颅内静脉血栓形成2例报告并文献复习

对 2例颅内静脉血栓形成病例结合文献分析总结 ,结果认为该病临床恢复较快而彻底 ,影像学上缺血性病灶消失完全 ,不留软化灶 ,病情变化与影像学变化可不同步 ,临床恢复可早于血管再通是本病的临床特征之一。 CT、 MRI等检查对诊断本病很关键。脱水降颅压、抗凝、溶栓是其基本治疗原则。     

剖宫产后左下肢静脉血栓形成1例

1 病例介绍 患者,28岁,孕1产0,因停经40+6周,规律腹痛2 h于2007年11月2日入院.平常月经规律,停经50 d出现恶心症状,同时测尿HCG呈阳性,孕4个月出现胎动,孕期平顺,既往无特殊病史.     

窦汇至左颈内静脉血栓形成1例报告并文献复习

1 病例报告 患者女,49岁.因突发头痛,伴恶心呕吐4天入院.既往体健,口服避孕药10月.起病2天后被收入其他医院,院外查体:意识昏睡,颈阻( ),无神经系统定位体征.     

病毒性脑炎合并下肢深静脉血栓1例报道及文献复习

病毒性感染合并血栓者临床并不多见，而病毒性脑炎合并深静脉血栓（DVT）者更少见。就目前文献报道，主要与免疫功能、血栓倾向以及内皮细胞损伤等因素有关。其临床表现从轻微到严重昏迷不等。有的病例可以出现发热、头痛和（或）呕吐、抽搐、肌无力、脑膜刺激征；有些病人仅有轻微的症状或一过性的运动失调。本文报道1例病毒性脑炎合并左下肢深静血栓形成者，并作文献复习。     

剖宫产术后左下肢静脉血栓形成1例

患者,25岁,孕1产0。因停经40周,规律腹痛2h。于2003年11月2日入院。平常月经规律,停经50d出现恶心,同时测尿hCG阳性,孕4个月出现胎动。孕期无异常,既往史无特殊。查体：T36．4℃,P80次／main,R20次／min,BP140／90mmHg,发育正常,营养中等,心肺（-）,下肢水肿（-）。产科检查：腹围104cm,官高36cm,胎位RSA,骨盆外测量无异常,     

平山病2例报道及文献复习

<正>平山病(hirayama disease,HD),1959年由日本学者平山惠造首次提出,又称青年上肢远端肌萎缩,是一种良性自限性疾病,多在青年期起病,男性多见,临床表现为单侧或双侧但以一侧为主的上肢远端进行性肌无力和肌萎缩,多在5年内不再进展~([1-2])。2014年6月—2015年4月浙江省中医院诊治该病2例,现报道如下。1病例介绍病例1,男性,21岁,学生。5年前左手出现肌肉     

白塞病合并白血病--附2例报道及文献复习

目的研究白塞病合并白血病的临床特征，探讨两者间的关系。方法报道2例白塞病合并白血病病例，结合文献报道的9例，共计11例进行临床分析。结果11例患者平均年龄42．4岁，平均病程11．5年。临床表现按发生率多少分别为：口腔溃疡(100．0％)、皮损(90．9％)、外阴溃疡(63．6％)、眼部病变(54．5％)和关节炎(54．5％)。本组患者在合并白血病前大多有不同程度的外周血象改变(6／7例)，并且有免疫抑制剂使用史(5／8例)。合并的白血病：急性髓细胞性白血病9例，急性淋巴细胞白血病和浆细胞白血病各1例。11例患者1年内均死亡。结论从发病诱因、临床表现、药物使用等方面分析，白塞病与白血病之间存在密切联系。     

肠系膜静脉血栓形成兄妹2例报道

肠系膜静脉血栓形成兄妹同患少见,今报告如下。例1 女,26岁,因上腹部持续性疼痛伴恶心呕吐5天于1988年7月26日入院,查体:腹稍胀,左上腹压痛反跳痛,移动性浊音(—),双下肢静脉红肿。疑“急性胰腺炎”。手术探查见空肠肠系膜静脉血栓形成,肠系膜动脉无明显阻塞,胰腺无明显异常,行空肠相应肠袢切除肠吻合术。术后第5天,患者再次出现腹疼     

顺行法静脉溶栓治疗恶性肿瘤并下肢深静脉血栓形成

目的探讨顺行法静脉溶栓治疗恶性肿瘤并下肢深静脉血栓形成的临床疗效.方法对23例恶性肿瘤并下肢深静脉血栓形成患者,选择患肢足背浅静脉推注尿激酶,同时合用皮下注射低分子肝素等治疗,疗程7～14 d:观察疗效以及有无出血、过敏等不良反应.结果痊愈16例(70%),基本治愈4例(17%),好转2例(8.7%),无效1例(4.3%).治疗期间患者临床症状及体征均有改善,未发现出血倾向及过敏反应.结论顺行法静脉溶栓治疗下肢深静脉血栓形成方法简便、安全、有效.     

