mbt zapatos Central venous catheter drainage of pe

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Central venous catheter drainage of pericardial cavity pericardial effusion in 46 patients treated

12 cases, 2 cases of thyroid cancer, hypothyroidism in 3 cases, 4 cases of uremia, acute myocardial infarction percutaneous coronary angioplasty (PT-CA) 1 case of rheumatic mitral dilatation in 1 case, rheumatoid heart mitral valve replacement in 1 case,[link widoczny dla zalogowanych], 1 case of systemic lupus erythematosus. 2h to 1 month duration. Ultrasound pericardial effusion liquid dark area 10 ~ 20mm3 cases, ~ 3Omm20 cases, more than 30mm23 cases. 1.2 The one-time treatment for preoperative preparation of a double-lumen central venous catheter, the patient semi-recumbent position to take,[link widoczny dla zalogowanych], the line ECG monitoring during surgery, to avoid ventricular arrhythmias. Bedside echocardiography by positioning, needle point or apex of the left medial xiphoid. Routine disinfection, shop towels, local anesthesia, needle holders through the puncture point along the negative direction of ultrasound needle, see the liquid is stopped when the needle out, indicating that the needle has entered the pericardial cavity, quickly into the J-type guide wire, pulling the needle. Guide wire into the skin in place, cut the skin with a scalpel, with the expansion of sheath expansion in separation of the subcutaneous tissue along the guide wire along the guide wire into the central venous catheter, tube depth is generally 6 ~ 10cm, and then exit the guide wire , the central venous catheter sutured to the skin on a fixed, one end connected to the drainage bag, you can line pericardial effusion drainage. 2 Results 46 patients could a successful puncture, the operating time of 8 ~ 20min. No perioperative complications. 1 ~ 2h drainage of the clinical symptoms were relieved, relieve compression symptoms. Drainage and 3 ~ 28d, the average (14.0 ± 5.O) d, flow control was first introduced in the 2OO ~ 300mL, 2 to 4 times daily drainage, daily drainage volume 3OO ~ 500mL, the total maximum daily drainage volume of 1500mL. Drainage gap infusion of heparin, saline sealed tube. * 237.3 Pericardiocentesis is a discussion of the aid measures in acute cardiac tamponade, but also the etiological diagnosis of pericardial effusion and pericardial important method of drug injection. Traditional pericardiocentesis is a dangerous operation, its complications can be as high as 11.4 ~ 20.0 [1], and pericardial puncture-related mortality was 2 ~ 4 ¨ 2], its serious complications, including puncture and tear the heart, coronary artery tear, ventricular fibrillation, pneumothorax, penetration of the abdominal cavity, infection ¨ 3]. The 46 cases pericardial effusion with automatic drainage lumen central venous catheter, guide wire, catheter soft, set people will not damage the package cavity and the myocardial blood vessels without any perioperative complications, but also single and flexible operations infusion of heparin saline drainage gap. All the patients no case of catheter during catheter blockage, infection and catheter slippage, and to avoid the single pumping too much liquid, caused by excessive hypotension, pulmonary edema, heart failure complications. The method has the following advantages: (1) a puncture, a small soft tube as central venous indwelling pericardial cavity without injury,[link widoczny dla zalogowanych], can be used repeatedly for a long time to avoid the complications caused by multiple puncture; (2) simple, fast, convenient, safe, small plane injury, rapid recovery, can be used for the rescue of cardiac tamponade; (3) ease of administration of the pericardial cavity to improve efficacy, while the dynamic observation of the amount of pericardial effusion, timely adjustment of treatment. In short, the central venous catheter drainage of pericardial cavity treatment of pericardial effusion is a simple, safe and effective rapid, less invasive, fewer complications,[link widoczny dla zalogowanych], the method can replace the traditional pericardiocentesis and drainage.
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