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目的 探讨降钙素原(PCT)与维持性血液透析(MHD)患者自体动静脉内瘘(AVF)并发症的关系。方法
选取使用AVF行MHD治疗的患者186例,根据随访过程中超声检查AVF是否出现并发症[狭窄和(或)血栓]分为并
发症组48例和非并发症组138例,收集2组患者透析龄、透析中收缩压下降≥30 mmHg(1 mmHg=0.133 kPa)例数、穿
刺失败或血肿形成例数、是否合并糖尿病等临床资料,并检测2组患者PCT、C反应蛋白(CRP)、血小板(Plt)等指标,
比较2组间上述指标的差异,应用二元Logistic回归分析AVF并发症的影响因素。结果 并发症组合并糖尿病、血液
透析中收缩压下降≥30 mmHg、穿刺失败或血肿形成发生率及PCT、CRP、透析龄高于非并发症组(P<0.05)。2组性
别、年龄、原发疾病、尿素清除指数、体质量指数、每月血液灌流及血液透析滤过时间等比较差异无统计学意义。二
元Logistic回归分析发现,较高水平的PCT、血液透析中收缩压下降≥30 mmHg、穿刺失败或血肿形成是发生AVF并发
症的独立危险因素(P<0.05)。结论 高水平PCT是MHD患者AVF并发症发生的危险因素,临床应重视对微炎症状
态的改善,并注意合理控制血压,避免血液透析中血压快速下降,不断提高穿刺技术。 相似文献
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目的:分析探讨上肢骨折患者发生深静脉血栓形成的危险因素。方法:回顾性分析833例上肢骨折住院患者的临床资料,按照是否有静脉血栓形成,将其分为血栓组(n=82)和非血栓组(n=751),对上肢骨折患者深静脉血栓形成的危险因素进行分析。结果:833例上肢骨折患者DVT发生率为9.84%。二元Logistic多因素回归分析显示,性别、年龄、BMI、肱骨骨折是上肢骨折患者深静脉血栓形成的危险因素,术前等待时间、术中输血、麻醉方式是患者术后深静脉血栓形成的独立危险因素(P<0.05)。结论:通过对上肢骨折患者深静脉血栓形成的危险因素进行分析,明确上肢骨折患者发生DVT的危险因素,及时评估高危人群,进行有效护理和干预,有效预防和减少DVT的发生。 相似文献
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Patricia Álvarez-López Isabel Campos-Varela Sergi Quiroga Iratxe Díez Ramón Charco Macarena Simón-Talero Lluís Castells 《Annals of hepatology》2022,27(3):100687
Introduction and objectivesSpontaneous portosystemic shunts (SPSS) are a common cause of recurrent hepatic encephalopathy (HE). Shunt occlusion is an effective and safe procedure when performed in patients with cirrhosis and preserved liver function. We aimed to describe our experience with SPSS embolization after liver transplantation (LT).PatientsWe identified five patients who underwent SPSS embolization after LT. Clinical, biochemical and technical procedure data were collected.ResultsAt presentation, all patients had developed graft cirrhosis and HE after LT. Median Model for End-stage Liver Disease (MELD) at embolization was 9 (range 7-12), median Child-Pugh was 8 (range 7-9). Splenorenal and mesocaval shunt were the most frequent types of SPSS found. Three patients have been completely free of HE. Of the two patients who had HE recurrence after embolization, one patient had two episodes of HE which was controlled well with medications. The other patient required three embolizations because of recurrent HE. Median follow-up was 4.4 years (range 1.0-5.0) and MELD score at last follow up was 13 (range 10-18) and median Child-Pugh score B, 7 points (range 5-12).ConclusionsSPSS can be considered as a cause of HE after LT. SPSS embolization is feasible and safe in LT recipients. 相似文献
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《Journal of vascular and interventional radiology : JVIR》2022,33(12):1476-1484.e2
PurposeTo evaluate temporal trends, practice variation, and associated outcomes with the use of intravascular ultrasound (US) during deep venous stent placement among Medicare beneficiaries.Materials and MethodsAll lower extremity deep venous stent placement procedures performed between January 1, 2017, and December 31, 2019 among Medicare beneficiaries were included. Temporal trends in intravascular US use were stratified by procedural setting and physician specialty. The primary outcome was a composite of 12-month all-cause mortality, all-cause hospitalization, or repeat target vessel intervention. The secondary outcome was a composite of 12-month stent thrombosis, embolization, or restenosis.ResultsAmong the 20,984 deep venous interventions performed during the study period, 15,184 (72.4%) utilized intravascular US. Moderate growth in intravascular US use was observed during the study period in all clinical settings. There was a variation in the use of intravascular US among all operators (median, 77.3% of cases; interquartile range, 20.0%–99.2%). In weighted analyses, intravascular US use during deep venous stent placement was associated with a lower risk of both the primary (adjusted hazard ratio, 0.72; 95% confidence interval [CI], 0.69–0.76; P < .001) and secondary (adjusted hazard ratio, 0.32; 95% CI, 0.27–0.39; P < .001) composite end points.ConclusionsIntravascular US is frequently used during deep venous stent placement among Medicare beneficiaries, with further increase in use from 2017 to 2019. The utilization of intravascular US as part of a procedural strategy was associated with a lower cumulative incidence of adverse outcomes after the procedure, including venous stent thrombosis and embolization. 相似文献
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