A narrow surgery method _'s treatment of lung artery

A narrow surgery method _'s treatment of lung artery
Lung artery one narrow at intermediate low-temperature generally in the past ' 30- 32 ) Implement, look the intersection of valve and juncture straight, cut skill, low-temperature method simple and convenient, until physiological disorder of function less in the body, resume smoothly while being postoperative, but because low temperature only can offer, circulate, block 6- 8 minutes such as time limit safely, must finish to operate hurriedly in the heart, and does not have abundant time to ascertain and correct and manage the deformity in the heart. Extracorporal circulatory system becoming better and approaching perfection day by day in recent years, myocardium protection and the intersection of operation and progress of skill make in the heart regarding performing the operation as safe direct, therefore lung the intersection of artery and the intersection of mouth and narrow operation adopt extracorporal circulatory system generally direct-view correct cure skill in the lower heart.
1. One is narrow to cut the skill and only suitable for the simple lung artery in a petal of direct-view of lung artery at low temperature, and condition to have, continue person who send funnel a narrow and other companions take place the deformity in the heart.
After trachea intubate anaesthetize, steep, enter patient competent body surface cool in the frozen water, wait nasopharyngeal temperature drop to at 35 surfacing, dry the body, the body temperature will continue dropping to 32- 30 .
The patient fetches and lies supine the location, the centre of brestbone cut-outs and cuts the brestbone longitudinally, cut the pericardium, carry on the palpation outside the heart, can touch systolic phase to tremble in the lung artery root, can lay one's hand on and increase and harden the valve merged thick while pressing this department, right room present obviously plump to increase, dissociate up and down vena cava and suit around blocking bringing respectively check-off, on lung in front of the artery at the wall and underpart, and both sides put draw suture by 4 stitch, pincers insert some lung wall cut the intersection of lung and wall in front of the artery longitudinally in front of the artery, after the anaesthetist walks several times and excessively takes a breath, tighten the up and down vena cava around taking separately, block the blood flow of vena cava, unlock the lung forceps artery after the heartbeat empty a of over blood of heart 6- 8 times, exhaust the intersection of lung and blood under artery, with draw the hook, involve and open the lung artery to cut-out and expose lung artery one and a ring, see clearly the integration spine of the valve, by cutting off or the knife is cut and driven to a ring to the artery wall of Damien's lung progressively from a hole along merging the spine, using the forefinger is ascertained whether the right ventricle has plump and narrow muscles by a hole cut, mention the traction line of the lung artery wall in the heart after finishing, the open superior vena cava blocks bringing, resume, breathe, treat blood cut-out, gush out by artery by lung while being auxiliary, arrange, remain pincers insert the lung artery cut-out behind the air in the right room to the limit, sew up and cut-out with the fine rule, stay for half a minute, relax down one more of quiet and block bringing, the operation is all finished promptly. Might present, pass the intersection of and reactive hypertension while being postoperative, sew up pericardium, cut-out after returning to normal in blood pressure and heart rate, the intersection of brestbone and the intersection of trailing and porous drainage tube in the pericardium, ventricle quiver should cut behind the narrow valve making heart massage and shocking by electricity, going quiver rapidly such as take place in the skill. 2. Extracorporal circulatory system lay direct-view correct, manage skill, suitable for all kinds of lung the intersection of artery and the intersection of mouth and narrow treatment, patient's body posture, chest cut-out and dissect the step and look the operation straight with the heart trunk if at low temperature, until the intersection of 3mg/ kg and Heparin take, aorta insert artery in pour into, in charge of, insert up and down the intersection of vena cava and drainage tube in respectively through right auricle of heart and atrium dextrum on rise, the blood lowers the temperature at the beginning after setting up extracorporal circulatory system, according to heart function state and pathological change complexity, lower the intersection of patient and nasopharyngeal temperature, aorta hinder bring up the rear, rise aorta root fast to inject the cold heart into, park, fight liquid, pericardium pour with frozen water, heart surface lower the temperature and protect the cardiac muscle with little the intersection of ice bag and part, then block the up and down vena cava around taking, cut the intersection of lung and artery or right room, implement the intersection of lung and the intersection of artery and petals of the intersection of direct-view and lower juncture, cut skill and/or the intersection of funnel and parts of plump muscle, excise skill or flow out line expand, mend slices of skill.
Funnel part is plump excise muscle it should include not separating bunch, among bunch and muscles plump of ridge in some room, the plump meat column should be excised, in order to dredge and flow out one, but need to avoid cutting off skin of neighbouring papilla, taper skin and regulating bunch in the heart, flowing out a diameter adult and should be greater than 1.7cm after dredging, children should be greater than 1. About 4cm, otherwise employ the pericardium one to be cut out and mended slice in order to expand and flow out one as a shuttleless loom shape, a ring of narrow and small lung artery should also be cut until the right room flows out one, then by weave slice or pericardium slice and expanding. Step petals of ring, mend block, will produce the intersection of lung and the intersection of artery and petal, close completely, might it produces right rooms to be depleted while being postoperative. Can't close completely in order to avoid producing the serious lung artery one, spend postoperative critical days safely, can adopt and take a leaf and mend one and expand a ring of lung artery, avoid leading to the fact the lung artery one can not be closed completely because a ring is expanded. Skill finish right room and the intersection of aorta and the intersection of root and part insert needle rank angry, the open aorta blocks pincerses, shocking by electricity if necessary quiverly makes the heart reply and beat. Wait to reply warmly to 35 , the heartbeat stops the extracorporal circulatory system with blood pressure after being steady effectively, successively pulled out up and down vena cava intubate and artery to pour into and manage, according to fish's precise albumen 4 of per kilogram of weight. 5mg vein instilled in order to neutralize Heparin.

|