摘要
目的通过动物实验或临床应用,对带蒂大网膜在心胸外科的应用进行了系列研究。方法动物实验:(1)大网膜覆盖主动脉感染裂口或已感染的主动脉裂口移植物;(2)大网膜覆盖缺血心肌表面,促进侧支循环建立。临床:充填各种脓胸脓腔,包绕植入的人工气管,包绕食管胃吻合口防瘘,治疗食管裂口感染破溃,充填纵隔、胸骨感染缺损和将主动脉移植物与消化道隔开防瘘。结果动物实验:(1)主动脉感染裂口出血死亡率由100%分别降至33%和27.3%;(2)缺血心肌明显增加血液供应。临床:89例患者全部康复痊愈。结论带蒂大网膜在心胸外科的应用,使一些难治顽症变成了可治之症,提高了某些疾病的治愈率或明显减少了并发症。
Objective The experimental study and clinical application of pedicled omentum were performed to decrease the complications and mortality in thoracic and cardiovascular surgery.Methods Experimental study:(1)Coverage of the infected aortic wound or infected aortic graft.(2)Wrapping the heart surface for increasing the blood supply of ischemic myocardium.Clinical application:(1)Filling up the pleural cavity of chronic empyema which failed to or not suitable to all conventional operations;(2)Wrapping up the artificial trachea after trachea resection of extend trachea tumor;(3)Coverage of the anastomosis line after esophagogastrostomy of esophageal or cardial carcinoma on patients with poor general condition to prevent anastomotic leak;(4)Filling up the fistula of infected esophageal rupture which failed to conventional operations;(5)Repair the thoracic wall defect due to mediastinal infection in middle sternal incision;(6)As a partition between aortic graft and alimentary tract.Results In experimental study:(1)The mortality of infected aortic wound or infected aortic graft due to hemorrhage after coverage was decreased from 100%to 33%and 27.3%respectively.(2)After wrapping the heart with omentum the blood supply of ischemic myocardium increased significantly.In clinical application satisfactory results and complete recovery were obtained in all 89 patients by using pedicled omentum.Prolonging omentum technique,the pathway for omental paving from abdomen to thoracic cavity and the key point of operation are discussed.Conclusion Pedicled omentum can be used to decrease the complications and mortality of several diseases in thoracic and cardiovascular surgery.
作者
高尚志
涂仲凡
林道明
姚震
程邦昌
王土生
鲁世千
Gao Shangzhi;Tu Zhongfan;Lin Dao-ming(Department of Cardiolhoracic Surgery First AffliCted Hospital Hubei Medical University,Wuhan 430060,P.R.China)
出处
《中国胸心血管外科临床杂志》
CAS
1998年第1期1-3,共3页
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
基金
湖北省科委资助
关键词
大网膜
移植
心脏外科手术
胸外科手术
Pedicled omentum
Artificial trachea
Infected aortic wound
Ischemic myocardium
