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临床资料患者男,69岁,主要因“瓣膜置换术后3个月,咳嗽,咳痰2个月”于2004年9月24日收入院。入院前3个月因联合瓣膜病于外院行“二尖瓣,主动脉瓣膜置换术”,术中体外循环时间大于6 h,术后意识不清,持续昏迷15 d,尿量逐渐减少,曾9次给予血液滤过／透析,血肌酐水平逐渐降低,尿量恢复正常。6月20日行开胸探查清除心包内血块,术后给予呼吸机辅助通气。6月28日行气管
Clinical data Male, 69 years old, mainly due to “valvular replacement 3 months after cough, sputum 2 months” in September 24, 2004 income hospital. 3 months before admission due to joint valvular disease outside the hospital line “mitral valve, aortic valve replacement surgery,” the cardiopulmonary bypass time is greater than 6 h, postoperative unconsciousness, coma 15 d, urine output decreased gradually, had Hemofiltration / dialysis was given nine times, with serum creatinine levels gradually reduced and urine output returned to normal. June 20 thoracotomy to clear the pericardial blood clots, postoperative ventilator-assisted ventilation. June 28 tracheal