Minami H, Kuinose M, Murakami T, Kuroki K, Kanaoka Y, Tanemoto K
Department of Cardiovascular Surgery, Iwakuni National Hospital, Iwakuni, Japan.
Kyobu Geka. 2002 Sep;55(10):867-70.
Chronic dialysis patients who received open heart surgery were examined, and main concern was perioperative management. There were 12 chronic dialysis patients and open heart surgeries were performed between October 1990 and June 2000. The patients were comprised of 7 men and 5 women with the average age being 64 with plus or minus 7.9. The operative procedure of 6 coronary artery bypass grafting (CABG) [on-pump], 1 CABG + mitral valve replacement (MVR), 3 aortic valve replacement (AVR), 1 mitral valvuloplasty (MVP) and 1 ascending aorta replacement were performed. All patients were discharged from the hospital with good conditions 27.1 days after operation. There were no hospital deaths. One postoperative complication of mediastinitis of the sternum has been found. A conventional dialysis was performed the day before the operation and an intra-operative hemodialysis (HD) was performed, placing a dialyzer into a cardiopulmonary system during the operation. For the perioperative management, HD was started the day or 2 days after the operation with no immediate postoperative hemocatharsis and returned to the normal HD 7 days after the operation. The result of the perioperative management has been good.
对接受心脏直视手术的慢性透析患者进行了检查,主要关注点是围手术期管理。1990年10月至2000年6月期间,有12名慢性透析患者接受了心脏直视手术。患者包括7名男性和5名女性,平均年龄为64岁,上下浮动7.9岁。实施了6例冠状动脉搭桥术(CABG)[体外循环]、1例CABG +二尖瓣置换术(MVR)、3例主动脉瓣置换术(AVR)、1例二尖瓣成形术(MVP)和1例升主动脉置换术。所有患者术后27.1天均康复出院,无院内死亡病例。发现1例术后胸骨纵隔炎并发症。术前一天进行常规透析,并在手术中进行术中血液透析(HD),即在手术期间将透析器置入心肺系统。围手术期管理方面,术后当天或第二天开始进行HD,术后未立即进行血液滤过,术后7天恢复正常HD。围手术期管理效果良好。