Respiratory failure with chronic pulmonary heart d -

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Respiratory failure with chronic pulmonary heart disease Clinical analysis of thyroid hormone

l, an average of 25ml, 20ml more than 4 cases. 2 Methods and Results ll cases were experts in the disease after 6-7 hours of bilateral lateral ventricle drainage, intracerebral hematoma in 3 cases (2 cases of hematoma in basal ganglia, thalamus hematoma in 1 case) while a separate aspiration UK drainage. Shunt surgery were drilled in the skull under local anesthesia,[link widoczny dla zalogowanych], the lateral brow catheter, drainage tube diameter 3-4mm, as much as possible after the release catheter bloody cerebrospinal fluid, and pumped a small amount of blood clots immediately at the end of surgery intraventricular injection of domestic UK2-3 million units / 5ml solution, clamped drainage tube about 4 hours open drainage, drainage bottle height and head level, into the UK3 times a day, injected with a saline flush before the drainage tube. Dynamic CT brain scan confirmed intraventricular hemorrhage disappeared and continuous tube drainage of 1 week dial, call control to the cerebrospinal fluid after lumbar puncture and normal daily line. Following the above treatment, 3 patients died, including 2 cases of recurrent bleeding in brain, severe pulmonary infection in 1 case, the mortality rate 27.3%. Follow-up six months, living skills (ADL): ADLI4 cases, ADL23 cases, ADL1 cases. 3 Discussion 3.1 The timing of surgery: cerebral hemorrhage indoor bloody hand can quickly lead to obstructive hydrocephalus, caused a sharp increase in intracranial pressure and cerebral hernia formation; the other hand, can cause severe hemorrhage and hypothalamus brainstem compression damage, and thus make nerve fibers, glial cells and nerve cells within the mitochondria, organelles such as endoplasmic reticulum swelling, part of the structure disappeared, nuclear chromatin margination,[link widoczny dla zalogowanych], and even lead to cell death 【. Therefore, in the hematoma that caused irreversible damage, you should actively eliminate hematoma, brain tissue can reduce secondary damage to a minimum, which reduce mortality and improve quality of life of patients has an important role. Ll patients in this group are in the 6-7 hours after the emergency patients for treatment, 3 died and 8 patients in the survival of patients, thalamic hemorrhage in 1 patient survival of plants, the remaining 7 patients met the ADL level, their quality of life Comprehensive literature is better than I3】. So, very early urokinase better drainage. 3.2 urokinase (UK) Application: UK is a plasminogen activator,[link widoczny dla zalogowanych], is exogenous direct non-specific plasminogen activator, a strong role in the dissolution of hematoma. According to Zhu Fengqing II report, UK is a safe and effective biological agents on normal brain cells do not produce harmful effects, with increasing doses of UK,[link widoczny dla zalogowanych], hematoma to reduce the time to be dissolved. Every time we made the intraventricular injection of UK2.3 million units / 5ml solution, 3 times a day. The dynamic observation of brain CT, cerebral hemorrhage clearance time indoors: 1 day 2 cases, 2 days in 3 cases, 2 cases of 4 days, 6 days in 2 cases. Cured by this group did not occur very early UK intraventricular drainage rebleeding. ① 3_3 prevention of postoperative complications of rebleeding Prevention: rebleeding after hypertensive intracerebral hemorrhage is the main direct impact on results of operations, according to the current literature I, diastolic blood pressure> 90mmHg on the second occurrence of cerebral hemorrhage is the primary risk factors. 2 patients in this group of patients re-bleeding in brain were significantly increased due to postoperative blood pressure, diastolic blood pressure above 100mmHg continuous death has not been effectively controlled. Therefore, control of diastolic blood pressure of 90mmHg following are important measures to prevent further bleeding. ② lung infection: 5 cases occurred in this group, 1 patient died of pulmonary infection can be seen is the most common complications. Therefore, patients should be routine for unconscious tracheotomy,[link widoczny dla zalogowanych], and implementation of standard tracheotomy care, bacterial culture and sensitivity test, select the sensitivity of antibiotics to prevent lung infections. ③ gastrointestinal hemorrhage: Hypertensive intracerebral hemorrhage is another common early surgical complication rate of up to 50% or more. We are in the active treatment of this group of patients the primary disease, based on the application of acid and gastric mucosal protective drugs, intravenous and nasogastric nutrition support preventive treatment, occurred only in 1 case. ④ central high fever: This is a serious complication occurred in this group 2 patients, both thalamic hemorrhage, the physical cooling and artificial hibernation and other treatment to control.

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