| Japanese |
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| Title | 開心術後ICUにおける緊急再開胸術施行症例の検討 |
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| Subtitle | 症例 |
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| Authors | 林研二*, 田中一彦**, 公文啓二**, 内藤泰顕***, 藤田毅*** |
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| Authors(kana) | |
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| Organization | *済生会下関総合病院心臓血管外科, **国立循環器病センターICU, ***国立循環器病センター心臓外科 |
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| Journal | 循環制御 |
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| Volume | 5 |
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| Number | 3 |
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| Page | 395-399 |
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| Year/Month | 1984/ |
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| Article | 報告 |
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| Publisher | 日本循環制御研究会 |
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| Abstract | 「要旨」当センターICUにおける1979年1月から1981年12月までの緊急再開胸術施行症例は16例で, 同期間のICU入室開心術症例(1,146例)の1.4%にあたる. 緊急再開胸術の原因となった病態は不整脈7例, 出血3例, 心タンポナーデの疑い3例, 著明なLOS2例, external conduitによる心圧迫1例であった. 救命率は入室後早期に施行したものほど高く, 不整脈1例, 出血1例, 心タンポナーデの疑い3例の8例(50%)を救命した. これらの症例は, 根底にLOSの要素が加味されている場合が多く, 術中・術後を通じ, LOSに注意を払うことが重要である. 術後合併症としては, 感染, 腎不全, DICおよび神経系合併症が重要で, これらに対する厳重な管理が望まれる. 「はじめに」開心術後急性期は血行動態もきわめて不安定であり, 種々の原因から著明なLOSや低血圧を示す場合がある. その際は, 迅速かつ効果的な治療を積極的に行う必要がある. しかし, 種々の治療が効を奏さない場合, 患者の状態は急速に悪化し, 著明な悪循環に陥る. |
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| Practice | 基礎医学・関連科学 |
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| Keywords | |
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| English |
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| Title | Emergency Thoracotomy in the Intensive Care Unit after Open Cardiac Operation |
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| Subtitle | |
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| Authors | 林研二*, 田中一彦**, 公文啓二**, 内藤泰顕***, 藤田毅*** |
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| Organization | |
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| Journal | Circulation Control |
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| Volume | 5 |
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| Number | 3 |
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| Page | 395-399 |
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| Year/Month | 1984/ |
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| Article | Report |
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| Publisher | Japan Society of Circulation Control |
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| Abstract | Emergency thoracotomy was conducted between January, 1979 and December, 1981 in the ICU of our Center in a total of 16 cases which were accounted for 1.4% of all cases (1,146 cases) that underwent open cardiac operation during the same period. Indications for emergency thoracotomy were arrhythmia in 7 cases, bleeding in 3 cases, suspected heart tamponade in 3 cases, severe LOS in 2 cases and heart oppression due to external conduit in 1 case. The life-saving rate was higher for those who received thoracotomy earlier after admission in the ICU; a total of 8 cases (50%) survived, consisting of 4 cases with arrhythmias, 1 case with bleeding and 3 cases with suspected heart tamponade. LOS was basically involved in many cases, so that it is important to pay attention to LOS during and after thoracotomy. As important post-operative complications are infection. acute renal failure. DIC and neurological complications, over which carefully treatment must be taken. Emergency thoracotomy in the ICU will have betterment of its life-saving rate if it is carried out at the right time after diagnosis has been correctly grasped at an early time. |
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| Practice | Basic medicine |
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