心臟手術(shù)英文

演講人：日期：心臟手術(shù)英文目錄OverviewofcardiacsurgeryTypeofcardiacsurgeryCardiacsurgerystepsComplicationsofcardiacsurgeryPostcardiovascularsurgerycareRiskandpreventionofcardiacsurgery01OverviewofcardiacsurgeryDefinitionCardiacsurgeryisanysurgicalprocedureperformedontheheartoritsmajorbloodvesselsPurposeThemainpurposeofcardiacsurgeryistorepairorreplacedamagedordiseasedpartsoftheheart,restorebloodflow,andimprovetheheart'sfunctionDefinitionandPurposeSurgicalindicationsCoronaryartdiseaseBlockagesinthecoronaryartsthatsupplybloodtotheheartmusclemayrequiresurgerytorestorebloodflowHeartvalvediseaseDamagedordiseasedheartvalvesmayneedtoberepairedorreplacedtoensureproperbloodflowthroughtheheartCongenitalheartdefectsSomeCongenitalheartdefects,suchasVenturalSeptaldefectsorAtrialSeptaldefects,mayrequiresurgicalcorrectionHeartfailureInsomecases,surgerymaybenecessarytotreatheartfailurebyimplementingdevicessuchaspacemakersordefibrillatorsSeverelungdiseasePatientswithseverelungdiseasemaynotbeabletotollthestressofcardiovascularsurgeryPoorgeneralhealthPatientswithpoorgeneralhealthormultiplecomorbiditiesmaybeatincreasedriskforapplicationsduringandaftersurgeryBleedingdisordersPatientswithbleedingdisordersorwhoaretakingantibioticsmayneedtoundergoadditionaltestingandpreparationbeforesurgeryUntreatableinfectionsActiveinfections,specificallythoseinvolvingtheheartoritssurroundingstructures,mayneedtobetreatedbeforesurgerycanbeperformedContainmentstosurgeryMedicalhistoryandphysicalexaminationAdetailedmedicalhistoryandphysicalexaminationareessentialtoassessthepatient'soverallhealthandidentifyanypotentialrisksDiagnostictestingDiagnostictestssuchaselectrocardiograms(ECGs),echocardiograms,andcardiaccatalysismaybeperformedtoevaluatethepatient'sheartfunctionandanalysisPreoperationalevaluationPreoperativecounselingPatientsshouldreceivecounselingabouttherisksandbenefitsofsurgery,aswellasinstructionsonhowtoprepareforsurgeryandwhattoexpectduringrecoveryMedicalreviewandadjustmentPatientsmayneedtostoptakingcentralmedicinebeforesurgeryandstarttakingotherstoreducetheriskofcomplicationsPreoperationalevaluation02TypeofcardiacsurgeryCoronaryartbypasssurgeryIndicationsCoronaryartdiseasewithsignificantstenosis,typicallycausinganginaorheartattackGraftoptionsInternalsummaryart(IMA),saphenousvein,orradialartcanbeusedasgradesProcedureCreatinganewpathforbloodflowtotheheartmusclebygraftingahealthybloodvesselaroundtheblockedcoreartPostoperationalcareClosemonitoringofheartfunction,gradepatience,andmanagementofanyapplicationsIndicationsValvularheartdiseasesuchasstenosis(narrowing)orregression(leakage)ofthevalvesValverepairorvalvereplacement,dependingontheseverityandnatureofthevalveissueMechanicalvalves(dualbutrequirelifetimeanticoagulation)orbiologicalvalves(lessdualbutdonotrequireanticoagulation)Closemonitoringofheartfunction,valvefunction,andmanagementofanyapplicationsProceduretypesValveoptionsPostoperationalcareHeartvalvesurgeryStructuralheartdefectspresentatbirth,suchaspartialdefects,valveabnormalities,orcomplexcongenitalheartdefectsIndicationsSurgicalcorrectionofthestructuraldefect,ofteninvolvingrepairorreplacementofaffectedheartstructuresProcedureOpenheartsurgeryorminimallyinvasivetechniques,dependingonthecomplexityofthedefectandthepatient'sconditionSurgicalapproachesClosemonitoringofheartfunction,surgicalsite,andmanagementofanyapplicationsPostoperationalcareCongenitalheartdiseasesurgeryIndicationsEndstageheartfailurereferraltomedicaltherapyandothersurgicaloptionsDonorselectionRigorousscreeningprocesstoensuredonorheartissuitablefortransportationPostoperationalcareIntensivecareunit(ICU)monitoring,immunosuppressiontherapytopreventrejectionofthedonorheart,andclosefollow-upforlongtermmanagementProcedureRemovalofthediseasedheartandreplacementwithahealthydonorheartHearttransplantsurgery03CardiacsurgerystepsGeneralAnesthesiaisadministeredtoensurethatthepatientisunconsciousandunabletofeelpaidduringtheprocedureAnesthesiaThepatientispositionedontheoperatingtableinawaythatprovidesthelargewithoptimalaccesstotheheartThiscommonlyinvolveslyingonthebackwiththearmsextendedouttothesidesPositionAnesthesiaandPostureDecisionAsurgicaldecisionismadethroughtheskinandintothechemicalactivityThelocationandsizeoftheinvestmentdependonthetypeofsurgerybeingperformedExposureTheribsarespreadaroundandthesternum(breakbone)maybedividedtoprovideaccesstotheheartRetractorsareusedtoholdtheribsandsternuminpositionduringthesurgeryDecisionandexposureBypasssurgeryIncoronaryartbypassgrafting(CABG),ahealthybloodvesselistakenfromanotherpartofthebodyandattachedtotheblockedcoronaryarttoreroutebloodflowtotheheartmuscleValvesurgeDamagedordiseasedheartvalvesmayberepairedorreplacedwithartisticvalvesduringheartvalvesurgeOtherproceduresOthersurgicalproceduresmayincluderepairingcongenitalheartdefects,treatingarrhythmias,orimplementingdevicessuchaspacemakersordefibrillatorsSurgicalprocedureVSBleedingiscontrolledusingvarioustechniquessuchasapplyingpressure,usinghomeostaticagents,orcausetizingbloodvesselswithheatorelectricitySuturingThedecisionisclosedusingsutures(sticks)thatareplacedintheskinandunderlyingissuesThesuturesaretypicallyremovedafterthesoundhasheatedupefficientlyHemastasisHemostasisandsuturing04ComplicationsofcardiacsurgeryPostoperativebleedingisacommonapplicationofcardiacsurgery,whichmayrequireadditionalsurgicalinterventionorbloodtransferBleedingSurgicalsiteinfections,pneumonia,andotherinfectionscanoccuraftercardiacsurgery,necessitatingantibioticsandothertreatmentsInfectionBleedingandinfectionAtrialfiltrationThisisthemostcommonarrhythmiaaftercardiacsurgery,characterizedbyirregularandsoftrapidheartbeatVentriculararrhythmiasThesecanbemoreseriousandmayrequiremedicine,defibrillation,orpacemakerinsertionRhythmiasHeartfailurePaidfunctionoftheleftvehicle,themainpumpingchamberoftheheart,canleadtoheartfailureLeftvehiculardysfunctionPaidfunctionoftherightvehiclecanalsooccur,specificallyaftercomplexsurgeriesinvolvingtherepairorreplacementofheartvalvesRightvehiculardysfunction01ClotsorEmbolicandisruptduringsurgeryandtraveltothebrain,causingastrokeStroke02PaidkidneyfunctioncanoccurduetoreducedbloodflowordamagecausedbycontrastdieusedduringtheprocedureRenalfailure03DifficultlybreakingcanoccurduetofluidaccumulationinthelungsordamagetotherespiratorymusclesduringsurgeryRespiratoryfailure04Nausea,invoicing,andconsistencyarecommonaftercardiacsurgeryandcanbemanagedwithmedicalanddietarychangesGastrointestinalcompositesOtherapplications05PostcardiovascularsurgerycareNursingintheintensivecareunitNursesaretrainedtoidentifyandrespondquicklytoanysignsofapplicationssuchasblending,infection,orarrhythmiasPreventionofapplicationsHeartrate,bloodpressure,respiratoryrate,andtemperaturearecontinuouslymonitoredtoensuretheyremainwithinsafelimitsClosemonitoringofvitalsignsPatientsaregivenpaintreatmentasneededtokeepthemcomfortableandfacilityrecoveryManagementofpainanddiscomfort03UseofrespiratoryaidsInsomecases,patientsmayrequiretheuseofhospitalsorotherrespiratoryaidstosupporttheirbreathing01RespiratorymonitoringPatients'respiratorystatusiscloselymonitored,includingoxygensaturationlevelsandlungsounds02AssistancewithbreakingexercisesPatientsareresourcedtoperformdeepbreakingandcoachingexercisestocleartheirlungsandpreventpneumoniaRespiratorycareManagementofChesttubesChesttubesareinsertedaftersurgerytodrainfluidfromtheChestcavityThesetubesarecarefullymonitoredandmanagedtoensureproperdrainageCareoftheinsertionsiteTheareaaroundthechemicaltubeinsertionsiteiscleanedanddressedregularlytopreventinfectionMonitoringofdrainageTheamountandcoloroffluiddrainedfromthechemicaltubesarecloselymonitoredtoassessthepatient'srecoveryprogressDrainagetubecareDietaryrecommendations01Patientsareprovidedwithdietaryguidelinestoensuretheyreceivethenutrientstheyneedforrecoverywhileavoi