ABSTRACT
Objective:To summarize the clinical characteristics, diagnosis and treatment of esophageal rupture caused by intestinal preparation, in order to improve the understanding of this disease.Methods:We combined with the clinical data of one patient with esophageal rupture caused by intestinal preparation admitted to Yijishan Hospital of Wannan Medical College in January 2020, and reviewed the relevant literature reports from 2009 to 2019 in CNKI database with esophageal rupture as the key word.Results:The patient suffered from esophageal rupture due to severe vomiting after magnesium sulfate enema preparing for endoscopic submucosal dissection.The patient was cured by endoscopic titanium clip therapy and closed thoracic drainage.A total of 89 articles involving 929 cases of esophageal rupture were retrieved, and it was found that males were more than females, the incidence of spontaneous>foreignness>traumatic>iatrogenic, the number of surgical cases(736 cases) was more than that of non-surgical cases(193 cases), the cure rate(86.65%) was higher than the death rate(13.35%).Conclusion:Esophageal rupture is one of the clinical emergencies with atypical clinical symptoms.Only detailed medical history inquiry and timely, effective imaging examination can make early diagnosis and early treatment, so as to reduce the fatality rate of the disease and improve the prognosis of patients with the disease.
ABSTRACT
Objective To investigate the changes of perioperative right ventricular function after pulmonary resction. Methods 45 cases of pulmonary resection were divided into four groups.Group Ⅰwas wedge resection(n = 10), GroupⅡ was lobectomy(n = 19), Group Ⅲ was double lobectomy(n=7)and Group Ⅳ was pneumonectomy(n=9). The changes of CVP, PAMP, PEP/ET, Sa, VTIs, RVSP, Ea/Aa, and Tel were evaluated by traditional ultrasonic and tissue Doppler ultrasonic techniques at different time inter- vals (pre-operation, 5-7 days orland 1 month post-operation), Results Compared with the pre-operation CVP, the indexes of all groups have no significant changes post-operatively. Wedge resection didn' t obviously influence right cardiac after load and systolic function/diastolic function. No evidet changes detected in Tei pre-and post-operatively. However, the indexes (PAMP, RVSP and PEP/ET ratio) reflecting right cardiac afterload evidently increased at post-pneumonectomy or lobectomy group5- 7 days post-opera- tive. All these reflect the decrease of Tei, which was more obvious in pneumonectomy than in lobectomy group. Right cardiac after- load, systolic/diastolic function and Tel index recovered to pre-operative level 1 month post-operation in single lobectomy group. But the above indicators, especially the Tel, were still high in double lobectomy and pmeunonectomy groups 1 morth post-operation.Tei index is positively correlated with PAMP and is weakly correlated with PET/ET ratio and Ea/Aa ratio. Conclusion Pulmonary wedge resection doesn't evidently influence right cardiac function. However, right cardiac diastolic function evidently decreases temporarily at lobectomy group. The systolic function and diastolic funetions decrease after double-lobectomy and pneumonectomy and it's more evident in pneumonectomy group. Though the right cardiac afterloads of lobectomy, double lobectomy and pneumonectomy groupa all increase significantly post-operativlye, only the former recover to pre-operative level 1 month after surgery.