5 kg以下低体重婴儿室间隔缺损的外科治疗

目的:探讨5 kg以下低体重婴儿室间隔缺损(VSD)的外科治疗适应证、手术时机、手术技术及围术期处理。方法:回顾性分析2001年1月至2005年12月期间,5kg以下VSD婴儿134例,年龄(3.9±1.9)月。患儿均于体外循环下行室间隔缺损修补术及同期合并畸形矫治术。结果:全组术后早期死亡1例,死亡率0.7%,死亡原因心律失常,心功能衰竭。术后并发肺炎14例,肺高压危象6例,肺不张4例,心律失常4例,低心排4例,胸腔积液1例。133例随访6个月~6年,生长发育良好;VSD残余分流2例,1年后超声心动图证实已自动愈合。结论:低体重婴儿VSD的外科治疗效果良好,正确选择手术适应证和时机、正确合理的体外循环和手术方法、加强围术期处理是提高治疗效果的关键。     

楮头红提取物的生物活性研究

目的 研究楮头红的生物活性,寻找活性成分.方法 对楮头红的石油醚、乙醚、乙酸乙酯、乙醇和水的粗提取物分别进行抗小鼠肝损伤试验和体外抗氧化、抑菌试验.结果 水提物具有抗小鼠肝脂质过氧化作用和抗肝损伤作用;乙醚、乙酸乙酯、乙醇等3个部位各具有不同程度的清除羟自由基和超氧离子自由基的作用及抑菌作用.结论 楮头红提取物具有清除羟自由基、清除超氧离子自由基、抗小鼠肝脂质过氧化和抗小鼠肝损伤及抑菌作用.     

紧急低温全晶体灌注循环抢救幼儿失血性休克心跳骤停1例

正小儿外科手术中意外发生重度失血性休克致心跳骤停的病例时有发生。采用紧急心肺复苏并快速建立体外循环抢救失血性休克致心脏骤停成功的病例多为个例报道,经验不足。本例由于出血凶猛且取血困难,采用全晶体灌注并快速降温,最后抢救成功,患儿存活,脏器保护良好,没有严重并发症和后     

匹那地尔对大鼠心肌细胞内钙及舒缩功能的影响

目的探讨匹那地尔对高钾停搏液处理后大鼠离体心肌细胞内游离钙与舒缩功能的影响。方法SD大鼠心室肌细胞酶解分离静息1~2 h后随机分为对照组,高钾停搏液组,匹那地尔强化组,格列苯脲拮抗组。四组细胞均在24℃下保存2 h,此后对细胞进行复氧、复灌20 m in并测定细胞收缩、[Ca2 ]i瞬态、肌浆网内贮钙释放功能。结果匹那地尔使心肌细胞在缺血再灌注中收缩功能,[Ca2 ]i瞬态,肌浆网内贮钙释放能力明显优于高钾停搏液组(P<0.01〉及细胞内钙释放后的钙峰回落时间明显短于高钾停搏液组(P<0.01〉。结论匹那地尔通过维持良好的肌浆网和细胞膜Na /Ca2 交换体功能来调节钙瞬态变化,减少细胞内钙超载从而改善心肌细胞缺血后收缩功能,同时避免了高钾停搏液的负面效应。     

深低温停循环在婴幼儿心内直视术中的应用

本院自1985年5月至1991年5月在27例婴幼儿心内直视术中采用深低温停循环技术,效果满意。其优点为心脏弛缓,术野无血及插管、暴露良好。     

冷血含钾停搏液在小儿心直视术中的应用

作者自１９９２年５月至１９９３年５月在３４例小儿重症先天性心脏病心直视术中应用冷血含钾停搏液（ＢＣＰ）１６例，与应用冷晶体停搏液（ＣＣＰ）的１８例作对比，ＢＣＰ组取得满意的心肌保护效果。结果表明，ＢＣＰ组术后心肌同工酶，门冬氨酸基转移酶的活力明显低于ＣＣＰ组，并且自动复跳率高，无脱机困难，术后所需血管活性药物支持少，无低心排和死亡。     

小儿贲门失弛缓症临床特征与外科治疗

小儿贲门失弛缓症是较少见的良性食管疾病.近年来随着食管生理功能检查的不断开展,可以较全面地了解本病的病理生理变化.我院自1984～1999年共收治17例患儿,现分析其临床特征.     

含乌司他丁肺保护液在心肺转流术中的肺保护作用

Objective To evaluate protective effects of hypothermic pulmonary protective solution with uli-nastatin on lung function during cardiopulmouary bypass (CPB) in the patients with congenital heart disease(CHD) and pulmonary hypertenion. Method Fifty-four children,who had CHD of left-to-fight shunts with moderate-se-rious pulmonary hypertension, were enrolled. They had been performed with the radical operation under CPB from September 2005 to December 2006 in the Department of Cardiovascular Surgery, Children' s Hospital of Zhejiang University. Moderate-serious pulmonary hypertension was defined as pulmonary-to-systolic pressure ratio > 0.45(Pp/Ps > 0.45). Fifty-four children were randomly divided into three groups. Patients in group A (n = 18)didn't receive pulmonary protective solution, and scrved as control; patients in group B (n = 18) were adminis-tered with pulmonary protective solution without ulinastatin;patients in group C (n = 18) were administered with pulmonary protective solution with ulinastatin. The serum concentrations of MDA and MPO were measured at five different time points:pre-operation, 0 h, 3 h, 6 h and 24 h in the intensive care unit (ICU) (T1～5). Patients'lung functions were monitored at T1 - T4. The time of mechanical ventilation was recorded. Results No one died in this study. The mean time of mechanical ventilation was shorter in the group B and group C than that in the group A. The MDA and MPO levels were lower in group B compared with group A at T4. The MDA level at T3-T5 and the MPO level at T4 was lower in group C than those in group A. There were no significant in MDA and MPO levels between group B and group C at five time point.A-aDO2 was lower in groups B and C than those in group A at T3 and T4, whereas at T4, A-aDO2 was lower in group C than that in group B. Cdyn was higher in group B at T3and group C at T3 - T4 than those in group A. Cdyn was lower in groups C than that in group B at T4.Condusions Lung perfusion with hypothermic protective solution during CPB can all lung injury and promote recovery after operation, especialy with ulinastatin.     

儿童钝性胸部创伤后主支气管断裂临床分析

目的　探讨儿童钝性胸部创伤后主支气管断裂的临床特点和早期诊治。方法　本组 11例 ,年龄 3～ 7岁 ,平均 (5 1± 1 4 )岁。患者均为闭合性损伤后主支气管完全性断裂 ,左侧 7例 ,右侧 4例。 4例伤后 2 4h内急诊行支气管断裂吻合术 ;7例延误诊断患儿于伤后 2～ 12个月内晚期手术 ,其中 3例行支气管断裂吻合术 ,4例行全肺切除术。结果　本组无手术死亡 ,7例行支气管断裂吻合术 ,恢复顺利 ,术后1个月胸片复查 ,肺组织复张良好。结论　认识儿童钝性胸部创伤后气管支气管断裂的临床特点 ,可提高早期诊断水平 ,明显降低其并发症和病死率。