Laboratory and Clinical Investigation(two times daily); 6, daily assessment of whether weaning;7, Objective monitoring, regular assessment of infectionchanges, adjust according to changes in treatment.After active treatment and control, patients withpulmonary infection were controlled quickly. X reviewof lung in good condition, successful weaning from theventilator. The ultimate success of patients with cervicaloperation, cured.ResultsThrough the monitoring and management of hospitalinfection in ICU ward, ventilator-associated pneumonia,central venous catheter-related bloodstream infection,catheter associated urinary tract infection rate decreasedyear by year, and achieved good results: (see Table 2, table 3)Therefore, after compared with statistical significance, theincidence of nosocomial infection was significant difference.ConclusionFrom the monitoring form in recent years, wecan draw the conclusion: in ICU, ventilator-associatedpneumonia, central venous catheter-related bloodstreaminfection, catheter associated urinary tract infection ratedecreased year by year. Among them, ventilator-associatedpneumonia from 280‰ in 2008 dropped to 80‰ now,central venous catheter-related bloodstream infection ratefrom 50‰ in 2008 dropped to 19‰ now, catheter-relatedurinary tract infection rate from 116.7‰ in 2008 dropped to33‰ now. After compared with statistical significance, thehospital infection rate changes have significant differences.Therefore, the effect of monitoring and management ofTable 2 The quality indexes of emergency ICU (2008-2012)YearCriticallyThe incidenceCatheter ill patients All kinds24/48of centralThe incidencerelated expected Severe of catheter Trachealhoursvenousof ventilatorassociatedtract and the bedsore and then herniationurinary mortality casualty slippage catheterICUcatheterrelatedreturnpneumonia%infection actual rate% plug the casesrate‰hematogenousrate% mortalityrate%infection%rate%2008 1.33 280 50 116.710.0011.600 8.00 12009 2.12 241.00 45.0 105.0013.009.870.67 7.21 02010 1.24 136.00 34.00 92.0012.3310.650 6.03 22011 0.98 99.00 35.00 89.0015.539.680 6.52 12012 0.85 95.00 19.00 33.0014.878.790 5.97 0nosocomial infection in ICU is very effective.DiscussionICU infection control has been the emphasis anddifficulty of ICU management, how to effectively carry outthe infection control is the ICU staff has been pursuing thegoal. Compared with other departments of the hospital,in ICU ward, ventilator-associated pneumonia, catheterrelatedurinary tract infection rate is higher. We considerthe main reason: ICU ward patients with more seriousillness, coma and without spontaneous activity, breathing、swallowing and cough expectoration difficulties, activitywas inhibited, much longer time of indwelling catheterand endotracheal intubation, invasive intubation airwaymucosal barrier defense injury, ventilator closed pipelinecaused by bacteria in circulating retention, easy to causeinfection such as bacterial colonization. [3-4] The positiveanalysis of the majority of patients with ICU, the suggestionaccording to the target monitoring table, take the positiveprevention and control measures such as artificial airwaypatients: proper posture (15-30º), strict indications, sputumstrict aseptic operation, ventilation pipe, atomizer highlevel disinfection, pipe replaced weekly, regular oral care,daily assessment of whether weaning, regular assessment ofinfection changes, adjust according to changes in treatment.Through these effective measures, can reduce the incidenceof hospital infection; improve the quality of medicaltreatment, more effective to save the patient's life.Table 3 Detection of indicators of emergency ICU quality (2012)Month Ventilator-associated‰Central venous catheter related Catheter-associated urinaryinfection ‰tract infection‰1 166.7 25.7 39.12 155.2 22.4 38.93 130.6 26.7 46.24 138 18.2 355 121 21 326 115 17.5 397 107 22 388 98 21 33.89 93 19 3310 95 20 3211 89 18 3112 83 19 33Comparison of statistics in 2008 and 2012: X 2 =49.18 P
李 晓 密 韩 宏 光 李 新 民 王 辉 山方 敏 华 尹 宗 涛 韩 劲 松 孟 庆 涛沈 阳 军 区 总 医 院 心 血 管 外 科 辽 宁 沈 阳 110016膨 体 聚 四 氟 乙 烯 片 作 单 瓣 重 建 右 室 流 出 道 术后 早 期 并 发 症 及 处 理Early Complications and its Management after Right Ventricular Outlet TractReconstruction with Gore-tex Monocusp ValveXiao-mi Li, Hong-guang Han, Xin-min Li, Hui-shan Wang, Min-hua Fang, Zong-tao Yin, JinsongHan, Qing-tao MengDepartment of Cardiac Surgery, General Hospital of Shenyang Military District, Shenyang, 110016, LiaoningProvince, ChinaAbstractObjective: To evaluate the efficacy of reconstruction of right ventricular outlet tract(RVOT)with 0.1 mm Gore-Tex monocusp valve for short term.Methods: Between June 2002 to June 2010, 75 patients (42 male, 33 female) underwent reconstruction of RV0T with Gore-Tex monocusp valve tocorrect cardiac anomalies,including 57 patients with tetralogy of Fallot (TOF) and pulmonary stenosis, 10 patients with TOF and pulmonary atresia,4 patients with TOF and absent pulmonary valve, 2 patients with double outlet of right ventricle and pulmonary stenosis, 1 patient with truncus arteriousand 1 patient with complete transposition of great artery, ventricular septal defect and pulmonary stenosis.Results: There was no operative death. The postoperative blood oxygen saturation was up to 96%-100%. PaO 2 was 82-207mmHg. The ratioes of rightventricular systolic pressure and left ventricular systolic pressure were between 0.22 to 0.70.The gradient between right ventricle and left or right pulmonaryartery was less than 10 mmHg; Left ventricular ejection fraction (LVEF) was 0.53-0.80, right ventricular ejection fraction (RVEF) was 0.52-0.71, leftventricular end-diastolic volume index was 0.28-0.62ml/m 2 . Early postoperative complications: hypoxemia (oxygenation index
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