切换至 "中华医学电子期刊资源库"

第五届中国出版政府奖音像电子网络出版物奖提名奖

中国科技核心期刊

中国科学引文数据库(CSCD)来源期刊

中华重症医学电子杂志 ›› 2017, Vol. 03 ›› Issue (04) : 271 -274. doi: 10.3877/cma.j.issn.2096-1537.2017.04.008

所属专题: 文献

临床研究

Stanford B型主动脉夹层腹膜支架术后的程序化重症监护治疗
沈晔1, 张美齐1, 韩楠楠1, 陈环1, 方玲翠1, 蔡文伟1,()   
  1. 1. 310014 杭州,浙江省人民医院 杭州医学院附属人民医院急诊医学科
  • 收稿日期:2017-04-12 出版日期:2017-11-28
  • 通信作者: 蔡文伟

Protocolized management in intensive care unit for post-interventional Stanford B aortic dissection patients

Ye Shen1, Meiqi Zhang1, Nannan Han1, Huan Chen1, Lingcui Fang1, Wenwei Cai1,()   

  1. 1. Department of Emergency, Zhejiang Province People′s Hospital, People′s Hospital of Hangzhou Medical College, Hangzhou 310014, China
  • Received:2017-04-12 Published:2017-11-28
  • Corresponding author: Wenwei Cai
  • About author:
    Corresponding author: Cai Wenwei, Email:
引用本文:

沈晔, 张美齐, 韩楠楠, 陈环, 方玲翠, 蔡文伟. Stanford B型主动脉夹层腹膜支架术后的程序化重症监护治疗[J/OL]. 中华重症医学电子杂志, 2017, 03(04): 271-274.

Ye Shen, Meiqi Zhang, Nannan Han, Huan Chen, Lingcui Fang, Wenwei Cai. Protocolized management in intensive care unit for post-interventional Stanford B aortic dissection patients[J/OL]. Chinese Journal of Critical Care & Intensive Care Medicine(Electronic Edition), 2017, 03(04): 271-274.

目的

探讨程序化重症监护策略对腹膜支架治疗Stanford B型主动脉夹层术后的缺血再灌注器官功能疗效的维护。

方法

回顾性分析2012年2月至2017年2月61例Stanford B型主动脉夹层的临床资料。61例患者均采用覆膜支架植入术。分别经过肺保护通气、循环管理、器官功能保护、抗感染等程序化重症监护治疗,评估术后呼吸、肾功能、及术后康复情况。

结果

2例患者死于多脏器衰竭,其余患者术后均成功拔除呼吸机,大部分已康复出院。

结论

Stanford B型主动脉夹层患者经有效的维护缺血再灌注器官及肺保护通气策略能有效提高治愈率。

Objective

To investigate the effect of protocolized management in intensive care unit for patients with Stanford type B aortic dissection (AD) undergoing thoracic endovascular aortic repair (TEVAR).

Methods

We retrospectively analyzed clinical data from February 2012 to February 2017. All 61 patients with Stanford type B AD patients undergoing TEVAR accepted the following care principles: lung protective ventilation, hemodynamic support, organ function protection and anti-infection therapy. Postoperative function of respiratory system and kidney, and rehabilitation were compared.

Results

Two patients died of multiple organ failure. The rest were successfully extubated and most of them were discharged after rehabilitation.

Conclusion

For post-interventional Stanford B aortic dissection patients, use of lung protective ventilation and prevention of ischemia-reperfusion injury improved the prognosis.

