胸导管

Among them, 20 patients were candidates of valve replacement and 18 PDA and pericarditis had their blood samples taken before operation,and 1,2,24 and 48 hours after closure of thorax for measurement of concentrations of CK、CK-MB and TnT,together with ECG recording. Results Of the 60 patients, concentrations of cTnT before operation were normal; 2 hours after aortic unclamping, the correlation coefficient between cTnT and aortic clamping was r = 0.873( P＜0.01), the regression analysis showed Y = 0. 019X-0. 026. Of the 20 patients, ECG showed the myocardium was ischemic; CK、CK-MB and cTnT all rose significantly, reaching the peak after closure of thorax. Of the 18 patients, the ECG and cTnT before operation and after closure of thorax were normal; except 2 patients with pericarditis.

结果 60例瓣膜手术患者术前cTnT均在正常值范围内，主动脉开放后2 h时，阻断时间和cTnT的相关系数为r=0.875(P＜0.01)，回归方程为Y=0.019X-0.026；其中20例瓣膜手术患者心脏经过阻断后，心电图有缺血性改变，周围血液中的CK、CK-MB和cTnT均有明显升高，分别在关胸后2 h达到高峰，数值分别为术前的12.6、9.2和257倍；18例行动脉导管结扎和心包剥脱术的患者术前和关胸后的心电图和血液中的cTnT均正常，CK和CK-MB除2例心包炎患者关胸后出现明显变化外，余均未见改变。

Abstinence 6 hours of above. 1.2 spile method introduces recorder of the Digitrapper MDIII of Swedish CTD company, MDII PH, use vessel of small electrode of single crystal antimony, use standard amortize liquid first corrective PH value, the patient takes upright seat, cleanness is wet and rhinal, with lube before wet conduit paragraph, nasal cavity of a side of light firm will tracheal edge is inserted to pitch of head of patient of the enjoin when 15cm is controlled, make under the forehead stands by pectoral wall, in order to increase the radian of pharynx ministry passageway, make conduit is entered not easily by accident tracheal, and its do enjoin deglutition movement, slow guide conduit stomach, right now PH shows 1~2 is controlled, again will tracheal slow take out, when PH the value comes by .0 jump 5 when, judgement is ministry of gastric esophagus join , drag electrode 5cm to secure again with this.

禁食6小时以上。1.2插管方法采用瑞典CTD公司的Digitrapper MDIII、MDII型pH记录仪，应用单晶锑微电极导管，先用标准缓冲液校正pH值，患者取端坐位，清洁湿润鼻腔，用润滑油湿润导管前段，轻稳将导管沿一侧鼻腔插至15cm左右时嘱患者头部前倾，使之下额靠近胸壁，以加大咽部通道的弧度，使导管不易误入气管，并嘱其做吞咽动作，并缓慢将导管导入胃，此时pH显示1~2左右，再将导管缓慢抽出，当pH值由。0突升至5.0时，判定为胃食管连接部，以此将电极再拽5cm固定。

Keywords patent ductus arteriosus;residual diffluence;chest surgery

动脉导管未闭；残余分流；胸外科手术

Under transthoracic echocardiography, electrode catheters positioned intracardiac and target ablation were performed with the permentnent pacemaking catheter of left subclavian vein and the ablation catheter of right femoral vein.

在经胸心脏彩超引导下，采取"多切面观察"、"导管运动中观察"，密切结合心内电生理定位，尝试左锁骨下静脉永久起搏导管和右股静脉消融导管的心内定位和靶点消融。

Puncture into Attain long sheath of CS through left infraclavicular vein, guided by CS pipe, take sheath into CS, make reverse contrast of heart vein with Attain saccule contrast pipe, put the left ventricle electric pole into the vein through sheath, then bring it into right ventricle apex and right cardiac ear through the electric pole of right ventricle and atrium, connect it with 3-cavity pulse generator, which is buried under left chest skin.

