至2018年12月在广东省人民医院行顺行性脑灌注(37例)和逆行性脑灌注(24例)主动脉弓部替换手术患... 目的比较主动脉夹层患者在主动脉弓部置换术中使用两种脑灌注方式下脑保护的效果,优化主动脉弓部手术脑保护策略。方法回顾性分析2017年9月至2018年12月在广东省人民医院行顺行性脑灌注(37例)和逆行性脑灌注(24例)主动脉弓部替换手术患者的临床资料,结合脑氧饱和度监测和脑损伤标记物检测,比较两组患者资料的差异。结果主动脉弓部置换术后患者顺灌组和逆灌组发生暂时性神经功能障碍分别为7、1例,永久性脑损伤各1例,两组死亡分别为2、3例。顺行性脑灌注组和逆行性脑灌注组患者除近红外线光谱脑氧饱和度监测数据,其他观测指标比较,均无统计学意义(P>0.05)。结论顺行性脑灌注与逆行性脑灌注在深低温停循环主动脉弓置换术患者中对脑保护具有相近的效果。 展开更多
关键词 主动脉弓部置换 脑保护 灌注方式 脑损伤标记物 近红外线光谱 脑氧饱和度
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双侧颈动脉前向灌注在急性A型主动脉夹层合并单侧颈总动脉闭塞外科治疗中的应用 被引量:3
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作者 洪亮 庄建 +5 位作者 范瑞新 孙图成 曲艳吉 陈泽锐 王超杰 范小平 《岭南心血管病杂志》 2019年第6期672-677,共6页
目的在急性Stanford A型(A型)主动脉夹层合并单侧颈动脉闭塞患者手术治疗中,通过改进传统手术、体外循环插管等方式,实施患者术中双侧颈动脉前向血流灌注、行闭塞侧颈动脉人工血管置换,以探索减少此类高危患者神经系统并发症的有效措施... 目的在急性Stanford A型(A型)主动脉夹层合并单侧颈动脉闭塞患者手术治疗中,通过改进传统手术、体外循环插管等方式,实施患者术中双侧颈动脉前向血流灌注、行闭塞侧颈动脉人工血管置换,以探索减少此类高危患者神经系统并发症的有效措施。方法本队列回顾性分析2017年9月至2019年2月,于广东省人民医院同期行主动脉夹层矫治以及颈动脉人工血管置换的5例急性A型主动脉夹层合并单侧颈动脉闭塞患者的临床资料。本组患者均行Bentall或Wheat合并主动脉弓部血管岛状吻合、术中降主动脉直接植入、患侧颈总动脉灌注及人工血管置换术(两例为右、三例为左侧颈总动脉闭塞),体外循环均行右腋动脉、股动脉、病变闭塞侧颈总动脉远端(近端颈总动脉结扎、远端颈总动脉与人工血管端-端吻合后直接与体外循环一分支动脉灌注)插管,后行患侧颈总动脉人工血管近端与升主动脉人工血管吻合完成主动脉-患侧颈总动脉血运重建;术中持续行双侧脑灌注,降主动脉支架植入过程暂停经股动脉血流灌注,待支架释放、固定后于人工支架内植入隔离球囊恢复全身循环。分析此5例A型主动脉夹层合并单侧颈动脉闭塞的患者基本资料及临床数据。结果5例患者中4例为男性,年龄(52±12.4)岁,体质量(65.9±11.9)kg,发病至手术时间(9.6±7.1)d,体外循环时间(262.6±37.3)min,主动脉阻断时间(148.2±27.1)min,下半身停循环时间(19.2±10.2)min,术后呼吸机使用时间(82±56.1)h,术后重症监护病房停留时间(8.4±4.0)d,术后住院时间(不包括重症监护病房停留时间)(22.6±10.3)d;术后随访时间(17.6±7.4)个月。患者经计算机断层扫描复查显示血运重建良好,无神经系统及其他主要并发症发生。结论急性A型夹层合并单侧颈动脉闭塞患者外科治疗风险、神经系统并发症发生率高,经过早期针对闭塞颈总动脉行双侧脑灌注的体外循环和手术策略的改进,可以使神经系统并发症发生率降低,手术效果得到提高,是针对此类患者安全有效的外科干预策略。 展开更多
关键词 主动脉夹层 颈总动脉闭塞 双侧脑灌注保护 颈动脉置换
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诱导性多能干细胞在心血管领域的研究进展 被引量:1
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作者 陈尘 麦明杰 +2 位作者 孙图成 赵明一 朱平 《岭南心血管病杂志》 CAS 2021年第4期508-512,共5页
随着生活和医疗水平的提升,每年心血管疾病的病死率不降提升,随着干细胞生物学和再生医学的发展,诱导性多能干细胞技术也迅速发展起来,其衍生产品应用到临床越来越多的领域。本文综述了诱导性干细胞的背景,制备诱导性多能干细胞的方法... 随着生活和医疗水平的提升,每年心血管疾病的病死率不降提升,随着干细胞生物学和再生医学的发展,诱导性多能干细胞技术也迅速发展起来,其衍生产品应用到临床越来越多的领域。本文综述了诱导性干细胞的背景,制备诱导性多能干细胞的方法、安全性、有效性以及制备过程中遇到的问题和挑战。 展开更多
关键词 心血管疾病 诱导性多能干细胞 疾病建模 药物发现 干细胞治疗
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Advances in classification of aortic dissection
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作者 刘杰 吴进林 +5 位作者 梁志超 柯俊 胡皓昀 赵爽 孙图成 陈泽锐 《South China Journal of Cardiology》 CAS 2023年第2期99-109,共11页
Background Aortic dissection remains one of the most acute and critical diseases in cardiac surgery,with high mortality and disability rates.In the 1960s,DeBakeyfirst proposed the classification of aortic dissection.S... Background Aortic dissection remains one of the most acute and critical diseases in cardiac surgery,with high mortality and disability rates.In the 1960s,DeBakeyfirst proposed the classification of aortic dissection.Subsequently,various classifications of aortic dissection have been proposed.To facilitate clinicians and medical staff involved in the treatment of aortic dissection to make better assessment of the condition of aortic dissection patients and to make reasonable clinical decisions,we reviewed several current mainstream classification schemes.We hope that this paper inspires other researchers to propose a new,more suitable classification scheme for use in the clinical setting. 展开更多
