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The direct signs of Pulmonary embolism were luminal constriction,emphraxis,branched decreased,intraluminal lowD filling defect of blood vessel;while the indirect signs,formation of pulmonary infarction focus,pleural effusion,pneumonia,atelectasis,pulmonary dilatation and hydropericardium,etc.

肺栓塞的直接征象为管腔狭窄、阻塞、分支减少及血管腔内的低密度充盈缺损,间接征象为肺梗死灶形成、胸腔积液、肺炎、肺不张、肺动脉增宽、心包积液等。

At catheterization, all patients had elevated intrapericardial pressure (median, 12 mm Hg; interquartile range, 7 to 18) and elevated right atrial and end-diastolic right and left ventricular pressures.

在进行导管插管时,所有病人的心包内压都升高(中位数为 12mmHg,四分位数间距为 7~18mmHg),右房压以及左室和右室舒张期末压也都升高。

This paper included: the pathogenesis and resuscitation of commotio eordis ; traumatic pericardial rupture associated with heart luxation and/or diaphragmatocele in pericardial cavity; indication selection of emergency room thoracotomy for severe heart injury and traumatic aortic disruption treated with endovascular stent graft.

本文概括了心脏震荡伤发病机制与急救,钝性心包破裂合并心脏疝和/或心包内隔疝的诊断和治疗,严重心脏伤急诊室开胸术适应证的选择和外伤性胸主动脉破裂等介入性腔内支架血管植入术等内容。

Methods To review and analyze the clinical data of 42 cases of the intrapericardial total pneumonectomy.

回顾性分析42例经心包内全肺切除术患者的临床资料。

To summarize the experience of surgical resection of intra-pericardial pneumonectomy of lung cancer at the middle or late stage.

目的 总结171例心包内处理肺血管全肺切除治疗中晚期肺癌的外科手术经验。

Objective To explore the surgical procedure,postoperative respiration,blood gas analysis and heart function changes relevant to intrapericardial total pneumonectomy.Methods To review and analyze the clinical data of 42 cases of the intrapericardial total pneumonectomy.

目的 探讨经心包内处理肺血管全肺切除术的手术操作、术后呼吸、血气及心功能的变化方法回顾性分析42例经心包内全肺切除术患者的临床资料。

Objective To discuss the indication and op erating technique of intrapericardial pneumonectomy,the repair of pericardial d efect,prevention of cardiac herniation and the postoperative arrhythmia.

目的 探讨心包内全肺切除术的适应证,手术技术,心包缺损修补和心脏疝预防,术后心律失常的处理等问题。

Cardiac index and intrapericardial, left ventricular end-diastolic, right atrial, and right ventricular end-diastolic pressures were measured during basal state, after fluid overload, and after pericardiocentesis. Twenty-eight patients (57%) had physical signs of tamponade, and 10 (20%) were hypotensive.

分别于基础状态、容量负荷后和心包穿刺后测量心指数、心包内压、左室舒张末期压、右房压和右室舒张末期压。28例患者(57%)有心包填塞的体征,10例(20%)有低血压。

Intrapericardial pneumonectomy was decided in operation;to repair pericardial defect in operation can prevent cardiac herniation;continue EKG was necessary wi thin one week after operation.

结论术 中探查才能决定是否行心包内全肺切除术;术中妥善修补心包可预防心脏疝;术后1周内心电监护是必要的。

Later, under the untypical parasternal four-chamber view which can thoroughly display the ostium of coronary sinus, the catheter was promoted further to the ostium of coronary venous sinus. Then the echocardiography technician adjusted the transducer of TTE in order to thoroughly confirm the position of the catheter tip. After confirming the position of catheter tip in the coronary venous sinus, the operator inserted the catheter into the coronary venous sinus for 3~4 mm farther. It was noted that if resistance was encountered by operator, the operation must be stopped, which was the same as x-ray fluroscopy as image guiding. TTE guiding His bundle elactric cahteter、high right atrium electric cahteter and right ventricular electric catheter in site: It is difficult using TTE singly since there are too many crossroads in inferior venous.

本研究结果显示,(1)单独应用TTE作为影像学引导进行冠状窦电极导管置放的成功率为93.8%~96.7%,并且应用TTE作为影像学引导放置专用冠状窦电极导管和普通电极导管的成功率和放置时间在统计学上无显著差异;(2)TTE作为影像学引导,除过度肥胖患者外,可完全替代X线引导进行冠状窦电极导管置放,包括鞘管和扩张管的放置、指引导丝在静脉而非动脉内的证实均可由TTE完成引导,且较X线C型臂有一定优越性;(3)TTE结合普通X线胃肠透视机作为影像学导引,可顺利完成心内电生理检查时导管的安全到位,而不需昂贵的X线C型臂,可将心内电生理检查扩大到广大的基层医院;(4)TTE较X线更易和更早期发现介入治疗的并发症如急性心包填塞等,对并发症的防治甚至挽救病人的生命至为重要;(5)动物实验研究表明,TEE可引导射频导管消融术时大头电极导管成功到位。

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