置管溶栓治疗下肢深静脉血栓形成的护理

目的：探讨下肢深静脉血栓形成（deep venous thrombosis,DVT）置管溶栓（catheter-directed thrombolysis,CDT）的治疗效果及护理。方法：回顾分析245例混合型下肢DVT CDT治疗效果及护理的临床资料。结果：本组245例患者中,治愈219例,显效26例,有效100%。结论：CDT是治疗下肢DVT的重要手段,做好术前术后护理,可降低下肢DVT后遗症的发生。     

下肢深静脉血栓形成不同入路置管溶栓治疗的护理管理体会

下肢深静脉血栓形成（Deep Vein Thrombosis,DVT）是临床常见疾病,各种方式入路的深静脉置管溶栓越来越多地在临床应用。我科2009年1月以来采用不同入路置管溶栓治疗下肢深静脉血栓形成99例,配合精心护理,取得较满意效果。现就不同方式深静脉置管溶栓的护理管理异同点加以归类、阐述,体会报告如下。     

滤器植入加置管溶栓治疗下肢深静脉血栓形成的护理

目的探讨滤器植入加经胫后静脉导管溶栓治疗下肢深静脉血栓形成的护理方法及效果。方法对15例下肢深静脉血栓形成患者采取下腔静脉滤器植入及置管溶栓术治疗,对其进行密切的观察和精心的护理。重点是做好患者的心理护理及健康宣教,加强一般护理,重视导管溶栓治疗期间的护理,加强并发症的观察,给予详细的出院指导。结果本组15例患者置管溶栓治疗下肢髂股静脉、胭静脉、胫后静脉血栓基本溶解,无肺动脉栓塞发生,无手术后死亡病例,1例术前合并肺动脉栓塞者临床症状消失。结论下腔静脉滤器植入及置管溶栓术是治疗下肢深静脉血栓形成安全有效的方法,通过细致入微的观察和严密周到的护理可提高溶栓治疗的效果,降低并发症的发生率。     

经颈静脉置管联合足背静脉溶栓治疗下肢深静脉血栓形成的护理

目的 探讨238例经颈静脉置管联合患肢足背静脉加压注射尿激酶溶栓治疗下肢深静脉血栓形成的护理经验.方法 回顾性分析2007年1月～2009年12月238例经颈静脉置管联合患肢足背静脉加压注射尿激酶溶栓治疗下肢深静脉血栓形成的临床资料,总结发病原因、治疗结果及护理对策.结果 血栓完全溶解199例,部分溶解39例.并发症:穿刺点出血6例,颅内出血1例,腹膜后出血1例,肌肉间出血1例,血尿6例.结论 经颈静脉置管联合患肢足背静脉加压注射尿激酶溶栓治疗下肢深静脉血栓形成安全、有效,正确的用药方法及周密细致的护理,可减少并发症的发生,提高治疗效果,促进患者康复.     

介入治疗下肢深静脉血栓形成的护理配合

目的：探讨介入治疗下肢深静脉血栓形成的护理配合及效果。方法：对25例下肢深静脉血栓形成患者采用下腔静脉滤器置人术及导管腔内溶栓治疗,对其进行术前护理及溶栓中的观察与护理。结果：25例下腔静脉置入加导管内溶栓治疗的患者手术均获成功,临床症状减轻,患肢肿胀消退,阻塞段血管再通,未发生肺动脉栓塞等并发症。结论：对于下腔静脉滤器置人术和溶栓治疗下肢深静脉血栓形成的患者,应降低肺栓塞的发生率,提高患者的生存质量。     

置下腔静脉滤器及溶栓治疗下肢深静脉血栓的护理

目的:探讨置下腔静脉滤器及溶栓治疗下肢深静脉血栓的护理效果。方法:对8例患有下肢深静脉血栓患者,进行置下腔静脉滤器术心理护理、肢体护理、下肢深静脉溶栓护理等康复指导。结果:下肢肿胀消失,无肺栓塞,痊愈出院。结论:下肢静脉滤器及溶栓治疗下肢深静脉血栓取得了好的效果。     

