摘要:目的: 探討動脈硬化閉塞癥(ASO)和靜脈血栓形成(VT)患者同型半胱氨酸(Hcy)變化。 方法 :通過循環酶法對34例非動脈硬化閉塞癥(ASO)和靜脈血栓形成(VT)患者(對照組),30例動脈硬化閉塞癥(ASO)患者和26例靜脈血栓形成(VT)患者血液中Hcy進行測定。 結果 :循環酶法測定HCY的批內平均變異系數為2．23％,批間平均變異系數為1．59％。34例對照組,〖WTBX〗t =1135,〖WTBX〗P =0266gt;005;動脈硬化閉塞癥(ASO)組Hcy含量明顯高于對照組(〖WTBX〗P lt;O．05),靜脈血栓形成(VT)組Hcy含量高于對照組(〖WTBX〗P lt;0．O5)。 結論 :高同型半胱氨酸血癥可能是動脈硬化閉塞癥(ASO)和靜脈血栓形成(VT)及復發的致病因素。可將同型半胱氨酸作為動脈硬化閉塞癥(ASO)和靜脈血栓形成(VT)及復發的重要指標。Abstract: Objective: TO syudy the changes of the Homocysteine about Atherosclerosis obliterans and Venous thrombosis patients. Methods : To measure the Hcy in the blood of 34 healthy cases both non ASO and non VT(the comparison group),30 cases of ASO patients and 26 cases of VT patients respectively by enzymatic cycling assay。〖WTHZ〗Results :The average variation coefficient of Hcy within the groups was 223% and among the groups was 159% measured by enzymatic cycling assay.In the 34 cases of comparison group,t=1135,P=0266gt;005,The content of Hcy in the blood of ASO patients group were significantly higher than the comparision group (Plt;005),and the content of Hcy in the blood of VT patients group were also higher than the comparison group (Plt;005). Conclusion : Hyper Hcy may be the pathogenic diathesis to form or to recrudesce ASO and VT.So we can treat Hcy as the significant index to form or to recrudesce ASO and VT.
The way of intravenous drug abuse is to puncture the peripheral blood vessels and inject the drug directly into the blood. Therefore, this method has an impact on the peripheral artery and venous system of the users, and can cause a variety of peripheral vascular diseases, such as phlebitis, deep vein thrombosis, chronic venous insufficiency, phlebangioma, atherosclerosis, acute arterial ischemia, pseudoaneurysm, etc. However, due to the particularity of drug abusers, the vascular complications caused by intravenous drug abuse have not attracted enough attention. This paper reviewed the types and pathogenesis of peripheral vascular diseases caused by intravenous drug abuse, so as to improve the clinical understanding of peripheral vascular diseases caused by intravenous drug abuse, improve the prognosis of patients, reduce occupational exposure of medical staff, and play a certain role in social warning.
Objective To explore the relationship between the structure and function of galectin-3， lipid metabolism disorders， and investigate the expression of galectin-3 in the occurrence and progress of lower limb arteriosclerosis block disease. Methods Related articles were reviewed. Results Galectin-3 participates in inflammatory reaction and lipid metabolism disorders， regulates the cell growth， differentiation， adhesion， apoptosis， and angiogenesis， and palys a role in the occurrence and progress of arteriosclerosis obliterans. Conclusion Galectin-3 is correlation with the occurrence， progress， and the prognosis of arteriosclerosis obliterans.
Objective
To investigate the status of the knowledge, attitudes and intervention behaviors in medical professionals in the prevention and treatment of deep vein thrombosis (DVT), and explore the weak links in knowledge-attitude-practice of DVT.
Methods
From December 2017 to February 2018, a convenient sampling method was used to extract 158 medical professionals out of 204 medical professionals from Department of Orthopedics, West China Hospital of Sichuan University. The questionnaire included the general information and basic situation of DVT learning, the knowledge of DVT, intervention attitude and implementation of preventive measures. The survey involved orthopedic doctors, nurses, rehabilitation therapists and nutrition managers.
Results
A total of 158 questionnaires were distributed and 150 valid questionnaires were completed. The effective questionnaire recovery rate was 94.9%. The mean score of basic knowledge of DVT was 6.45±1.83, the mean score of risk factors was 13.29±3.38, the mean score of intervention attitudes was 9.57±0.78, and the mean score of prevention implementation was 23.33±5.85.
Conclusions
The knowledge-practice of DVT intervention in orthopedic medical staff is moderate, and the attitude of DVT intervention is better among medical staff. There are various characteristics and weaknesses in knowledge-practice. It is necessary to regularly carry out knowledge about DVT among medical staff to improve the professional level of medical staff to prevent and treat DVT.
