心内直视术中射频消融治疗风湿性心脏瓣膜病合并心房颤动

目的研究心内直视术中射频消融风湿性心脏病合并心房颤动的疗效。方法瓣膜手术同期行射频消融术病例15例,年龄32～58(44±8)岁,临床确诊风湿性瓣膜病合并心房颤动,心房颤动史1～7年。其中阵发心房颤动1例,持续性心房颤动14例,二尖瓣病变11例,双瓣病变4例,合并中度三尖瓣关闭不全7例。射频消融时间20～35(25.0±2.2)min。术后随访3～12月。结果15例病人升主动脉开放后复搏心律均为非心房颤动。2例术后住院期间出现快速型房性心律,经抗心律失常药处理转为窦性;1例出院时为结性心律;术后3个月呈窦性心律12例,6个月呈窦性心律11例。术后无死亡病例,心功能均恢复为1～2级,未见出血及栓塞。结论术中射频消融治疗风湿性心脏病合并心房颤动安全有效、操作简单、容易掌握,值得临床推广。

Clinical Experience of Extracorporeal Membrane Oxygenation for Severe Lung Contusion

Abstract]: Objective: To conclude the clinical experience of Extracorporeal Membrane Oxygenation (ECMO) in 3 cases of severe lung contusion. Methods: During -3 cases of severe lung contusion were treated by ECMO in our department, including male 2 case, female 1case. Patients get to ECMO for respiratory support by using V-V ECMO technique. The support time of ECMO were 69-96 hours, mean 83 hours. Results: Hypoxemia were improved rapidly by ECMO, there have some degree of blood injury during ECMO but can be reversed by blood transfusion. The coagulation management and ECMO flow rate need more study for better results, good teamwork is most important to get an success ECMO.