下腔静脉变异并发下肢深静脉血栓形成的临床诊断及治疗

  目的  探讨先天性下腔静脉变异(inferior vena cava malformation,IVCM)合并下肢深静脉血栓形成(deep vein thrombosis,DVT)的临床诊断与治疗方法。  方法  回顾性分析2011年8月—2021年7月蚌埠医学院第一附属医院血管外科收治的16例下腔静脉变异患者的临床资料,分析其临床表现及诊治方法。  结果  双下腔静脉(double inferior vena cava,DIVC)变异12例,其中9例合并下肢DVT(5例合并左下肢DVT,均行下腔静脉滤器植入+导管溶栓术,3例合并右下肢DVT,行右位IVC滤器植入术,1例合并双下肢DVT, 分别于左右位IVC各置入1枚滤器),3例合并不明原因双下肢肿胀,给予消肿治疗;左位下腔静脉(left inferior vena cava,LIVC)变异4例,其中2例因下肢肿胀行左下肢深静脉造影发现,给予消肿治疗,2例合并右下肢DVT术中经左股静脉穿刺造影发现,行下腔静脉滤器植入术,其中1例同时行置管溶栓术。放置永久性滤器1例,可回收滤器10例,所有DVT患者术后均给予抗凝治疗。  结论  IVCM是静脉血栓栓塞症的重要危险因素,合适位置的下腔静脉滤器置入具有重要的临床意义。      

下肢深静脉血栓形成治疗中并发症的分析

目的:分析下肢深静脉血栓形成(DVT)治疗过程中发生的主要并发症.探讨其原因、治疗和预防措施.方法:回顾分析98例下肢深静脉血栓患者采用Fogarty导管取栓后,导管插入溶栓和药物治疗的临床资料.结果:78例治疗经过顺利,痊愈出院;治疗过程中发生出血6例;栓塞后综合征10例;致死性肺栓塞2例.结论:治疗过程中密切观察血常规和凝血象的变化可有效预防出血的发生;腔静脉滤网可预防肺栓塞的发生;穿弹力治疗袜和适当的抗凝治疗可减少栓塞后综合征.     

Portal vein thrombosis in a complicated case of Crohn's disease.

Portal vein thrombosis is a rare complication of ulcerative colitis and is invariably fatal. This report describes a patient with severe Crohn''s disease who underwent elective surgery complicated by an anastomotic disruption with faecal peritonitis. Following emergency laparotomy he developed left hypochondrial pain which was a manifestation of splenomegaly consequent upon portal vein thrombosis. Anticoagulation was successful in preventing further spread of the thrombosis as monitored by colour Doppler ultrasound. Severe active disease, surgery and sepsis have been recognized as predisposing factors for thromboembolic complications in inflammatory bowel disease and this patient was exposed to all three. It is conceivable that portal vein thromboses occur more commonly than suspected and ultrasound scanning could ascertain the prevalence if performed prospectively.     

Gene variants associated with deep vein thrombosis

Irene D. Bezemer, MSc; Lance A. Bare, PhD; Carine J. M. Doggen, PhD; Andre R. Arellano, BS; Carmen Tong, BS; Charles M. Rowland, MS; Joseph Catanese, BS; Bradford A. Young, PhD; Pieter H. Reitsma, PhD; James J. Devlin, PhD; Frits R. Rosendaal, MD, PhD

JAMA. 2008;299(11):1306-1314.

Context  The genetic causes of deep vein thrombosis (DVT) are not fully understood.

Objective  To identify single-nucleotide polymorphisms (SNPs) associated with DVT.

Design, Setting, and Patients  We used 3 case-control studies of first DVT. A total of 19 682 gene-centric SNPs were genotyped in 443 cases and 453 controls from the Leiden Thrombophilia Study (LETS, 1988-1992). Twelve hundred six SNPs associated with DVT were reinvestigated in the Multiple Environmental and Genetic Assessment of Risk Factors for Venous Thrombosis study (MEGA-1, 1999-2004) in a subset of 1398 cases and 1757 controls. Nine SNPs associated with DVT in both LETS and MEGA-1 were investigated a third time in 1314 cases and 2877 controls from MEGA-2, a second subset of MEGA. Additional SNPs close to one SNP in CYP4V2 were genotyped in LETS and MEGA-1.

Main Outcome Measure  Odds ratios (ORs) for DVT were estimated by logistic regression. False discovery rates served to investigate the effect of multiple hypothesis testing.

Results  Of 9 SNPs genotyped in MEGA-2, 3 were strongly associated with DVT (P < .05; false discovery rate .10): rs13146272 in CYP4V2 (risk allele frequency, 0.64), rs2227589 in SERPINC1 (risk allele frequency, 0.10), and rs1613662 in GP6 (risk allele frequency, 0.84). The OR for DVT per risk allele was 1.24 (95% confidence interval [95%CI], 1.11-1.37) for rs13146272, 1.29 (95% CI, 1.10-1.49) for rs2227589, and 1.15 (95% CI, 1.01-1.30) for rs1613662. In the region of CYP4V2, we identified 4 additional SNPs (in CYP4V2, KLKB1, and F11) that were also associated with both DVT (highest OR per risk allele, 1.39; 95% CI, 1.11-1.74) and coagulation factor XI level (highest increase per risk allele, 8%; 95% CI, 5%-11%).

Conclusions  We identified SNPs in several genes that were associated with DVT. We also found SNPs in the region around the SNP in CYP4V2 (rs13146272) that were associated with both DVT and factor XI levels. These results show that common genetic variation plays an important role in determining thrombotic risk.