肠系膜上静脉血栓形成的诊断和治疗

目的探讨肠系膜上静脉血栓形成(MVT)的诊断及治疗。方法总结15例MVT的诊治经验,从病因、诊断和治疗等方面进行分析。结果初诊多数表现为急腹症,症状和体征不相符。9例经手术病理证实,6例术前确诊,3例误诊,7例治愈,2例死亡。6例急性MVT诊断确立后立即采用抗凝溶栓等保守治疗,5例治愈,1例中转手术治愈。结论该病症状和体征无特异性。诊断更主要依靠影像学检查(彩色超声多普勒、CT、磁共振成像、血管造影)发现肠系膜上静脉的栓子征象来确立。急性MVT在肠缺血尚未导致透壁性肠坏死、肠穿孔时,抗凝溶栓治疗可行,如有急性腹膜炎时中转手术。在肠坏死时,早期切除坏死肠段,包括静脉阻塞的肠系膜部分,术中、术后抗凝治疗,是提高治愈率的重要措施。     

妇科手术术后下肢深静脉栓塞临床分析

目的:探讨妇科手术后并发下肢深静脉栓塞的临床特征。方法:收集28例妇科手术后发生下肢深静脉血栓患者的临床资料,并进行分析。结果:发生下肢深静脉血栓的高危因素有肥胖、妇科恶性肿瘤手术、阴式子宫切除术等。采用低右、肝素等预防效果好。结论:对高危患者在术前术后应加强预防措施。     

老年病血液流变学100例分析

目的 了解老年病各类疾病血液流变学特点。方法 对我院100例老年病人进行血液流变学检测，并分组归类分析：A组：缺血性心脑血管病40例（冠心病28例，脑梗塞12例）；B组：与动脉硬化、血栓形成密切相关病类42例（高血压病26例，糖尿病16例）；C组：一般病类18例，包括消化性溃疡、支气管炎等，并设健康对照组30例。结果 A、B、C三组血栓长度、重量、红细胞刚性指数（IR）、红细胞电泳时间（EFT）均明显高于对照组；红细胞比积（HCT）各组无差异；A、B组胆固醇（TC）、甘油三酯（TG）、纤维蛋白原（Fib）升高；低切变时（40S^-1，10S^-1）全血表现粘度（BAV）升高，尤以A组为重；血小板粘附率（PadT）A组升高。结论 老年病血栓容易形成，红细胞聚集性（EA）增高，变形能力（ED）下降。缺血性心脑血管病危险因素多而严重，糖尿病、高血压病次之。血栓形成、血管内膜病变过程中，细胞因素占重要地位。     

三保心对大鼠体内外血栓形成的影响

目的:观察三保心对大鼠体内外血栓形成的影响.方法:大鼠灌服三保心高、中、低3种剂量(10g生药/kg、5g生药/kg、1g生药/kg)后,采用Chandler法造成体外血栓和电刺激颈总动脉形成体内血栓,观察三保心对体内外血栓形成的影响.结果:三保心高剂量组明显延长大鼠体内血栓形成时间(P<0.05);高、中、低各剂量组均能显著抑制大鼠体外血栓的形成,使血栓长度明显缩短,血栓湿重和干重明显减轻(P<0.05或P<0.01).结论:提示三保心具有抑制血栓形成的作用.     

ANTITHROMBIN III SUPPLEMENTATION IN CHILDHOOD ACUTE LYMPHOBLASTIC LEUKEMIA TREATED WITH L-ASPARAGINASE

The change of plasma antithrombin III (AT) levels after supplementation of AT concentrates was examined in ALL children with acquired AT deficiency following L-asparaginase (ASP) administration. The patients received AT concentrates of 34.5 &#45 7.6 U/kg. The increase of plasma AT activity and antigen was 2.07 &#45 0.62% and 0.70 &#45 0.16 mg/dL per unit AT infused per kilogram of body weight, respectively. The activity decreased to 62.0 &#45 7.7% of the peak values by 48 hours after supplementation. The administration of AT concentrates constantly increased the plasma AT activity in ALL children treated with ASP, which may minimize the acquired prothrombotic state.     

Deep Venous Thrombosis in Lap Band Surgery: A Single Center Study

Bariatric surgery has been demonstrated to be an effective treatment for morbid obesity. The purpose of this study is to investigate the incidence of pre- and post-operative deep venous thrombosis (DVT) in Lap-Band surgical patients. This study group comprised 56 consecutive patients who underwent Lap-Band surgery. Mean age and body mass index were 38 years (range: 18–64 years) and 50.9 kg/m² (range: 53–74 kg/m²), respectively. All the patients were screened with duplex ultrasonography pre- and post-operatively. There were no iliac, femoral, or popliteal vein thromboses detected at any given point of time. No patient had any clinical signs or symptoms of DVT post-operatively. There were no observable differences attributable to DVT prophylaxis. This data suggest that in the setting of chemical and mechanical prophylaxis, the incidence of DVT in patients undergoing Lap-Band surgery at an established bariatric centre is minimal.     

超声在肠系膜上静脉血栓治疗过程中的应用价值

目的:在肠系膜上静脉血栓治疗过程中,超声用于评价疗效和指导治疗的价值。方法:肠系膜上静脉血栓住院治疗的8例患者,超声连续观察肠系膜上静脉内径,血栓回声;肠系膜上动脉血流速度及阻力指数;水肿肠管的长度,肠壁厚度;周围小血管情况;腹腔积液的量等指标,评价治疗效果,指导临床。结果:8例肠系膜上静脉血栓的患者,根据临床资料,结合超声指征,3例手术治疗,其中1例术后第2天死亡,其余术后症状明显缓解,超声呈逐渐恢复表现。5例保守治疗,超声征象改善,症状逐步缓解,出院。结论:超声实时、动态观察肠系膜上静脉血栓治疗中的声像图变化,及时评价治疗效果,为临床提供直接证据,指导治疗。     

高血压患者抗血小板治疗研究进展

心肌梗死和脑卒中是高血压最严重的并发症,且往往与血栓形成堵塞血管所致。抗血小板药物阿司匹林可以有效预防血栓性事件,因此抗血栓治疗可能减少这些并发症的发生。但抗血栓治疗是否应成为高血压患者的常规治疗措施,综述如下。