Direct-view correct manage skill treat the intersection of lung and the intersection of artery and the intersection of mouth and narrow _'s treatment

Direct-view correct manage skill treat the intersection of lung and the intersection of artery and the intersection of mouth and narrow _'s treatment
Operation method:
Until the intersection of 3mg/kg and Heparin take, aorta insert artery in pour into, in charge of, insert up and down the intersection of vena cava and drainage tube in respectively through right auricle of heart and atrium dextrum on rise, the blood lowers the temperature at the beginning after setting up extracorporal circulatory system, according to heart function state and pathological change complexity, lower the intersection of patient and nasopharyngeal temperature, aorta hinder bring up the rear, rise aorta root fast to inject the cold heart into, park, fight liquid, pericardium pour with frozen water, heart surface lower the temperature and protect the cardiac muscle with little the intersection of ice bag and part, then block the up and down vena cava around taking, cut the intersection of lung and artery or right room, implement the intersection of lung and the intersection of artery and petals of the intersection of direct-view and lower juncture, cut skill and/or the intersection of funnel and parts of plump muscle, excise skill, flow out line expand, mend slice come on.
Funnel part is plump excise muscle it should include not separating bunch, among bunch and ridge dirt muscles plump in some room, the plump meat column should be excised, in order to dredge and flow out one, but need to avoid cutting off skin of neighbouring papilla, taper skin and regulating bunch in the heart, flowing out a diameter adult and should be greater than 1.7cm after dredging, children should be greater than about 1.4cm, otherwise employ the pericardium one to be cut out and mended slice in order to expand and flow out one as a shuttleless loom shape, a ring of narrow and small lung artery should also be cut until the right room flows out one, then by weave slice or pericardium slice and expanding.
Step petals of ring, mend block, will produce the intersection of lung and the intersection of artery and petal, close completely, might it produces right rooms to be depleted while being postoperative. Can't close completely in order to avoid producing the serious lung artery one, spend postoperative critical days safely, can adopt and take a leaf and mend one and expand a ring of lung artery, avoid leading to the fact the lung artery one can not be closed completely because a ring is expanded. Skill finish right room and the intersection of aorta and the intersection of root and part insert needle rank angry, the open aorta blocks pincerses, shocking by electricity if necessary quiverly makes the heart reply and beat. Wait to reply warmly to 35 , the heartbeat stops the extracorporal circulatory system with blood pressure after being steady effectively, successively pulled out up and down vena cava intubate and artery to pour into and manage, instilled in order to neutralize Heparin according to fish's precise albumen 4.5cm vein of per kilogram of weight.
Postoperative complication:
First after it is removed that the intersection of lung and the intersection of artery and mouth is narrow, the blood capacity of circulation of lung obviously increases, so should fill the blood capacity appropriately according to arterial pressure and central venous pressure, in order to prevent postoperative low heart from arrange the intersection of blood and disease, vein instil dopamine and the west inside strong heart such as being blue step up medicine if necessary, in order to strengthen myocardium contractile force, the transition is steady to dynamics of blood flow.
Second if flow out one is too narrow to remove completely, the right room is still tall in pressure, it is postoperative apt to cause the right room to cut-out and bleed, and apt to produce the right heart depletedly.
Operation mortality relatively low disease this, generally in about 2%, operation result satisfied, postoperative symptom improve or disappear totally, can resume normal life.
|