1
Silbert BS, Myles PS. Is fast-track cardiac anesthesia now the global standard of care? [J]. Anesth Analg, 2009, 108(3):689-691.
2
Ender J, Borger MA, Scholz M, et al. Cardiac surgery fast-track treatment in a postanesthetic care unit: six-month resultsof the Leipzig fast-track concept [J]. Anesthesiology, 2008, 109(1):61-66.
3
Crimi E, Hill CC. Postoperative ICU management of vascular surgery patients [J]. Anesthesiol Clin, 2014, 32(3):735-757.
4
Pasin L, Nardelli P, Belletti A, et al. Pulmonary Complications After Open Abdominal Aortic Surgery: A Systematic Review and Meta-Analysis [J]. J Cardiothorac Vasc Anesth, 2017, 31(2):562-568.
5
Mulligan MS, Berfield KS, Abbaszadeh RV. Management of Postoperative Respiratory Failure [J]. Thorac Surg Clin, 2015, 25(4):429-433.
6
尚蔚,刘楠,孙立忠, 等. 急性A型主动脉夹层术后急性呼吸功能不全的治疗 [J]. 心肺血管病杂志, 2012, 9(31):519-522.
7
杨毅,孙立忠,刘楠, 等. 无创正压通气及其不同界面改善主动脉夹层手术后低氧血症的研究进展 [J]. 心肺血管病杂志, 2015, 34(2):146-149.
8
Nielsen J, Ostergaard M, Kjaegaard J, et al. Lung recruitment maneuver depresses central hemodynamics in patients following cardiac surgery [J]. Intensive Care Med, 2005, 31(9):1189-1194.
9
Dünser MW, Takala J, Brunauer A, et al. Re-thinking resuscitation: leaving blood pressure cosmetics behind and moving forward to permissive hypotension and a tissue perfusion-based approach [J]. Crit Care, 2013, 17(5):326.
10
Zhu JC, Chen SL, Jin GZ, et al. Acute renal injury after thoracic endovascular aortic repair of Stanford typeB aortic dissection: Incidence, risk factors, and prognosis [J]. J Formos Med Assoc, 2014, 113(9):612-619.
11
Schetz M, Gunst J, Vlieger G, et al. Recovery from AKI in the critically ill: potential confounders in the evaluation [J]. Intensive Care Med, 2015, 41(9):1648-1657.
12
Yunos NM, Bellomo R, Glassford N, et al. Chloride-liberal vs. chloride-restrictive intravenous fluid administration and acute kidney injury: an extended analysis [J]. Intensive Care Med, 2014, 41(2):257-264.
13
Kara A, Akin S, Ince C. The response of the microcirculation to cardiac surgery [J]. Curr Opin Anesthesiol, 2016, 29(1):85-93.
14
Schraag S. Postoperative management [J]. Best Pract Res Clin Anaesthesiol, 2016, 30(3):381-393.
15
Le Guen M, Liu N, Tounou F, et al. Dexmedetomidine reduces propofol and remifentanil requirements during bispectral index-guided closed-loop anesthesia [J]. Anesth Analg, 2014, 118(5):946-955.
16
Fiorani P, Speziale F, Calisti A, et al. Endovascular graft infection: preliminary results of an international enquiry [J]. J Endovasc Ther, 2003, 10(5):919-927.
17
Anderson L, Quasim I, Steven M, et al. Interoperator and intraoperator variability of whole blood coagulation assays acomparison of thromboelastography and rotational thromboelastometry [J]. J Cardiothorac Vasc Anesth, 2014, 28(6):1550-1557.
[1] 邵世锋, 肖钦, 沈方龙, 张迅, 郝志鹏, 伍正彬, 谢晓娟, 王耀丽. 老年胸主动脉钝性伤的重症救治分析[J/OL]. 中华肺部疾病杂志(电子版), 2024, 17(05): 762-767.
[2] 廖江荣, 吴秀琳, 陈光春, 郭亮, 吕慈, 蔡俊, 陈夕. 急性主动脉夹层并发急性肺损伤的研究新进展[J/OL]. 中华肺部疾病杂志(电子版), 2024, 17(03): 488-492.
[3] 谢开晶, 白伟志, 王震, 李婷, 邵世锋, 王耀丽. 严重爆炸伤单中心重症的监护与救治[J/OL]. 中华肺部疾病杂志(电子版), 2024, 17(02): 201-206.
[4] 王庭宇, 邵联波, 刘珊, 沈振亚. Stanford A 型主动脉夹层相关基因KIF20A 的共表达网络构建及作用靶点分析[J/OL]. 中华细胞与干细胞杂志(电子版), 2024, 14(05): 303-312.
[5] 鲁悦, 李伟, 庄宗, 王娟, 赵鹏来, 杭春华. 脑出血继发吉兰-巴雷综合征二例报道并文献复习[J/OL]. 中华脑科疾病与康复杂志(电子版), 2024, 14(02): 120-123.
[6] 刘春峰, 徐朝晖, 施红伟, 陈瑢, 马腾飞, 李鹏飞, 袁蓉, 陈建荣, 徐爱明. 机械通气患者肌肉减少症的诊断及其对预后的影响[J/OL]. 中华临床医师杂志(电子版), 2024, 18(09): 820-825.
[7] 张平骥, 徐钰, 李天水, 庞文翼, 符师宁, 张梦圆. 重症患者镇静治疗现状及期望的调查研究[J/OL]. 中华临床医师杂志(电子版), 2024, 18(06): 562-567.
[8] 钱建伟, 周春高, 田伟, 祖庆泉, 严海涛, 施海彬, 刘圣. 腔内修复急性Stanford B型主动脉夹层后支架远端主动脉重塑的因素分析[J/OL]. 中华介入放射学电子杂志, 2023, 11(03): 230-235.
[9] 杨伟洪, 向先俊, 郭宗锦, 王亮, 周汝明, 魏民新, 王赞鑫. 主动脉夹层累及腹腔分支二期腔内治疗的中期研究[J/OL]. 中华介入放射学电子杂志, 2023, 11(03): 236-240.
[10] 刘平娟, 罗科城, 吴家茵, 廖康, 胡雯雯, 陈怡丽. 神经内科重症监护室患者肠道耐碳青霉烯类肠杆菌目细菌主动筛查研究[J/OL]. 中华临床实验室管理电子杂志, 2023, 11(04): 235-240.
[11] 马俊蓉, 叶艳彬. 减重手术后的营养管理与复胖:现状与思考[J/OL]. 中华肥胖与代谢病电子杂志, 2023, 09(03): 165-172.
[12] 李璇, 邓岚, 郭微, 邓永梅, 刘杰昕. 标准化皮肤管理流程在防治脑卒中患者失禁相关性皮炎中的应用[J/OL]. 中华脑血管病杂志(电子版), 2024, 18(05): 479-482.
[13] 邓仙裕, 罗钰璇, 张溱乐, 余展鹏, 彭亮. 自发性脑出血重症患者30 d死亡风险预测模型的建立及验证[J/OL]. 中华脑血管病杂志(电子版), 2024, 18(02): 121-128.
[14] 李安, 张秀萍, 白波, 赵阳, 薛国芳, 李东芳. 主动脉夹层术后并发神经系统并发症二例及文献复习[J/OL]. 中华脑血管病杂志(电子版), 2023, 17(04): 373-378.
[15] 李永凯, 吐尔洪·吐尔逊, 杨建中. 开颅术后患者大脑中动脉的经颅多普勒超声测量值与意识评分、血生化指标的相关性[J/OL]. 中华脑血管病杂志(电子版), 2023, 17(03): 221-226.
阅读次数
全文


摘要


AI


AI小编
你好!我是《中华医学电子期刊资源库》AI小编,有什么可以帮您的吗?