方法］经左锁骨下静脉穿刺送入Attain冠状静脉窦长鞘，在CS导管的导引下，将鞘送人CS，用Attain球囊造影导管进行心脏静脉逆行造影，将左心室电极经长鞘放入选择的静脉，送人右心室及右心房电极至右室心尖和右心耳。与三腔脉冲发生器连接，脉冲发生器埋藏于左上胸皮下。

Successful tracheal intubation wasverified using the following criteria: 1 identification ofthe trachea and tracheal rings, 2 visualization of vocal cords,3 widening of glottis as the tracheal tube passes through,and 4 tracheal tube position above carina and demonstrationof movement of the chest wall visceroparietal pleural interface(i.e., sliding sign) after manual ventilation of the lungs.

成功的气管插管通过如下的标准证实：1）辨别气管和气管环，2）可见到声带，3）当气管导管置入时声门变宽，4）隆突上气管导管的位置以及手控通气时胸壁内脏壁胸膜界面的运动。

At present three-dimensional ICE rebuilds the technology has been built, the classics bosom with the tradition is supersonic and enchanted graph and classics esophagus are supersonic and enchanted graph photograph is compared, ICE does not suffer the limitative; that resembles a window not to suffer gas to affect; patient not to need complete hemp, the unwell; that can reduce patient spile reduces tracheal room to operate personnel, reduce personnel radiate; to be based on this consequently, ICE application limits is expanding gradually.

目前三维ICE重建技术已经建立，和传统的经胸超声心动图和经食管超声心动图相比，ICE不受成像窗的限制；不受气体影响；患者不需要全麻，可以减少患者插管的不适；减少导管室操作人员，因而减少人员辐射；基于此，ICE应用范围正在逐渐扩大。

All patients underwent femoral venipuncture catheterization examination to insert the occluder. Patent ductus arteriosus and ventricular septal defect needed femoral artery puncture operation. Aortic arch descending part or left ventricular ventriculography was performed before occlusion to further clarify the diagnosis and surgical indications and help choose occluder type. Angiography was repeated after surgery to judge the effect. Patients with atrial septal defect and ventricular septal were defected with conventional transthoracic echocardiography monitoring and evaluation.

患者均经股静脉穿刺行右心导管检查及送入封堵器械，动脉导管未闭和室间隔缺损需经股动脉穿刺，封堵前行主动脉弓降部或左室造影以进一步明确诊断和适应证，帮助选择封堵器的型号，术后重复造影以判断封堵效果；房间隔缺损和室间隔缺损患者术中常规行经胸超声心动图监测和评价。

Methods 69 patients with malignant pleural effusion were randomized into two groups,and then,they were placed the center vein catheter into the pleural cavity by pleurocentesis and closed-drainage contiuously.

选择由组织学和细胞学诊断的恶性胸腔积液病人 6 9例，随机分为两组，采用胸腔穿刺，置入中心静脉导管持续闭式引流胸液。

Into sheet of the travel after the bosom lung aerates, discovery is flat, examination anaesthesia machine and whorl canal all are not had unusual, hind art person discovery is tracheal inside grand dash forward initiative point comes next right total bronchus the gap that tracheal film ministry has one to grow 4~6cm below pectoral top, remove vessel to grand dash forward outside insert to left bronchus afresh, repair burst mouth, travel is right go up alobe of the lung...

进胸后行单肺通气，发现漏气，检查麻醉机和螺纹管均无异常，后术者发现气管内隆突下右总支气管起始处至胸顶下气管膜部有一长4~6cm的裂口，将导管退至隆突外重新插至左支气管，修补破裂口，行右上肺叶。。。

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And unto the angel of the church in Sardis write; These things saith he that hath the seven irits of God, and the seven star I know thy works, that thou hast a name that thou livest, and art dead.

3：1 你要写信给撒狄教会的使者，说，那有神的七灵和七星的，说，我知道你的行为，按名你是活的，其实是死的。