The early postoperation complications and treatments in 30 children with total anomalous pulmonary venous connection / 中国小儿急救医学

ObjectiveTo summarize the early postoperation complications and treatments in children with total anomalous pulmonary venous connection (TAPVC).MethodsThirty TAPVC children who were treated with corrective operation and transferred into PICU were collected.Patients were monitored routinely for electrocardiogram,blood pressure and SpO2.The routine treatment measures included mechanical ventilation,sedation,hemostasis,positive inotropic agents,diuresis,vasodilator,antibiotics and symptomatic treatment.Adrenaline or isoproterenol was used when low cardiac output syndrome appeared and temporary pacemaker was employed in the case of bradycardia.Alprostadil and sildenafil were added instantly after corrective operation when severe preoperative pulmonary hypertension or reactive postoperative pulmonary hypertension was present.ResultsThe early postoperation complication was found in 30 cases of TAPVC,which included 13 cases of pneumonia (43.3％ ),8 of arrhythmia (26.7％ ),7 of low cardiac output syndrome (23.3％),6 of respiratory failure (20.0％ ),4 of pulmonary hypertension ( 13.3％ ),3 of pulmonary edema or atelectasis( 10.0％ ) and 1 of pneumorrhagia ( 3.3％ ).Two cases died postoperatively.The interval of stay in PICU was 1 ～ 21 d and the mean time was (5.95 ± 4.94) d.ConclusionOccurrence of respiratory complications is high among early postoperative complications of TAPVC.Therefore,preventing pulmonary infection and maintaining pulmonary function should be viewed as the key points in early postoperative monitoring and managing.In addition,more attention should also be paid on correction of arrhythmia,prophylaxis and treatment of low cardiac output syndrome and pulmonary hypertension crisis,which may improve the postoperative survival rate and care quality of TAPVC.

Analysis of early complications after surgery for portal hypertension / 中国普通外科杂志

Objective To investigate the relevant factors for development of early postoperative complications in patients with portal hypertension due to advanced schistosomiasis, and to offer a theoretical basis for preventing the occurrence of postoperative complications. Methods The cases of advanced schistosomiasis with portal (hypertension) operated upon over the past 40 years were retrospectively reviewed. Results In 8 240 cases, the complication rate was 19.66% at one month after operation, and the mortality rate was 15.31%. The main causes of death were MDOS, massive hemorrhage into abdominal cavity, hepatorenal syndrome and (recurrence) of bleeding of upper alimentary tract. Conclusions The relevant factors for development of early complications after operation in patients with portal hypertension is related to the cause of portal hypertension, whether or not there is a history of ascites, the timing of operation and the stage of liver function(Child′s classification).

Surgical treatment of acute arterial ischemia of the lower extremity and (prevention) of postoperative complications:a report of 32 cases / 中国普通外科杂志

Objective To evaluate the effective treatment for and prevention of complications. Methods The diagnosis and treatment of 32 patients with acute arterial ischemia of the lower extremity were analyzed (retrospectively). 4 cases were treated with thrombolytic therapy, 28 cases underwent emergency operation, of which 3 cases underwent amputation after embolectomy, and 25 cases were treated by arteriotomy of femoral artery and embolectomy with Fogarty catheter(7 cases underwent concomitant arterioplasty).Results One (patient) in the nonoperative group died; but there was no mortality in the operated group. Limb amputation was done in 3 cases, and limbs were saved in 28 cases. Conclusions For acute arterial ischemia of the lower (extremity), emergency arteriotomy of femoral artery plus embolectomy is the treatment of choice. This (therapeutic) approach can lower mortality and limb amputation rate.