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px477801
Wysłany: Czw 14:40, 03 Mar 2011
Temat postu: new balance outlet Intermittent positive pressure
Intermittent positive pressure ventilation anesthesia time and the comparison of pressure control ventilation
. Beijing: People's Medical Publishing House. 2004:1758-1764. 『3] Hu Zhiyong, Xiao Han, Huang Jinjin. Different modes of one-lung ventilation in pediatric respiratory mechanics,
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, hemodynamics and arterial partial pressure of oxygen [J]. Chinese Journal of Anesthesiology, 2003,23 (8) :573-576. [4] Ye Zhenhai. Constant volume and constant pressure ventilation in acute lung injury application [J]. Of Postgraduates of Medicine, 2006,29 (12) :42-46. (Received :2007-11-14 Revised :2008-01-29) with acute myocardial infarction after PCI in asymptomatic subacute thrombosis in 1 case Pande Feng Li Huaxia Yong Dong Ye Wu Jiandong Li Zhang Maria Liu increase male patient, 53 years old, episodes of chest tightness due to 3d, 10h chest pain in May 11, 2006 to No previous history of hypertension and diabetes. People at the hospital to clopidogrel 300mg loading dose of oral, emergency coronary angiography showed: two vessel disease, left anterior descending artery (LAD) 70% stenosis of proximal left circumflex coronary artery (LCX) proximal occlusion. Intraoperative proximal LCX PTCA + General bare stent implantation. Repeat after LCX vascular imaging see thick. Developing a good distal blood flow TIMI3 level. Patients to clopidogrel, low molecular weight heparin and aspirin, anticoagulant, antiplatelet, who made the United intravenous infusion of tirofiban (Xin Weining Gp Ⅱ b / llIa receptor antagonist) enhance anticoagulation. Postoperative chest pain symptoms, electrocardiogram consistent with the dynamic evolution of acute myocardial infarction. Prepared at 1 week after PCI, LAD lesions. The results contrast found LCX stent thrombosis. 100% proximal occlusion of the remote without blood flow. To 2.5mm × 20mm balloon has expanded 3 times narrowest. Repeat angiography showed restoration of blood flow distal TIMI2 grade Author: 221002 Department of Cardiology, Affiliated Hospital of Xuzhou Medical College, again after 5min imaging and completely occluded. Urokinase 100,000 to u and Xinwei Ning 7mL slow coronary injection, the balloon dilation of blood clots, repeat angiography showed distal TIMI2 level. Impact is still visible thrombus. Communication with family members of patients, the decision to retain sheath. Suspension surgery, return to ward, postoperative clopidogrel increased to 75mg,
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, 2 times a day, and maintain intravenous pumps were Xinwei Ning 0.15Ixg / (kg · min), a total of 36h. Intraoperative heparin dosage of subcutaneous low molecular weight heparin after 50-70IU/kg 0.4mL. Each 12h1 times. LCX 36h before coronary angiography showed good development. Blood flow within the stent, distal flow of TIMI3 level. 10d postoperative hospital stay was discharged without cardiac adverse events, follow-up has been good. Discussion of direct coronary stenting with use. Complications of stent implantation and gradually rise to the concern of doctors, stent thrombosis is a serious complication of percutaneous coronary intervention. Emergency department with acute coronary syndrome PC1 stent thrombosis rate was 2.9%. Elective PCI in the stent thrombosis rate of 0.4% to 1.3%. China reported stent thrombosis rate was 2.6%. It is reported that after 24h of acute thrombosis rate of 0.6%, 4 weeks,
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, subacute thrombosis rate of 0.5% to 0.8%. 1 year after surgery because of thrombosis leading to myocardial infarction or death rate was 15.8%. High risk of thrombosis after PCI may be the main reasons: (1) acute coronary syndrome. Patients often accompanied by diabetes, hyperlipidemia, smoking, risk factors are prone to cause thrombosis risk. Often in platelet activation and fibrinolytic activity in decline. (2) PCI expansion will enable the instruments of local coronary plaque rupture, a complete destruction of endothelial expression of tissue factor which initiates the process of coagulation Rights cause thrombosis. (3) the metal stent surface lowering of blood compatibility of bio-induced stent thrombosis. Statistical analysis showed. Stent thrombosis, including the independent predictors of early disabling dual antiplatelet therapy, renal failure, bifurcation lesions,
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, diabetes and left ventricular ejection fraction lower. Since stent into the anti-platelet,
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, anticoagulant therapy is closely involved in the concerns of doctors. PCI postoperative anticoagulant, antiplatelet not need regular medication, but also to adjust the condition of patients. Section 2 of the patients served wave after V1 set Vega to 75mg, 2 times a day. Repeated surgery for high-pressure balloon stent thrombosis within the site. And intracoronary injection of urokinase 100 000 U and Xinwei Ning. This method several other patients with stent thrombosis treatment have received good results. (Received :2007-10-12)
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