Abstract： Objective To analyze clinical outcomes of interventional therapy for common congenital heart diseases （CHD）. Methods We retrospectively analyzed the clinical records of 57 patients with CHD who underwent catheter interventional therapy in People’s Hospital of Deyang City between March 2009 and January 2012. There were 31 male patients and 26 female patients with their mean age of 29.4±3.5 years（ranging from 1.5 to 75.0 years）. There were 21 patients with patent ductus arteriosus （PDA）, 12 patients with ventricular septal defect （VSD）, and 20 patients with atrial septal defect（ASD）；and 2 patients with VSD plus ASD, 1 patient with VSD plus PDA, and 1 patient with ASD plus PDA. Occluder and supplying system made in China were used in the interventional therapy. For the patients with ASD plus PDA, PDA was blocked before ASD；for the patients with VSD plus PDA, PDA was blocked before VSD；and for the patients with VSD plus ASD, VSD was blocked before ASD. Results The duration of interventional therapy ranged from 30 to 90 minutes. The success rate of operation was 98.3%（56/57）. Operation was given up in an old female patient with ASD and chronic obstructive pulmonary disease because of pulmonary hypertension. The hospital stay was 3 -7 days. All the patients were followed up at the outpatient department for 1 month to 2 years by color Doppler echocardiogram, chest X-ray and electrocardiograph, and no complication occurred during follow-up. Conclusion With complete understanding of surgical indications and strict compliance with procedures, catheter interventional therapy is safe, minimal invasive, and effective in CHD treatment.
ObjectiveTo compare the clinical effect of single mediastinal drainage tube and both mediastinal drainage tube and closed thoracic drainage tube for the patients who received thoracoscopic radical resection of esophageal carcinoma.MethodsWe enrolled 96 esophageal carcinoma patients who received thoracoscopic radical resection from June 2016 to October 2018. Of them, 49 patients were indwelt with both mediastinal drainage tube and closed thoracic drainage tube (a chest & mediastinal drainage group, a CMD group) while the other 47 patients were indwelt with single mediastinal drainage tube (a single mediastinal drainage group, a SMD group). The total drainage volume, intubation time and incidence of postoperative complications (postoperative atelectasis, pulmonary infection, pleural effusion and anastomotic leakage) between the two groups were compared. The pain score and comfort score were also compared between the two groups.ResultsThe total drainage volume and intubation time in the SMD group were not significantly different from those in the CMD group (1 321±421 mL vs. 1 204±545 mL, P=0.541; 6.1±3.7 d vs. 6.4 ±5.1 d, P=0.321). The incidence of postoperative complications (postoperative atelectasis, pulmonary infection, pleural effusion and anastomotic leakage) in the SMD group was not significantly different from that in the CMD group (10.6% vs. 6.1%, P=0.712; 4.3% vs. 10.2%, P=0.656; 6.4% vs. 12.2%, P=0.121; 2.1% vs. 4.1%, P=0.526). The numerical rating scale (NRS) pain scores on the first to the fifth day after surgery and during extubation in the SMD group were significantly lower than those in the CMD group (3.2±2.1 vs. 5.1±2.4, P=0.041; 2.8±0.6 vs. 4.8±1.4, P=0.015; 2.1±0.4 vs. 4.5±0.4, P=0.019; 1.7±0.7 vs. 4.0±0.8, P=0.004; 1.8±0.7 vs. 3.2±1.2, P=0.006; 1.4±0.2 vs. 2.5±3.4, P=0.012). The VAS comfort scores in the SMD group were significantly lower than those in the CMD group (3.6±1.7 vs. 6.6±3.7, P=0.018; 2.9±2.0 vs. 5.1±3.4, P=0.007; 2.1±1.4 vs. 5.5±2.4, P=0.004; 3.0±0.9 vs. 4.6±3.8, P=0.012; 1.8±1.1 vs. 4.2±2.7, P=0.003; 2.4±3.2 vs. 5.3±1.7, P=0.020).ConclusionThe clinical effect of single mediastinal drainage tube in thoracoscopic resection of esophageal carcinoma is similar to that of both mediastinal drainage tube and closed thoracic drainage tube, but it can significantly improve the comfort of the patients.
Objective To summarize the treatment and outcomes of patients with multiple injuries combined with thoracic trauma following the Wenchuan earthquake. Methods The wounded patients admitted from 12th to 31st May with multiple injuries combined with thoracic trauma after the earthquake were retrospectively analyzed. This includes baseline information, treatments, outcomes and deaths. Results Liver repair, spleen abscission, decompression and removed of intracranial hematoma ranked the first three of the main reasons for the emergency surgery death of multiple injuries. Heart-lung machine support, trachea cannula and closed drainage of thoracic cavity ranked the first three of the main reasons for the death of thoracic trauma. Moreover, ARDS, fracture of sternum and flail chest ranked the first three of the main reasons for the death of other multiple injuries. All the casualties had the worst situation with high ISS scores. The main death reasons were cerebral wound, peritoneum viscera injuries and the four limbs and pelvis injuries. Besides, the severe thoracic trauma accelerated their death. Conclusion Main death reasons for the inpatients with multiple injuries combined with thoracic trauma are hemorrhagic shock and severe cerebral wound. The thoracic trauma degree will increase the risk of their death. The more the injury positions, the higher ISS scores, and the more serious thoracic trauma, the higher mortality rate. Rapid examination and diagnosis, rapied triage and distribution of thoracic trauma can help to create more chances for the further treatment and increase the success rate of rescue.
