ABSTRACT
@#Objective To explore and analyze the risk factors for arrhythmia in patients after heart valve replacement. Methods A retrospective analysis of 213 patients undergoing cardiac valve replacement surgery under cardiopulmonary bypass in our hospital from August 2017 to August 2019 was performed, including 97 males and 116 females, with an average age of 53.4±10.5 year and cardiac function classification (NYHA) grade of Ⅱ-Ⅳ. According to the occurrence of postoperative arrhythmia, the patients were divided into a non-postoperative arrhythmia group and a postoperative arrhythmia group. The clinical data of the two groups were compared, and the influencing factors for arrhythmia after heart valve replacement were analyzed by logistic regression analysis. Results There were 96 (45%) patients with new arrhythmia after heart valve replacement surgery, and the most common type of arrhythmia was atrial fibrillation (45 patients, 18.44%). Preoperative arrhythmia rate, atrial fibrillation operation rate, postoperative minimum blood potassium value, blood magnesium value in the postoperative arrhythmia group were significantly lower than those in the non-postoperative arrhythmia group (P<0.05); hypoxemia incidence, hyperglycemia incidence, acidosis incidence, fever incidence probability were significantly higher than those in the non-postoperative arrhythmia group (P<0.05). The independent risk factors for postoperative arrhythmia were the lowest postoperative serum potassium value (OR=0.305, 95%CI 0.114-0.817), serum magnesium value (OR=0.021, 95%CI 0.002-0.218), and hypoxemia (OR=2.490, 95%CI 1.045-5.930). Conclusion Taking precautions before surgery, improving hypoxemia after surgery, maintaining electrolyte balance and acid-base balance, monitoring blood sugar, detecting arrhythmia as soon as possible and dealing with it in time can shorten the ICU stay time, reduce the occurrence of complications, and improve the prognosis of patients.
ABSTRACT
Objective To investigate the etiology,clinical charactieristics,treatment and prognosis in pediatric hemoptysis to provide reference for its diagnosis and treatment to pediatric doctors .Methods The retrospective analysis was performed on the clinical manifestations ,laboratory tests ,imagiological and bronchoscopic manifestations ,treatment methods and outcomes in the children patients with hemoptysis as the chief complaint admitted to our hospital from April 2009 and December 2014 .Results A-mong 102 children cases of hemoptysis ,55 cases were male and 47 cases were female .The median age was (7 .05 ± 1 .2) years old . Mild hemoptysis was in 87 cases(85 .3% ) ,moderate hemoptysis was in 10 cases(9 .8% ) and massive hemoptysis was in 5 cases (4 .9% ) .The relatively exact causes of hemoptysis were found in 88 cases ,in which the lower respiratory tract infection was most common ,the top 3 causes were pneumonia ,pulmonary tuberculosis and bronchitis .In the non-infection causes ,idiopathic pulmonary hemosiderosis(IPH) was most common ,while connective tissue diseases ,pulmonary vascular malformation and airway foreign body were rare .85 cases showed different pathological lesions on chest CT scan .Among the 35 cases underwent the bronchoscopy ,3 ca-ses of bronchial stenosis caused by granulation proliferation was improved after bronchoscopic cryotherapy ,5 cases of active bleed-ing under endoscopic stopped bleeding by topical hemostasis ,among 10 cases of suspected tuberculosis with negative sputum bacte-ria ,acid-fast bacilli was found in 8 cases by bronchofiberscopic lavage .The treatment of pediatric hemoptysis was dominated by the medical etiological and symptomatic therapy .Conclusion Chest CT scan can provide a very important basis for the etiological diag-nosis of hemoptysis and the bronchoscopy examination also has an important value in the diagnosis and treatment of hemoptysis . The etiological and symptomatic treatment is predominat in pediatric hemoptysis ,and the majority have good prognosis .