Thoraco-abdominal treatment success_ _86701 by heku


									?Thoraco-abdominal treatment


Heart and liver phase according to the total casting life

Recently, in our hospital Central Hospital of cardiothoracic surgery
and Hepatobiliary surgery successful for joint efforts: thoraco-
abdominal surgical treatment of patients, to rescue his young life,
but also highlights our clinical department collaboration spirit
worthy of carry forward, and the other brothers Department learning.

Patients, male, 25 years old, because of the "knife the sternum
xiphoid sense of pain, bleeding, Department 6 hours" by the county
hospital emergency room into my home. The performance tolerance for
patients with acute, pale, rapid breathing, heart rate 126 times/min,
radial pulse is not palpable, heart dullnes slightly enlarged, wound
dressings, all wrapped in thick, with a slightly damp penetration
cold, is a State of shock. Anxious to open two venous channel, fast
anti-shock therapy, sniffing xiphoid Department wounds, exploration
and right pleural, pericardial and celiac. According to the patient
the above findings and wound depth, height of suspected heart injury,
pericardial effusion, right lung injury, injury of intra-abdominal
viscera (liver injury likely). And Hepatobiliary surgery discussions,
I Division decision line sternotomy (leave room for exploration, the
liver may extend incisions in the abdomen). Immediately in the
thoracic anesthesia downlink, in patients with thoracic sternotomy,
see pericardial mild pericardiac diaphragmatic face bulging,
laceration; mediastinum hematoma, ruptured right chest, lower right
mediastinum pleural lung injury; left diaphragmatic face injury, the
injury Department have seen active bleeding. Immediate incision of
pericardium, clear the coagulation block, discover heart surface,
does not see obvious and laceration, suture pericardial diaphragmatic
surface and laceration; patch right lung injury, clear the thoracic
cavity blood about 2000ml; liver and laceration injuries after
further exploration and left hepatic vein, hepatic surgery decision
line left liver resection, to extend incisions in the abdomen, with
left and clear about abdominal hemorrhage 1000ml. Adequate hemostasis,
line thoracic drainage, suture the incision. At the same time, blood
transfusion, infusion, resistance to shock, postoperative loop
stability, safety and return to the intensive care unit. 2 weeks
after the patient has recovered and been discharged. CHENZHOU city
first renminyiyuanzhongxin Guo Yapeng cardiothoracic surgery hospital

Thoracoabdominal trauma is more serious chest injury and complex one,
shock rate as high as 60%, the mortality rate of up to 25% to 30%. If
delay treatment or mishandled often result in death. This type of
patient diagnosis is clear injury mechanisms, chest, upper abdomen
trauma, extrusion, blast injury should think of Thoracoabdominal
trauma may, medical examination and diagnosis of abdominal
paracentesis should be placed in the first place. This class is the
common characteristics of patients: ٠efficient reduction of
circulating blood volume swift; ‫ڠ‬respiratory dysfunction, both ready-
to-life-threatening, in deciding on the chest or laparotomy improved
ventilation and anti shock treatment demand synchronization.
Therefore, such patients, promptly correct diagnosis, comprehensive
plans for maintaining operation breathing cycle stability at the same
time, rapid implementation of operation is the key to successful
treatment. Combined with the patients, our experience is that we do
the following:

1, cardiothoracic surgery and Hepatobiliary surgery timely and
accurate diagnosis, the severity of the precise judgement, thoracic
and abdominal surgery of timely implementation;

2, before two departments of effective communication, making careful
operation programme for the implementation of operation laid the
solid foundation for working together to rapidly complete surgery, is
a powerful guarantee of successful operation; after two departments
actively cooperate with consolidation therapy, avoiding the
complications and thus won the surgery last victory;

3, also can not be separated from other related departments of
actively cooperate.

Therefore, in this case the patient treatment success, with the
exception of the sophisticated medical techniques, more embodies the
solidarity of the human spirit. As shown in the title, as long as the
"heart" phase, we will be able to share the life-casting.
Wenn Sie Fragen Urheberrecht. Bitte haben E, wir
werden so bald wie m?glich.


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