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冠状动脉旁路移植术中乳内动脉损伤类型与处理
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作者 陈密 黄方炯 《心肺血管病杂志》 2018年第10期919-922,共4页
目的:回顾性分析冠状动脉旁路移植术(CABG)中,乳内动脉损伤的情况以及相应的应对措施。方法:自1997年7月至2017年4月,共实施了10 360例包含乳内动脉取材的CABG术,其中发生286例乳内动脉损伤;损伤后改用大隐静脉旁路移植145例(50.7%)、... 目的:回顾性分析冠状动脉旁路移植术(CABG)中,乳内动脉损伤的情况以及相应的应对措施。方法:自1997年7月至2017年4月,共实施了10 360例包含乳内动脉取材的CABG术,其中发生286例乳内动脉损伤;损伤后改用大隐静脉旁路移植145例(50.7%)、行损伤乳内动脉游离移植104例(36.4%)以及其他方法37例,记录和分析围术期的不良事件及死亡情况。结果:常见的乳内动脉损伤病理分型包括:内膜撕裂188例(65.7%)、夹层86例(30.0%)等。按操作失误分类,其中电刀伤183例(64.0%),牵拉伤86例(30.1%)等。围术期死亡1例、围术期心肌梗死1例、术中心室颤动2例、围术期脑梗死2例、行IABP辅助2例,术中由微创小切口转胸骨正中切口1例。结论:乳内动脉损伤在CABG术中有一定的发生率。对于不同病理分型以及不同部位的乳内动脉损伤,可以采用不同的应对方法。改用大隐静脉旁路移植、游离移植损伤的乳内动脉等13种方法,可作为CABG术中乳内动脉损伤的应对措施。 展开更多
关键词 冠状动脉旁路移植术 乳内动脉损伤 游离移植
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Assessment of internal mammary artery injury after blunt chest trauma: a literature review
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作者 Jin-ming CHEN Jin LV +1 位作者 Kai MA Jing YAN 《Journal of Zhejiang University-Science B(Biomedicine & Biotechnology)》 SCIE CAS CSCD 2014年第10期864-869,共6页
The occurrence, bleeding, and treatment of internal mammary artery(IMA) injury after blunt chest trauma have not been well described in the literature. We reviewed articles published from July 1977 to February 2014 ... The occurrence, bleeding, and treatment of internal mammary artery(IMA) injury after blunt chest trauma have not been well described in the literature. We reviewed articles published from July 1977 to February 2014 describing IMA injury after blunt chest trauma in 49 patients. There was a predominant incidence in males and on the left side. Blunt trauma to the IMA can cause anterior mediastinal hematoma, hemothorax, pseudoaneurysm, arteriovenous fistula, and extra-pleural hematoma. Of the 49 patients studied, 20 underwent embolization, 22 underwent surgical operation, 4 were managed by clinical observation, and 3 had undescribed treatment. Different parts and extents of IMA injury, adjacent vein injury, as well as the integrity of the pleura determined differences in bleeding modality. Prompt diagnosis, complete hemostasis, aggressive resuscitation, and multidisciplinary teams are recommended for patients with IMA injury. 展开更多
关键词 Internal mammary artery injury Blunt chest trauma BLEEDING TREATMENT
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