ABSTRACT
Pulmonary atresia with intact ventricular septum(PA/IVS) is one of the complicated cyanotic congenital heart diseases with high mortality,which needs early intervention after birth.With further understanding of the disease and the development of surgery,the operative plan of the disease is gradually changing and some fundamental changes have taken place.The hemodynamic awareness of the disease is an important factor in the selection of surgery and the improvement of prognosis.In addition,it is also important for the selection of surgery and the improvement of prognosis to evaluate the development degree of the right ventricle comprehensively and accurately.At present,it is generally believed that the most effective treatment strategy can be obtained by classifying the development degree of the right ventricle in morphology.The surgical treatment has developed from early surgical pulmonary bypass to the interventional and hybrid surgery,which greatly improves prognosis and reduces surgical trauma.Among them,the pereutaneous pulmonary valve radiofrequency perforation plus balloon dilation and PDA stent implantation can be used as the preferred treatment for PA/IVS with dysplasia of the right ventricle.Particularly,PA/IVS can be cured with the interventional surgery alone for children with mild or even moderate dysplasia of the right ventricle.Hybrid surgery that significantly reduces trauma compared with traditional surgery is also an important choice for the areas where interventional surgery is relatively outdated.This article reviews and summarizes the progress of recognition and surgical treatment of PA/IVS,in order to provide reference for the clinical diagnosis and treatment.
ABSTRACT
Objective To investigate the application effect of interventional surgery in the treatment of facial superficial mixed hemangi-oma through the laryngeal mask ventilation under desflurane anesthesia. Methods In the period from February 2016 to April 2017 in our hospital 118 cases of facial superficial hemangioma under interventional surgery in infants( aged 3-15 months) were retrospectively analyzed;according to the difference of anesthesia,they were divided into control group (51 cases) and observation group (67 cases);the two groups of children were administered sufentanil anesthesia, in the control group laryngeal mask airway under propofol, the observation group was giv-en under laryngeal mask airway inhalation of desflurane maintenance. Then was compared the difference in anesthesia monitoring indexes of the two groups, such as mean arterial pressure ( MAP) , saturation of pulse oximetry ( SpO2 ) , heart rate ( HR) , end-tidal carbon dioxide ( ETCO2 ) , laryngeal mask removal time, loss of consciousness time, laryngeal mask removal time, consciousness recovery duration, clinical efficacy and intraoperative and postoperative adverse reactions difference. Results For the control group, the laryngeal mask removal time and consciousness recovery time length were significantly longer than those of the observation group and the difference was statistically signifi-cant (P<0. 05);after anesthesia induction, the laryngeal mask insertion time, operation start time and laryngeal mask removal time, MAP and HR of the observation group and the control group were lower than those before anesthesia induction, and MAP and HR of control group were lower than those of the observation group and the deference was statistically significant (P<0. 05). The total efficiency of the observa-tion group (97. 02％) was significantly higher than the control group (88. 24％), the adverse reaction rate (23. 52％) of children in the control group was significantly higher than that (7. 46％) of those in the observation group, and the differences were statistically significant (P<0. 05). Conclusion In the infant facial superficial hemangioma interventional surgery, laryngeal mask airway can be used for anesthe-sia maintenance for desflurane effect and clinical curative effect in the effective protection of anesthesia at the same time, but also can reduce the risk of anesthesia and intraoperative blood pressure fluctuations, especially in the stabilization of hemodynamics of the patients.
ABSTRACT
Objective To investigate prophylactic application of antibacterial agents in perioperative period of vascular interven‐tional surgery in our hospital before and after intervention ,and to evaluate the effects of intervention measures .Methods One hun‐dred cases from March to May 2011 were selected as non‐intervention group ,and 100 cases from March to May 2012 after interven‐tion were selected as intervention group .Analysis was conducted on medical information of two groups by questionnaire about their antibiotic drugs use .we evaluated the the percentage of antimicrobial application ,drugs choice ,initial time of medicine treatment ,the course of medication and so on .Results The rational rate of antibacterial use increased from 6% (before intervention) to 99% (af‐ter intervention) (P<0 .01) .The rationality was improved significantly in respect of initial time of medicine treatment ,antibacterial agents and the course of medication .the percentage of antimicrobial application ,cost of antibacterials and the value of antibiotics use density (AUD) were decreased significantly .Conclusion The intervention of our hospital is feasible and effective ,and could signifi‐cantly improve the perioperative antibacterial application .
ABSTRACT
With the continuous innovation and development in the field of interventional therapy, the complexity of surgery has been gradually increased, meanwhile, the psychological expectation from patients for a minimally invasive surgery has also become higher and higher. Patients expect not only to be safe to complete the surgery, but also to maintain the comfort during operation process. For ensuring these demands, anesthesia plays a key role. This paper aims to discuss the current situation, problems and development direction of anesthesia application in interventional surgeries in order to help promote the anesthesia management concepts in performing interventional procedures.