【摘要】 目的 〖JP2〗评价腔静脉滤器植入联合足背静脉溶栓在下肢深静脉血栓(DVT)治疗中的疗效。 方法 2006年12月-2009年10月,对26 例下肢深静脉血栓患者行下腔静脉滤器植入术,并结合足背静脉溶栓治疗。 结果 26例患者均未出现大出血和致死性肺动脉栓塞等严重并发症,彩色多普勒超声显示17例患者下肢DVT 完全溶解,11例部分溶解。 结论 介入性综合治疗下肢DVT 是一种安全可行、疗效好的方法。【Abstract】 Objective To evaluate the therapeutic effect of filter planting combining thrombolysis therapy through the dorsum pedis vein on patients with deep veins thrombosis of lower limb. Methods The clinical data of 26 patients from December 2006 to October 2009 were retrospectively analyzed. All the patients underwent filter planting combining thrombolysis therapy through the dorsum pedis vein. Results There was no serious complication such as hemorrhea or fatal pulmonary embolism. The phlebothrombosis was fully dissolved in 11 patients and partial dissolved in 17 patients. Conclusion Interventional combined therapy is safe and effective for deep venous thrombosis of lower limb.
To explore the effectiveness and methods of intervention assistant operation in the treatment of phalanx closed fracture combined with artery crisis. Methods Between August 2002 and December 2008, 24 cases (31 toes) of phalanx closed fracture combined with artery crisis were treated. There were 17 males (22 toes) and 7 females (9 toes), aged from 16 to 62 years (mean, 38 years). The causes of injury included crush and bruise (20 cases), traffic accident (3 cases),and machine twist (1 case). The locations were the first toe (19 toes), the second toe (10 toes), and the third toe (2 toes). The period between injury and hospital ization was 1-10 hours (mean, 6.8 hours). Phalanx angiography was performed by using venous indwell ing needle for dorsal is pedis artery and posterior tibial artery puncture; according to angiography results, proper treatment could be done, then the constrast medium was injected to the artery to observe the blood supply. According to different types and locations of fracture, Kirschner wire and plate were choosen to fix fracture after the blood supply were recovered. Results Two cases (2 toes) received amputation due to necrosis at 4 days and 6 days after interventional therapy, respectively. Twenty-two cases (29 toes) survived. Incision healed primarily in 21 cases. Exudation occurred at wound of 1 case and was cured at 3 weeks after dressing change. Twenty-two cases (29 toes) were followed up 1-6 years (mean, 3.5 years) postoperatively. Two cases (3 toes) felt cool or anaesthesia and could not tolerate even in cold environment. The other toes had no senses of cold pain and paresthesia. Two cases (2 toes) had nonunion and achieved fracture heal ing after grafting bone. The mean union time was 4.5 months (range, 3-6 months) in other cases. Conclusion Intervention assistant operation is an effective measure in the treatment of phalanx closed fracture combined with artery crisis.
Objective To explore the treatment of thromboangitis obliterans (TAO) of lower extremities. Methods From March 1994 to February 2009, 24 cases (26 limbs) affected by chronic ischemia were diagnosed as TAO by Doppler ultrasound and DSA, CTA or MRA. According to the different levels of the extensive and diffuse arterial occlusion, the revascularization was performed in the ways: 19 cases (21 limbs) underwent venous arterialization, 3 cases (3 limbs) underwent endovascular therapy, and 2 cases (2 limbs) underwent thrombectomy. Results After the venous arterialization, 19 cases (21 limbs) were followed up for 1 to 14.5 years. Apart from the 5 limbs amputation (23.8%), the postoperative results of the most limbs were satisfactory (61.9%). The ABI before therapy (0.38±0.11) was significantly lower than that 6 months after therapy (0.79±0.08), Plt;0.05. In 3 cases (3 limbs) underwent endovascular therapy, one case failed and then received the venous arterialization. Two cases (2 limbs) finished thrombectomy successfully. After endovascular therapy and thrombectomy, these 4 cases were followed up for 1 to 4 years without the amputation. ConclusionIn order to improve the curative effect, it is important to choose the suitable therapeutic strategy according to the different levels of the extensive and diffuse arterial occlusion. The venous arterialization is an effective treatment for TAO of lower extremities.
目的总结分析经左胸微创冠状动脉旁路移植术(MIDCAB)与经皮冠状动脉介入治疗(PCI)联合应用治疗冠状动脉多支血管病变的初步临床经验。 方法回顾性分析郑州市第七人民医院2013年1月至2014年11月共16例多支冠状动脉病变冠心病患者的临床资料,其中男10例、女6例,年龄46~73(58.4±9.7)岁,采用“分站式”复合技术(Hybrid)进行心肌再血管化。 结果16例患者手术均顺利完成,无围手术期死亡,PCI时行冠状动脉造影提示冠状动脉吻合口通畅,随访3~22(14.0±8.6)个月,临床症状缓解,恢复正常工作及生活。 结论“分站式”复合技术治疗冠状动脉多支血管病变近期效果满意,长期效果有待进一步随访。
ObjectiveTo compare and analyze the clinical effects of two kinds of frame design valves after transcatheter aortic valve replacement (TAVR).MethodsWe retrospectively reviewed 124 patients who underwent TAVR and were followed up for 1 year. There were 71 males and 53 females aged 75.57±6.21 years. These patients were treated with Venus-A or Edwards Sapien aortic valves. The hemodynamics and cardiac function of these two kinds of transcatheter aortic valves (THV) were evaluated by echocardiography. The 30-day mortality and 1-year clinical effect of the patients were calculated.ResultsEight-one patients used Venus-A valve and 43 patients used Edwards Sapien valve. The aortic valve transaortic pressure gradient was reduced and the rate of perivalvular leakage was low (both 2.6%) in both groups, and there was no statistical difference between the two groups. The implantation rate of permanent pacemaker was 17.3% and 11.6%, respectively. The 1-month survival (94.0% and 93.0%) and 1-year survival (94.0% and 91.0%) rates were not statistically different.ConclusionThe two groups of THV with different stent structures have good short-term clinical effect and low implantation rate of permanent pacemaker.
Tricuspid regurgitation (TR) affects a wide population in China, and frequently coexists with other conditions as comorbidities. Moderate to severe TR is associated with a poor prognosis and medical treatment alone does not prevent progression of disease. Although minimal invasive catheter-based techniques might be an option for TR treatment in selected high risk patients, there is no relevant recommendations for the transcatheter treatment of TR in practice guidelines. Several transcatheter edge-to-edge repair devices are currently in preclinical and early clinical evaluation as potential novel treatment options for symptomatic TR in patients at increased risk for surgery, becoming as the most common technique applied for interventional TR treatment. Hence, the present study will introduce the clinical features of TR, the progress of edge-to-edge repair, and the application and challenges in the future.
T lymphocyte acid α-naphthl acetate esterase (Tc-ANAE) activity was measured in 23 pathologically proved gastric cancer patients before and after surgical intervention. The result showed that interventional treatment obviously decreased the Tc-ANAE activity in patients with gastric cancer (P<0.01), especially decreased the immune function in late stage cases (stage Ⅳ) (P<0.01), the more advanced the cancer was, the more impaired the immune function was. Interventional treatment had no influence on immune function in earlier stages (P>0.05).