心包的

Objective To discuss the cause,clinical characteristics,management,early diagnosis and pro-phylaxis of pericardial tamponade after open-heart surgery.

目的 探讨心内直视术后心包填塞的原因、临床表现、早期诊治方法和预防。

Methods Thoracopagus twins were admitted for evaluating possible separation and repair before surgery.X-rays, CT, MRI and ultrasound scan of torso showed separated and normal gastrointestinal, biliary tracts and heart,conjoined pleura,conjoined pericardium,connected diaphragm and liver parenchyma.

术前经 X 线、CT、MRI 和 B 超等检查确诊，该联体儿肝脏相连、膈肌相连，胸膜紧贴、心包紧贴，有2个完全独立的心脏，两副消化道和胆管。

After pericardial effusion,the diastolic pressure of right ventricle and pulmonary vein pres-sure pulsated with intrathoracic pressure;the pressure of carotid vein and femoral vein were still stable.

颈内静脉及股静脉压较稳定，波动幅度较小，分别为0.06kPa和-0.06kPa；心包填塞后，胸内压呼吸性波动加大，左右心室舒张压、肺静脉压的波动幅度随之加大，但颈静脉压及股静脉压仍较稳定。

The surface of the heart with hemorrhagic pericarditis demonstrates a roughened and red appearance.

出血性心包炎的心脏表面呈红色粗糙状。

We successfully separated the connected liver parenchyma,sternums and the most inferior two pairs of the ribs, conjoined pleura,conjoined pericardium.

结果 术中见腹腔中有各自的消化道，共肝断面积 5cm ×6cm，胸腔中2个心包紧贴，2个胸膜紧贴，胸骨下段及 4~8 肋相连，均予完全分开。

Results They had normal separated gastrointestinal.The connected liver area were 5cm× 6cm.We successfully separated the connected liver parenchyma,sternums and the most inferior two pairs of the ribs, conjoined pleura,conjoined pericardium.

结果 术中见腹腔中有各自的消化道，共肝断面积 5cm ×6cm，胸腔中2个心包紧贴，2个胸膜紧贴，胸骨下段及 4～8 肋相连，均予完全分开。

The findings on physical examination included atrial fibrillation, a diffuse anterior chest heave and friction rub, and severe right heart failure.

在20出头时初次被诊断为三尖瓣下移，入院三年前患者拒绝了心脏移植手术，入院后检查发现房颤、弥散性心前区搏动和心包摩擦音，以及严重的右心衰竭。

The special screw is manufactured with the molding method and non-instantaneous envelope method on the numerical control millers generally.

异形螺杆的加工一般采用成型法及无瞬心包络铣削方法在专用数控铣床上进行。

The 4th left rib was cut and a model of left coronary artery occlusion/release was carried outo Rats were divided randomly into 4 groups: control group without LCA occlusion (group A, n=6);I/R group(group B, n=6); ketamine(5mg.kg-1)+I/R group (group C, n=6); ketamine(10mg.kg-1)+I/R group(group D,n=6)o All rats in groups B, C , D were subjected to 30 minutes of LCA occlusion followed by 120minutes of reperfusion. Rats in group C and D were injected with 5mg.kg-1 and 10mg.kg-1 of ketamine before reperfusion, respectively. Significant electrocardiogram and color changes at the area at risk were considered indicative of successful coronary occlusion and reperfusionc Serum was exampled from left jugular vein at 30 minutes and 120 minutes during reperfusion to measure IL-6 and TNF- level by ELISA measurements. After reperfusion of 120 minutes, the heart was removed and the cardiac apex was exampled with snap-frozen in liquid nitrogen and stored at -70 C .

采用左冠状动脉前降支结扎开放建立心肌缺血／再灌注模型，健康SD大鼠24只，随机分为心包打开假手术组(A组，n=6)，缺血／再灌注对照组(B组，n=6)，5 mg·kg~(-1)氯胺酮+缺血／再灌注组C组，n=6，缺血30min后右腹股静脉注入5 mg·kg~(-1氯胺酮，10mg·kg~(-1)KTM+I／R组D组，n=6，缺血30min后右腹股静脉注入10 mg·kg~(-1氯胺酮。10％水合氯醛40 mg·kg~(-1)腹腔注射麻醉，气管切开，连接多功能监护仪记录心电图；小动物呼吸机人工呼吸，呼吸频率60次／分，潮气量2ml／100g，于左胸第四肋间打开胸腔暴露心脏，在左心耳下1mm左冠状动脉处，用丝线，眼科外用不锈钢小圆针穿过心肌浅层，稳定10min后将U型含有铜丝的胶管置于冠状动脉表面一起结扎(A组不结扎，B、C、D组结扎)；结扎开始左心室心尖部即由红色变暗，30 min后呈暗红色，心电图中出现S-T段抬高，说明缺血形成。

Suffering from low blood pressure caused by cardiovascular disease, such as chronic pericardial effusion, severe mitral stenosis.

患有心血管疾病导致的低血压，如慢性心包积液、严重二尖瓣狭窄。

Do you know, i need you to come back

你知道吗，我需要你回来

Yang yinshu、Wang xiangsheng、Li decang,The first discovery of haemaphysalis conicinna.

1〕 杨银书，王祥生，李德昌。安徽省首次发现嗜群血蜱。