关键词 Aortic dissection CLASSIFICATION Connective tissue disease Inflammatory immunity Oxidative stress
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Perioperative nursing of multidisciplinary emergency surgery for a late-term pregnancy with acute Stanford type A aortic dissection
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作者 SONG Hai-juan XIE Qing +6 位作者 CHEN Xiao-xia ZHU Ping GUO Hai-jiang LIU Xiao-min LU Chang-qing ZHUANG Jian sun tu-cheng 《South China Journal of Cardiology》 CAS 2022年第3期236-239,243,共5页
To summarize a case of late pregnancy complicated with acute Stanford type A aortic dissection who underwent multidisciplinary treatment perioperative nursing experience in emergency surgery. The patient was 37weeks o... To summarize a case of late pregnancy complicated with acute Stanford type A aortic dissection who underwent multidisciplinary treatment perioperative nursing experience in emergency surgery. The patient was 37weeks of intrauterine pregnancy and suffered from sudden chest pain. The emergency admission was diagnosed with aortic dissection(Stanford A type), and the condition was dangerous and life-threatening. After preoperative multidisciplinary combined systematic comprehensive disease assessment and comprehensive surgical emergency plan was formulated, do a good job of effective psychological counseling and operation cooperation education,nursing cooperation during intraoperative anesthesia and nursing focus of multidisciplinary combined surgical treatment, postoperative prevention of massive bleeding, puerperium infection and a series of effective nursing measures, no perioperative period occurred nursing complications. The newborn survived, the patient recovered and was discharged from the hospital, and returned to the hospital for re-examination with normal indicators and good physical condition. 展开更多
关键词 Late pregnancy Stanford type A aortic dissection Multidisciplinary combination Perioperative care
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Perioperative care for patient with end-stage heart disease combined with type A aortic dissection: A case report
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作者 XU Xiao-feng CHENG Yun-qing +6 位作者 KUANG Jun-tao XIE Xue-jun HUANG Jing-song WU Yan-fen LAN Xue-ying FAN Rui-xin sun tu-cheng 《South China Journal of Cardiology》 CAS 2021年第3期203-209,共7页
INTRODUCTION End-stage heart disease is the late stage of heart disease caused by a variety of reasons.It refers to the developmental stage of heart disease in which the patient has progressive structural heart diseas... INTRODUCTION End-stage heart disease is the late stage of heart disease caused by a variety of reasons.It refers to the developmental stage of heart disease in which the patient has progressive structural heart disease,despite active medical treatment.Patient with this disease still has symptoms at rest,and requires special intervention. 展开更多
关键词 PATIENT DISSECTION HEART
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