吴清玉心脏外科学 吴清玉 著 生活 文轩网

IX   目    录 目    录 CONTENTS 第1篇  心脏外科基础 第1章  心脏大血管的解剖................................................................................................................3 第1节  心脏的位置和结构 ..........................................................................................................3 第2节  心包 ..................................................................................................................................4 第3节  心脏的表面 ......................................................................................................................5 第4节  心房与心室 ......................................................................................................................6 第5节  心肌 ..................................................................................................................................8 第6节  心脏纤维支架 ..................................................................................................................9 第7节  心脏的瓣膜 ....................................................................................................................10 第8节  心脏传导系统 ................................................................................................................12 第9节  心脏大血管 ....................................................................................................................12 第10节  冠状动脉和静脉 ..........................................................................................................14 第11节  心外科常用血管解剖 ..................................................................................................16 第2章  心脏生理..............................................................................................................................20 第1节  心肌细胞的结构和舒缩机制 ........................................................................................22 第2节  心脏的生物电活动 ........................................................................................................24 第3节  心动周期及心脏泵血过程 ............................................................................................26 第4节  心音 ................................................................................................................................28 第5节  心脏泵血功能评定 ........................................................................................................28 第6节  心脏泵血功能的调控 ....................................................................................................29 第3章  分子医学基础......................................................................................................................38 第1节  分子医学发展史 ............................................................................................................38 第2节  DNA、RNA与cDNA ...................................................................................................39 第3节  人类基因组 ....................................................................................................................41 第4节  细胞分子生物学技术简述 ............................................................................................44 第5节  遗传病简述 ....................................................................................................................47 第6节  先天性心脏病的分子遗传学进展 ................................................................................50 第4章  心脏外科的研究..................................................................................................................58 第1节  心脏外科研究的重要性 ................................................................................................58 第2节  心脏外科研究的条件和方法 ........................................................................................60 第3节  心脏外科研究的常见类型 ............................................................................................62 第4节  心脏外科研究常采用的统计学方法 ............................................................................65 第5节  心脏外科研究系统评价 ................................................................................................66 第6节  临床资料数据库 ............................................................................................................67 第2篇  辅助诊断检查 第5章  心电图诊断..........................................................................................................................75 第1节  心律失常和先天性心脏病 ............................................................................................75 第2节  窦房结功能异常 ............................................................................................................77 第3节  房室阻滞 ........................................................................................................................78 第4节  束支传导阻滞和室内传导延迟 ....................................................................................80 第5节  右位心 ............................................................................................................................81 第6节  心房扩大 ........................................................................................................................82 第7节  心室肥厚 ........................................................................................................................84 第8节  与缺血相关的心电图改变 ............................................................................................87 第9节  快速性心律失常 ............................................................................................................90 第6章  心脏超声诊断......................................................................................................................97 第1节  重要超声心动图技术种类 ............................................................................................97 第2节  超声心动图在常见心脏疾病诊断中的应用 ..............................................................113 第7章  心脏X线影像学诊断 .......................................................................................................124 第1节  心脏X线检查 .............................................................................................................124 第2节  心脏CT检查 ...............................................................................................................133 第8章  心导管诊断........................................................................................................................145 第1节  心导管检查 ..................................................................................................................145 第2节  心血管造影 ..................................................................................................................151 第9章  心脏磁共振诊断................................................................................................................154 第1节  概述 ..............................................................................................................................154 第2节  心脏、大血管MRI检查要点 .....................................................................................155 第3节  心脏、大血管MRI正常影像及测量 .........................................................................157 第4节  MRI心血管疾病诊断 ..................................................................................................159 第10章  心血管系统核医学诊断..................................................................................................166 第1节  心肌灌注显像 ..............................................................................................................166 第2节  心肌代谢显像与存活心肌评估 ..................................................................................171 第3节  心血池显像 ..................................................................................................................174 第3篇  辅助治疗技术 第11章  心脏外科手术麻醉 ..........................................................................................................179 第1节  先天性心脏病手术麻醉 ..............................................................................................179 第2节  心脏瓣膜手术麻醉 ......................................................................................................190 第3节  肥厚型心肌病（HCM）手术麻醉 .............................................................................193 第4节  冠状动脉旁路移植术的麻醉 ......................................................................................196 第5节  主动脉病变的麻醉 ......................................................................................................203 第6节  心脏介入治疗的麻醉 ..................................................................................................205 第7节  心脏肿瘤手术的麻醉 ..................................................................................................208 第8节  心脏移植手术的麻醉 ..................................................................................................211 第12章  体外循环..........................................................................................................................214 第1节  体外循环历史 ..............................................................................................................214 第2节  体外循环前的准备 ......................................................................................................214 第3节  体外循环术中的基础管理 ..........................................................................................217 第4节  重要脏器保护 ..............................................................................................................224 第5节  特殊病种的体外循环管理 ..........................................................................................230 第6节  总结 ..............................................................................................................................237 第13章  心肌保护..........................................................................................................................239 第1节  心肌保护的基础知识 ..................................................................................................239 第2节  心肌保护方法及临床应用 ..........................................................................................242 第3节  未成熟心肌的保护 ......................................................................................................248 第14章  心脏手术后的监护和处理..............................................................................................252 第1节  ICU团队的组织与管理 ..............................................................................................252 第2节  术后患者的转运 ..........................................................................................................253 第3节  体外循环对患者的影响 ..............................................................................................253 第4节  ICU的常规处理 ..........................................................................................................254 第5节  心脏手术后常见并发症的处理 ..................................................................................259 第15章  心脏手术后常用的医疗技术..........................................................................................270 第1节  胸腔穿刺与引流 ..........................................................................................................270 第2节  气管切开 ......................................................................................................................271 第3节  二次开胸 ......................................................................................................................271 第4节  肾脏替代治疗 ..............................................................................................................272 第16章  心肺复苏..........................................................................................................................274 第1节  心脏性猝死的原因 ......................................................................................................275 第2节  心肺复苏——基本生命支持（BLS） .........................................................................276 第3节  心肺复苏——高级生命支持（ACLS） ......................................................................280 第4节  心肺复苏常用药物 ......................................................................................................283 第5节  ECMO辅助心肺复苏 ..................................................................................................285 第6节  复苏后救治 ..................................................................................................................288 第17章  心脏起搏技术应用..........................................................................................................292 第18章  心脏外科手术的基本技术..............................................................................................306 第1节  心脏外科手术人员的组织与配合 ..............................................................................306 第2节  心脏外科基本操作技术 ..............................................................................................307 第3节  体外循环的建立 ..........................................................................................................308 第4节  体外循环撤除 ..............................................................................................................311 第19章  心脏外科手术的止血......................................................................................................313 第1节  心脏外科手术出血的原因 ..........................................................................................313 第2节  心脏外科手术出血的危害和预防 ..............................................................................314 第3节  心脏外科手术后常见的出血位置和诊治 ..................................................................315 第20章  手术的风险评估、决策和术前准备..............................................................................318 第1节  手术前风险评估的主要方法 ......................................................................................318 第2节  心脏手术的高危因素及决策 ......................................................................................319 第3节  常见心脏病手术的评估和决策 ..................................................................................320 第4节  心脏病的手术前准备 ..................................................................................................324 第4篇  先天性心脏病 第21章  心脏胚胎发育与先天性心脏病......................................................................................331 第22章  先天性心脏病分类与命名..............................................................................................337 第23章  房间隔缺损、部分型心内膜垫缺损..............................................................................347 第1节  房间隔缺损 ..................................................................................................................347 第2节  左心室右心房通道 ......................................................................................................361 第24章  接近型房室间隔缺损......................................................................................................364 第25章  三房心..............................................................................................................................379 第26章  肺静脉异位引流..............................................................................................................386 第1节  接近型肺静脉异位引流 ..............................................................................................386 第2节  部分型肺静脉异位引流 ..............................................................................................395 第27章  无顶冠状静脉窦综合征..................................................................................................403 第28章  体静脉异常连接..............................................................................................................411 第29章  先天性肺静脉狭窄..........................................................................................................419 第30章  动脉导管未闭..................................................................................................................426 第31章  肺动脉瓣疾病..................................................................................................................432 第1节  肺动脉瓣及瓣下狭窄 ..................................................................................................432 第2节  肺动脉瓣缺如 ..............................................................................................................437 第32章  室间隔缺损......................................................................................................................444 第33章  双腔右心室......................................................................................................................457 第34章  法洛四联症......................................................................................................................466 第35章  右心室双出口..................................................................................................................493 第36章  左心室双出口..................................................................................................................516 第37章  肺动脉闭锁合并室间隔缺损..........................................................................................527 第38章  室间隔完整的肺动脉闭锁..............................................................................................545 第39章  主-肺动脉间隔缺损 ......................................................................................................555 第40章  埃布斯坦畸形..................................................................................................................565 第41章  先天性房室瓣畸形..........................................................................................................587 第1节  先天性二尖瓣疾病 ......................................................................................................587 第2节  先天性三尖瓣疾病 ......................................................................................................595 第42章  先天性主动脉瓣及瓣下、瓣上狭窄..............................................................................600 第1节  先天性主动脉瓣狭窄 ..................................................................................................600 第2节  先天性主动脉瓣下狭窄 ..............................................................................................609 第3节  先天性主动脉瓣上狭窄 ..............................................................................................613 第43章  主动脉窦瘤破裂..............................................................................................................619 第44章  肺动脉异常起源升主动脉..............................................................................................629 第45章  先天性主动脉缩窄..........................................................................................................634 第46章  主动脉弓中断..................................................................................................................646 第47章  先天性血管环畸形..........................................................................................................654 第48章  先天性冠状动脉瘘..........................................................................................................664 第49章  冠状动脉起源异常、肌桥与冠状动脉瘤......................................................................671 第1节  冠状动脉异常起源于肺动脉 ......................................................................................671 第2节  冠状动脉异常起源于主动脉 ......................................................................................678 第3节  冠状动脉左主干闭锁 ..................................................................................................682 第4节  单一冠状动脉 ..............................................................................................................683 第5节  冠状动脉肌桥 ..............................................................................................................684 第6节  冠状动脉瘤 ..................................................................................................................689 第50章  矫正型大动脉转位..........................................................................................................693 第51章  解剖矫正型大动脉异位..................................................................................................705 第52章  接近性大动脉转位..........................................................................................................713 第53章  单心室..............................................................................................................................737 第1节  心室双入口 ..................................................................................................................737 第2节  三尖瓣闭锁 ..................................................................................................................752 第3节  二尖瓣闭锁 ..................................................................................................................756 第4节  共同房室瓣连接一个发育正常的心室 ......................................................................758 第5节  单心室合并内脏异位综合征 ......................................................................................759 第54章  共同动脉干......................................................................................................................761 第55章  左心发育不良综合征......................................................................................................773 第56章  内脏异位综合征并心脏畸形..........................................................................................780 第5篇  获得性心脏瓣膜病 第57章  二尖瓣疾病......................................................................................................................789 第1节  二尖瓣狭窄 ..................................................................................................................789 第2节  二尖瓣关闭不全 ..........................................................................................................797 第3节  二尖瓣合并三尖瓣疾病 ..............................................................................................801 第4节  瓣膜再次替换术 ..........................................................................................................804 第58章  主动脉瓣疾病..................................................................................................................807 第59章  三尖瓣疾病......................................................................................................................823 第60章  联合瓣膜病......................................................................................................................831 第61章  感染性心内膜炎..............................................................................................................836 第62章  人工心脏瓣膜..................................................................................................................845 第1节  机械瓣 ..........................................................................................................................845 第2节  异种生物瓣 ..................................................................................................................852 第3节  组织工程瓣 ..................................................................................................................857 第4节  经导管介入瓣膜 ..........................................................................................................859 第63章  冠状动脉粥样硬化性狭窄..............................................................................................864 第64章  左心室室壁瘤..................................................................................................................886 第65章  心肌梗死后室间隔破裂..................................................................................................895 第66章  冠心病合并瓣膜病..........................................................................................................903 第1节  冠心病合并缺血性二尖瓣关闭不全 ..........................................................................903 第2节  冠心病合并风湿性心脏病 ..........................................................................................906 第3节  冠心病合并瓣膜退行性病变 ......................................................................................908 第6篇  其他心脏病 第67章  心包疾病..........................................................................................................................913 第1节  慢性缩窄性心包炎 ......................................................................................................913 第2节  急性化脓性心包炎 ......................................................................................................918 第3节  其他原因所致的急性心包炎 ......................................................................................919 第4节  心包肿瘤 ......................................................................................................................919 第5节  心包囊肿 ......................................................................................................................920 第68章  心脏肿瘤..........................................................................................................................922 第1节  心脏黏液瘤 ..................................................................................................................922 第2节  心脏横纹肌瘤 ..............................................................................................................929 第3节  心脏乳头状弹力纤维瘤 ..............................................................................................932 第4节  心脏纤维瘤 ..................................................................................................................933 第5节  其他心脏良性肿瘤 ......................................................................................................936 第6节  心脏恶性肿瘤 ..............................................................................................................937 第69章  心律失常的外科治疗......................................................................................................940 第1节  心房颤动 ......................................................................................................................940 第2节  预激综合征 ..................................................................................................................949 第3节  非缺血性室性心律失常 ..............................................................................................958 第70章  肺动脉栓塞......................................................................................................................963 第1节  急性肺动脉栓塞 ..........................................................................................................963 第2节  慢性栓塞性肺动脉高压 ..............................................................................................967 第71章  肥厚型梗阻性心肌病......................................................................................................974 第72章  心内膜心肌纤维化病......................................................................................................985 第73章  心脏、大血管创伤..........................................................................................................992 第1节  心脏穿透性损伤 ..........................................................................................................992 第2节  心脏钝性损伤 ..............................................................................................................996 第3节  胸内大血管损伤 ..........................................................................................................999 第7篇  主动脉疾病 第74章  主动脉夹层....................................................................................................................1007 第75章  胸部主动脉瘤................................................................................................................1027 第76章  主动脉腔内介入治疗....................................................................................................1041 第8篇  心血管疾病的介入治疗 第77章  心脏手术后心律失常的介入治疗................................................................................1057 第1节  儿童先天性心脏病相关快速心律失常 ....................................................................1057 第2节  成人心脏外科手术后的心律失常 ............................................................................1070 第78章  先天性心脏病的介入治疗............................................................................................1081 第1节  房间隔造口术 ............................................................................................................1081 第2节  先天性肺动脉狭窄的介入治疗 ................................................................................1081 第3节  先天性主动脉瓣狭窄的介入治疗 ............................................................................1088 第4节  主动脉缩窄的介入治疗 ............................................................................................1089 第5节  先天性心脏病及异常血管堵塞术 ............................................................................1090 第6节  先天性心脏病复合畸形的介入治疗 ........................................................................1096 第7节  室间隔完整的肺动脉闭锁的介入治疗 ....................................................................1096 第8节  复杂先天性心脏病外科术后的介入治疗和镶嵌治疗 ............................................1097 第79章  瓣膜病的介入治疗........................................................................................................1103 第1节  主动脉瓣的介入治疗 ................................................................................................1103 第2节  二尖瓣疾病的介入治疗 .............................................................................................1113 第3节  肺动脉瓣疾病的介入治疗 ........................................................................................1123 第4节  三尖瓣疾病的介入治疗 ............................................................................................1128 第9篇  心血管外科微创手术 第80章  心脏小切口手术............................................................................................................1135 第81章  微创冠状动脉搭桥术....................................................................................................1141 第1节  非体外循环、心脏跳动下冠状动脉搭桥术 ............................................................1141 第2节  再次非体外循环冠状动脉搭桥术 ............................................................................1148 第3节  胸腔镜辅助下冠状动脉搭桥术 ................................................................................1149 第82章  微创心脏瓣膜手术........................................................................................................1151 第83章  心脏杂交手术................................................................................................................1156 第84章  机器人在心脏外科中的应用........................................................................................1161 第1节  机器人心脏外科发展简况 ........................................................................................1161 第2节  机器人心脏手术的适应证及禁忌证 ........................................................................1162 第3节  特殊的术前检查 ........................................................................................................1163 第4节  体外循环的管理 ........................................................................................................1163 第5节  右胸入路机器人辅助心脏手术 ................................................................................1164 第6节  左胸入路机器人辅助心脏手术 ................................................................................1167 第7节  其他机器人心脏手术 ................................................................................................1169 第10篇  心力衰竭的外科治疗 第85章  主动脉内球囊反搏........................................................................................................1173 第86章  心室辅助装置................................................................................................................1183 第87章  体外膜氧合生命支持....................................................................................................1201 第88章  全人工心脏....................................................................................................................1214 第89章  心脏移植........................................................................................................................1225 第90章  心肺移植........................................................................................................................1233 索引..................................................................................................................................................1241