查詢結果分析
來源資料
相關文獻
- Off-pump Coronary Artery Bypass (OPCAB) Is a Good Choice of Treatment for Hemodialysis-Dependent Uremic Patients with Severe Coronary Artery Disease
- Comparison of On-pump and Off-pump CABG in Hemodialysis Patients
- The Significance of Syphilis Serology Tests on Long-Term Hemodialysis Patients
- 花蓮地區長期接受血液透析患者對於疾病與治療的知識、態度及自我照顧行為相關性之研究
- 血管通路之評估--鹽液稀釋法
- 血液透析患者營養狀態主觀的總體評估(SGA)之應用
- 血液透析病人的高血壓一定合併高死亡率嗎﹖
- The Initial Status and Outcomes of Newly Diagnosed Uremic Patients in Southern Taiwan
- 血液透析療法應用於犬尿毒症之臨床病例報告
- 尿毒症患者對接受血液透析治療之認知與態度及其影響因素
頁籤選單縮合
題 名 | Off-pump Coronary Artery Bypass (OPCAB) Is a Good Choice of Treatment for Hemodialysis-Dependent Uremic Patients with Severe Coronary Artery Disease=不停跳冠狀動脈繞道是洗腎嚴重冠心症患者之良好治療方式 |
---|---|
作 者 | 諶大中; 林老生; 留志仁; 林志達; 陳志暐; 陳炳臣; 林俊龍; 李惟奇; 林庭光; | 書刊名 | 慈濟醫學 |
卷 期 | 17:4 民94.08 |
頁 次 | 頁227-231+297 |
分類號 | 416.262 |
關鍵詞 | 不停跳冠狀動脈繞道手術; 冠狀動脈疾病; 尿毒症; 血液透析; Off-pump coronary artery bypass; Coronary artery disease; Uremia; Hemodialysis; |
語 文 | 英文(English) |
中文摘要 | 目的:為洗腎腎衰竭病患執行冠狀動脈繞道手術,是心臟外科醫師的一大挑戰。我們藉由回顧在南臺灣某鄉村社區醫院之經驗,試圖評估不停跳冠狀動脈繞道手術(OPCAB)在洗腎病患的好處。病人與方法:此為一個溯型病歷研究。從2002年7月到2004年8月,共有13位洗腎病患接受不停跳冠狀動脈繞導手術,其中三位體性,十位女性,平均年齡65.4歲,所有患者都在手術前一天洗腎,術後則在第一天或第二天依照排程洗腎,如有特殊情況,則提早洗腎。術前均給予Desmopression(DDAVP)以提高血小板功能,術中出血均回收以減少流血量。術後照顧前為一般性照顧。結果:在十三位接受不停跳冠狀動脈繞道手術患者,其中九位(69.2%)患者因病況不穩定接受緊急手術,有一位(7.7%)中隔腔炎,以及一位(7.7%)術後出血須開胸探查。所有患者術後均無罹患腦中風:所有患者術後出血平均量735毫升,而有12位(93.3%)病患必須輸血。只有一位病患因代謝性酸血症需緊急洗腎,其餘病患都依排程洗腎。平均加護病房及術後住院日分別為2.8及13.3天。一位術前有多次腎造口感染的病患發生敗血症及呼吸衰竭。因而需要較長時間的呼吸器使用及住院。其餘病患復原良好,亦無感染。結論:不停跳冠狀動脈繞道手術是洗腎嚴重冠心症患者之良好治療方式。 |
英文摘要 | Objective: Surgical revascularization for uremic coronary artery patients on hemodialysis has been a challenge for cardiac surgeons We carried out this retrospective analysis to evaluate the role of off-pump coronary artery bypass (OPCAB) for uremic coronary artery patients in a rural community hospital in southern Taiwan. Patients and Methods: A retrospective chart review was done of hemodialysis-dependent uremic patients who underwent OPCAB from July 2002 through August 2004. Thirteen patients were included (3 men and 10 women, mean age 65.4±8.4 years). All patients underwent hemodialysis 1 day before the operation, and they were scheduled for hemodialysis on the first or second day postoperatively. When there was an indication, urgent hemodialysis was performed immediately after the operation. Desmopressin (1-deamino-8-D-arginine vasopressin, abbreviated DDAVP) was administered preoperatively to enhance platelet function and the pericardial-shed blood was retrieved and reinfused intraoperatively to minimize blood loss. The postoperative care was the same as ordinary practice. Results: Nine of the 13 patients were unstable and thus were operated on urgently or emergently. There was one death (7.7%), one mediastinitis (7.7%), and one mediastina bleeding requiring reexploration (7.7%). There were no postoperative strokes. The average chest tube drainage amount was 735 mL and 12 (93.3%) patients needed blood transfusions. Only one (7.7%) patient needed urgent hemodialysis after the operation because of metabolic acidosis. The other patients did well with the scheduled hemodialysis. The average intensive care unit (ICU) and hospital stays were 2.8 and 13.3 days, respectively. One patient with preoperative repeated percutaneous nephrostomy infections developed sepsis, respiratory failure, and had prolonged mechanical ventilation and hospital stay. The others recovered uneventfully and no other postoperative infections were encountered. All patients had good symptomatic relief. Conclusions: OPCAB is a good choice of treatment for hemodialysis-dependent uremic patients with severe coronary artery disease. |
本系統中英文摘要資訊取自各篇刊載內容。