下腔静脉滤器置入联合深静脉深置管溶栓治疗急性下肢深静脉血栓的临床研究

目的探讨下肢静脉滤器置入联合深静脉置管溶栓治疗急性下肢深静脉血栓的临床应用。方法收集2011年1—12月采用下腔静脉滤器置入联合深静脉置管溶栓治疗急性下肢深静脉血栓形成的病例15例,进行临床效果分析。结果 15例患者治疗10天后治愈4例,显效6例,有效5例。结论下腔静脉滤器置入联合深静脉置管溶栓,可以有效预防PE的发生,保护深静脉瓣膜,并可减少了溶栓药物用量及时间,降低出血并发症,治疗安全有效,已成为治疗急性DVT的主要方法。     

经静脉置管溶栓治疗下肢中央型深静脉血栓的护理体会

目的探讨经腘静脉介入治疗下肢中央型深静脉血栓的临床应用价值及护理的重要性.方法总结对13例下肢中央型深静脉血栓形成患者采用经患侧腘静脉入路置管溶栓介入治疗的护理经验.结果技术成功率为100%,治疗后闭塞血管开放,双下肢周径差<1cm,下肢活动正常.结论经腘静脉介入治疗下肢中央型深静脉血栓操作简便、安全有效,而科学的护理措施是提高置管溶栓成功率及预防并发症的重要因素.     

深静脉置管溶栓法治疗下肢深静脉血栓形成患者的护理

通过深静脉置管溶栓法治疗下肢深静脉血栓形成的患者,此方法可以有效地治疗下肢深静脉血栓,使溶栓药物能充分地达到血栓部位,局部血药浓度高,全身副反应小。经过精心细致的护理,患者康复出院。本文总结了在治疗过程中的各项护理要点及病情观察的方法。     

手术结合置管溶栓治疗急性下肢深静脉血栓形成的护理(附120例报道)

下肢深静脉血栓形成（DVT）是临床常见病、多发病，其后遗症严重影响患者的工作和生活质量，未被诊断和治疗的下肢深静脉血栓形成引起的肺栓塞（PE）是患者死亡的主要原因。我科于2002年1～2007年6月对120例急性下肢深静脉形成的病人，行手术结合置管溶栓治疗，均取得满意的效果，现就其治疗方法及护理体会介绍如下：     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

CLINICAL SIGNIFICANCE OF SERUM CYTOKINES IL-1β,sIL-2R,IL-6,TNF-α,AND IFN-v IN ACUTE CORONARY SYNDROME

Objectives To explore serum cytokines levels (including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v) and their significance in patients with acute coronary syndrome (ACS) and the subsequent follow-ups, with attempt to estimate the role of various serum inflammatory markers in the diagnosis and assessment of ACS.Methods The study population include 40 patients with acute myocardial infarction (AMI), 40 patients with unstable angina pectoris (UAP), and 40 controls. Among the 80 patients, 60 patients attended a follow up 4 months later. Serum inflammatory markers including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v were measured by enzyme linked immunosorbent assay.Results Serum IL- 1 β, sIL-2R, IL-6, TNF-α were significantly higher in AMI group or UAP group compared to the control group and became significantly lower 4 months later in the follow-up patients. Serum levels of IFN-v shows no significant difference between AMI group or UAP group and controls, also showing no significant change when measured in follow up patients. There was no correlation between serum creatine kinase-MB isoenzyme levels and serum inflammatory markers either in UAP or AMI group. Furthermore, when divided into two subgroups using Wagner's QRS scoring system in the AMI group, there is no difference of each serum inflammatory marker between ≤ 6 scores group and ＞ 6 scores group.Conclusion Serum levels of certain inflammatory markers may have some diagnostic value for ACS, and can be a useful marker reflecting disease stability.