心脏介入术中并发急性心脏压塞的观察与护理

对介入术中并发急性心脏压塞的9例患者通过严密观察，及时进行急救处理。结果均抢救成功，病情得到满意控制。提示在心脏介入术中，全面协助医生早期诊断，积极加强术前、术中及术后护理干预是急性心脏压塞抢救成功的关键。     

心脏介入治疗并发急性心脏压塞的抢救及护理配合

总结心脏介入术中并发急性心脏压塞患者的抢救和护理.认为做好术前、术中和术后常规护理的同时,需做好抢救准备,一旦出现心脏压塞应立即配合医生进行心包穿刺的紧急处理.经积极抢救和护理,8例心脏压塞患者均康复出院.     

心脏介入治疗并发急性心脏压塞的抢救及护理配合

总结心脏介入术中并发急性心脏压塞患者的抢救和护理。认为做好术前、术中和术后常规护理的同时，需做好抢救准备，一旦出现心脏压塞应立即配合医生进行心包穿刺的紧急处理。经积极抢救和护理，8例心脏压塞患者均康复出院。     

心脏术后并发急性心脏压塞10例的观察及护理

本文报道了我所２年内抢救的１０例心脏术后并发急性心脏压塞，探讨了发病原因、临床观察、鉴别要点及护理体会，对以血压逐渐下降为临床特征的急性心脏压塞病例，应进行血压、心率、呼吸的持续动态监测；严密观察胸腔引流液的性质、量和颜色；并阐述了ＣＶＰ监测在观察急性心脏压塞中的重要作用及注意观察中可能出现的假象。     

心脏介入治疗后心脏压塞的急诊抢救手术

心脏压塞是心脏介入治疗后的严重并发症之一,部分患者需要紧急开胸手术抢救.2007年11月至2011年4月急诊手术抢救14例心脏介入治疗后心脏压塞患者的临床资料,现报道如下. 资料和方法 14例中男11例,女3例;年龄48～ 85岁,平均(65.6±10.1)岁.全组临床资料见表1.原发疾病为心律失常者2例,其中阵发性房颤和预激综合征者各1例,均为在接受射频消融过程中发生心脏破裂、心脏压塞;冠心病患者12例,其中1例合并房颤,余11例接受经皮冠状动脉介入治疗(PCI)并置入冠状动脉支架中9例发生心脏压塞,术后拔除临时起搏导线后发生心脏压塞(病例1、病例14)2例.     

心脏大血管损伤并急性心包压塞5例分析

目的 探讨心脏大血管损伤并急性心包压塞的救治。方法 对5例心脏大血管损伤并急性心包压塞的患者进行临床分析。结果 5例患者中4例痊愈出院,1例死亡。结论 对心脏大血管损伤并急性心包压塞的患者,尽早手术探查止血,清除心包内的积血、凝血块,解除心脏压迫,是最有效的抢救手段。     

7例心脏外伤急救体会

目的:探讨心脏外伤的急救要点.方法:分析7例心脏外伤病人在急诊科救治的临床资料.结果:抢救成功6例,死亡1例.结论:快速正确诊断、及时解除心脏压塞地、迅速将病人送达手术宣,是急诊科成功抢救心脏外伤的关键.     

心脏大血管损伤并急性心包压塞的外科治疗（附15例报告）

目的心脏大血管损伤并急性心包压塞的救治体会。方法通过对15例心脏大血管损伤并急性心包压塞患者的救治体会,描述抢救过程及方法。结果术中发现右心室贯通伤2例,左心室心肌裂伤5例,右心室心肌刺裂伤5例,主动脉弓穿透破裂1例,纵隔心包内钢钎异物存留1例,单纯心包破裂1例,8例合并有肺裂伤。心肌破裂口在0.3cm～1.5cm13例,2.5cm1例,1例主动脉破裂口约0.6cm。15例中14例治愈出院,1例右心室心脏贯通伤患者死于术中失血性休克。结论对心脏大血管损伤并急性心包压塞的患者,尽早手术探查止血,清除心包内的积血、凝血块、解除心脏压迫,是最有效的抢救手段。     

36例心脏直视手术后心脏压塞

３６例心脏直视手术后心脏压塞阎玉生，龙国粹，李中学，李斌，童健心脏压塞是体外循环心脏直视手术后严重并发症之一，发生率为１．２％～３．４％［１］。１９８３年１月～１９９３年７月，我们共行体外循环心内直视手术５７５例，术后发生急性心脏压塞２９例，占５．０...     