Objective To explore the value of color Doppler ultrasonography and plasma D-dimer in diagnosis of lower limb deep venous thrombosis (DVT).Methods The clinical data of 70 cases of patients with lower limb DVT diagnosed clinically were retrospectively studied. The lower limb venous of each patient was examined by color Doppler ultrasonography and the plasma level of D-dimer were measured, furthermore the plasma levels of D-dimer in different phase and different type of thrombosis were compared. Results The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of plasma D-dimer and ultrasonography examination in lower limb DVT were 100%, 66.7%, 97.0%, 100%, and 97.1%, and 98.4%, 83.3%, 98.4%, 83.3%, and 97.1%, respectively. The plasma D-dimer in acute phase 〔(6 451±4 012.22) μg/L〕 and subacute phase 〔(2 063±1831.35) μg/L〕 of lower limb venous thrombosis were significantly higher than that in normal control group 〔(310±66.70) μg/L〕, Plt;0.01 and Plt;0.05, which was not different from that in chronic phase 〔(466±350.52) μg/L〕. Meanwhile, the plasma D-dimer in mixed limb venous thrombosis group 〔(4 464±3 753.16) μg/L〕 and central limb venous thrombosis group 〔(2 149±1 911.53) μg/L〕 were significantly higher than that in control group (Plt;0.05 and Plt;0.01), which was not different from that in peripheral limb venous thrombosis group 〔(560±315.62) μg/L〕. Conclusion Color Doppler ultrasonography is an optimal method and the plasma D-dimer is a predictive index in diagnosis of lower limb DVT.
ObjectiveTo investigate the effect and safety of tranexamic acid sequential rivaroxaban on perioperative blood loss and preventing thrombosis for elderly patients during lumbar interbody fusion (LIF) with a prospective randomized controlled study.MethodsBetween April and October 2019, the elderly patients with lumbar degenerative diseases requiring LIF were included in the study, among which were 80 patients met the selection criteria. According to the antifibrinolysis and anticoagulation protocols, they were randomly divided into a tranexamic acid sequential rivaroxaban group (trial group) and a simple rivaroxaban group (control group) on average. Finally, 69 patients (35 in the trial group and 34 in the control group) were included for comparison. There was no significant difference in general data (P>0.05) such as gender, age, body mass index, disease duration, diseased segment, type of disease, and preoperative hemoglobin between the two groups. The operation time, intraoperative blood loss, drainage within 3 days after operation, perioperative total blood loss, and proportion of blood transfusion patients were compared between the two groups, as well as postoperative venous thrombosis of lower extremities, pulmonary embolism, and bleeding-related complications.ResultsThe operations of the two groups completed successfully, and there was no significant difference in the operation time (P>0.05); the intraoperative blood loss, drainage within 3 days after operation, and perioperative total blood loss in the trial group were significantly lower than those in the control group (P<0.05). The proportion of blood transfusion patients in the trial group was 25.71% (9/35), which was significantly lower than that in the control group [52.94% (18/34)] (χ2=5.368, P=0.021). Postoperative incision bleeding occurred in 4 cases of the trial group and 3 cases of the control group, and there was no significant difference in bleeding-related complications between the two groups (P=1.000). There was 1 case of venous thrombosis of the lower extremities in each group after operation, and there was no significant difference in the incidence between the two groups (P=1.000). Besides, no pulmonary embolism occurred in the two groups.ConclusionPerioperative use of tranexamic acid sequential rivaroxaban in elderly LIF patients can effectively reduce the amount of blood loss and the proportion of blood transfusion patients without increasing the risk of postoperative thrombosis.
ObjectiveTo investigate the early diagnosis and proper treatment of acute mesenteric venous thrombosis (AMVT).
MethodsThe clinical data of 105 cases of AMVT treated from January 2000 to December 2013 were analyzed retrospectively.
ResultsThe diagnostic accuracy of ultrasonography and abdominal contrast-enhanced CT was 67.6% (71/105), 88.0% (81/92) respectively. The accuracy rate of abdominal cavity puncture or abdominal drainage in the diagnosis of intestinal necrosis was 100% (38/38). All cases received anticoagulation and thrombolysis as soon as the definite diagnosis of AMVT were made. Twenty-five cases underwent emergency operation due to the bowel necrosis at the visiting time, Anticoagulation and thrombolysis were performed in 80 patients, of which 7 patients received surgical treatment because of ineffective anticoagulation and thrombolytic therapy. Thrombectomy was performed in 15 cases simultaneously. Surgical treatment of 32 cases, 30 cases were cured and 2 patients died of multiple organ failure or short bowel syndrome within 1 month after operation. Seventy-three cases were treated with anticoagulation therapy alone, 72 patients were cured and discharged, the effective rate was 90.0%, another 1 case died due to cerebral hemorrhage within 1 month after operation.
ConclusionsEarly diagnosis of AMVT and bowel necrosis, timely and accurate anticoagulation and thrombolysis, and proper surgical intervention can often achieve satisfactory results.