心脏术后早期心搏骤停的原因分析和救治体会

目的 探讨心脏术后早期心搏骤停的原因和救治成功率。方法 回顾性调查心脏手术后第1个24h内发生心搏骤停的病历24份，对其发生的原因和救治结果进行分析。结果 术后发生心搏骤停的病例以风湿性心瓣膜病居多(58．3％)，冠心病次之(20．8％)。导致心搏骤停的原因有低心排综合征11例、电解质紊乱7例、心脏压塞3例、出血2例、不明原因1例。主要抢救措施包括心脏按压、人工呼吸、心血管兴奋药物应用、电击除颤、床边开胸和心肺复苏后综合治疗。抢救后心脏复跳18例，占75％；心肺脑复苏成功并治愈出院15例，占62．5％。结论 风湿性心脏病和冠心病术后发生心搏骤停的比率较高，应重视图术期治疗；致使心搏骤停的原因主要与低心排综合征、电解质紊乱、心脏压塞和出血有关，应及早发现并及时处理；当心肺复苏(CPR)无效时应考虑心脏压塞可能，及时床边开胸CPR可提高抢救成功率。     

Permanent Cardiac Pacing after Cardiac Operations

Abstract: From January 1980 through December 1990, implantation of a permanent pacemaker was performed in 34 patients following open heart surgery. The patients were divided into two groups according to the clinical indications for implantation of permanent pacemakers. Group I (9 patients) had surgical atrioventricular block, and Group 2 (25 patients) had sick sinus syndrome. Tricuspid valve surgery was involved in 67% of Group 1 and 64% of Group 2. Adams-Stokes syncopal attack was the prime indication for permanent pacing in 100% of Group 1 and in 72% of Group 2. There were 2 operative deaths in Group 1, and no deaths in Group 2 (22% in Group 1 vs. 0% in Group 2, p < 0.005). Causes of the deaths were not related to the pacemaker implantation but to congestive heart failure following surgery. Among 32 survivors, there were 2 late deaths in Group 1, and 4 deaths in Group 2 (25% in Group 1 vs. 16% in Group 2, p < 0.05). The overall actuarial survival rate at 10 years was 82.1 ± 2.8%. However, the actuarial survival rate of patients in Group 1 is 70.2 ± 4.1%, which is statistically less than 85.4 ± 2.2% in Group 2 (p < 0.01). As judged by these results, patients in Group I should be followed on a regular out-patient basis even if they are asymptomatic and there is no evidence of pacemaker failure.     

Cardiac Myxoma

Ten patients with cardiac myxoma were reviewed. They ranged from 23 months to 60 years old. Echocardiography was the most helpful noninvasive diagnostic technique. The tumor was demonstrated by angiocardiography, left atrial myxomas frequently migrating to the left ventricle in diastole. Hemodynamically, left atrial myxomas were associated with moderately severe pulmonary hypertension and simulated mitral stenosis or insufficiency and right atrial myxomas, with right atrial hypertension. There were 7 myxomas in the left atrium, 2 in the right atrium, and 1 in the right ventricle.Eight patients underwent open-heart operation with removal of the myxoma, 1 had concomitant tricuspid valve replacement, and 1 had biopsy of the right ventricle only. The other patient was a Jehovah's Witness and refused operation. One patient died of cardiac arrest intraoperatively, and another died of a bilateral cerebral infarct. One patient had recurrence requiring reoperation. Postoperative hemodynamic and clinical improvement was more striking in patients with a left atrial myxoma presumably due to a normal mitral valve in contradistinction to the tricuspid valve.     

Cardiac contusion

During a consecutive period of 24 months, 244 patients with a major trauma were admitted to the Intensive Care Unit. From this pool of patients 60 consecutively were selected who did fulfill the selected criteria. We intended to determine within this studygroup the incidence, clinical features and outcome of patients with myocardial contusion (MC). We could conclude that no currently used diagnostic test may be seen as an accurate prediction of patients who still develop morbidity or mortality from cardiac contusion. Data from the literature suggest that at present only radionuclide angiography, direct hemodynamic measurement with construction of a Starling curve, and/or 2D-echocardiography may be useful in the identification of the patients at the greatest risk and predictive of the severity of the myocardial injury.     

Cardiac arrhythmias

Canadian Journal of Anesthesia/Journal canadien d'anesthésie -     

Cardiac Tumors

Cardiac neoplasms and other mass-forming lesions are not commonly encountered in surgical pathology practice. Fortunately, for the most part, these fall into a small group of well characterized and readily-recognized entities, although they are not without diagnostic dilemmas. A brief and practical synopsis of cardiac tumors is presented in this section with attention to more frequently encountered and clinically significant diagnostic challenges as well as pertinent clinical associations and prognostic information.