Application of the sea-buckhorn ointment for the treatment of the burn wounds and trophic ulcers]

Clinical estimation was performed of the application efficacy of Unguentum cum Olei Hippopheae preparation in treatment of 30 patients with the burn wounds, 7--with the lower extremities ulcer due to postthrombophlebitis syndrome existence, 8--on the diabetic angiopathy background. The epithelisation acceleration by (4.6 +/- 1.4) days, an ulcer square reduction by (2.3 +/- 0.25)% in comparison with a control group were established.     

The assessment of long-term results of surgical treatment of patients with secondary lymphostasis lower extremity in predicting the course of the disease

With the development of vascular surgery began to attract attention to the problem of studying the long-term results of treatment. Long-term results of surgical treatment were studied in 110 patients with secondary lymphostasis lower extremities in the period 1997-2010. The estimation was made in two ways. First, the definition of value of basic clinical and social indicators, and secondly, the study target quality of life of patients. The analysis of remote results of treatment of patients with secondary lymphostasis lower extremities indicates that the quality of life and values of major clinical and social indicators quite adequately characterize the patient's condition after treatment and can be used alongside traditional medical data to assess long-term results, as well as serve as criteria in solving the optimal choice of treatment.     

介入联合自体有核细胞移植术治疗下肢动脉闭塞症疗效观察

目的 探讨下肢动脉闭塞性病变介入联合自体有核细胞移植术治疗的临床疗效.方法 对78例下肢动脉闭塞性疾病患者的临床资料进行回顾性分析.78例中单纯行介入治疗38例(45肢),介入治疗联合自体有核细胞移植治疗40例(53肢).通过比较治疗前和治疗后1个月临床症状(静息痛、间歇性跛行、溃疡)的评分、踝肱指数(ankle br...     

急性下肢深静脉血栓形成局部置管溶栓与外周静脉溶栓的比较

目的 比较急性下肢深静脉血栓形成经局部及外周静脉抗凝溶栓治疗的效果,以指导临床治疗.方法 回顾性分析我院2001年1月至2008年5月期间收治的225例下肢深静脉血栓形成患者的临床资料,按照治疗方法分A、B两组.A组为经股深静脉置管抗凝溶栓治疗患者,共71例,左侧47例,右侧20例,双侧4例;B组为经外周静脉抗凝溶栓治疗的患者,共154例,左侧121例,右侧27例,双侧6例.通过监测患者临床症状、测量下肢周径变化比较两组治疗效果.结果 A组患者治疗3 d后好转率优于B组患者(94.4%比69.5%,P＜0.01).治疗7 d后,A组的治愈率虽然优于B组患者,但差异无统计学意义(85.9%比75.3%,P＞0.05).治疗后平均随访(43±18)个月,两组的并发症及复发率差异无统计学意义(P＞0.05).结论 股静脉置管局部溶栓治疗的早期疗效优于经外周静脉给药,但两种方法的中远期治疗效果相似.

Abstract：

Objective To investigate the efficacy of anticoagulation and thrombolysis for deep venous thrombosis via local vein approach and peripheral vein approach to guide clinical treatment. Methods There were 225 patients with deep venous thrombosis admitted from January 2001 to May 2008. The cases were divided into two groups by therapy procedures. The patients in group A were treated by deep femoral vein catheter-directed anticoagulation and thrombolysis, including a total number of 71 patients, with right lower extremity in 20 patients, left lower extremity in 47 patients and bilateral lower extremities in 4 patients. One hundred and fifty-four patients were included in group B with anticoagulation and thrombolysis through peripheral vein, among them right lower extremity in 27 patients, left lower extremity in 121 patients and bilateral lower extremities in 6 patients. The efficacy was evaluated and compared by observing clinical symptoms and measuring of changes in limb circumference. Results Symptoms were alleviated in all patients in 3 d after the treatment, but the efficacy of group A was better than group B (94. 4% vs. 69. 5% ,P＜0. 01). The efficacy of group A was also better than group B in 7 days after treatment, but with no significant difference (85. 9% vs. 75. 3% , P ＞0. 05). A mean follow-up period was (43 ±18) months.There was no significant difference in incidence of complication and recurrence between two groups.Conclusions The earlier efficacy of anticoagulation and thrombolysis via femoral vein approach is better than via peripheral vein approach in earlier period of deep venous thrombosis. While peripheral intravenous therapy has also good results after long-term treatment.     

矫形器在下肢骨与关节疾患的临床应用

目的 研究矫形器在下肢骨与关节疾患治疗中的作用,以利于临床应用,提高骨科治疗水平。方法 对７８例应用矫形器辅助处理治疗下肢骨与关节疾患的患者进行疗效观察分析,结果 ７８例患者配戴各种类型矫形器后,均可以站及行走,患肢功能得到改善。结论 矫形器起到外固定,免荷,稳定关节,均衡肢体不等长,预防和矫正畸形的作用,是治疗下肢骨与关节疾患的重要手段之一,应进一步推广应用。     

Partial denervation in complex treatment of occlusive diseases of the lower extremity arteries

The interventions efficacy, conducted on a nervous structures in 198 patients for occlusive diseases of the lower extremities arteries, in 68 of whom a femoral and sciatic nerves blockade were performed together with epidural anesthesia and open alcoholizing of sciatic nerve, was estimated. Efficacy of partial denervation in complex treatment of patients, suffering chronic ischemia of the lower extremities stages II - IlIA, was established, when performance of a direct revascularization is impossible because of a secured functional reserve present.     

Changes in cell adhesion molecules under the influence of surgical treatment in patients with acute thrombophlebitis of the subcutaneous veins in the lower extremities

The content of soluble molecules of intercellular adhesion-1 (sICAM-1) in 60 patients with an acute thrombophlebitis (TP) of the lower extremities subcutaneous veins was studied preoperatively and 7 days after the operation using method of a solid phase immunoenzymatic analysis (IEA). The sICAM-1 level before treatment in men was increased at average by 75.8% (P < 0.001), in women--by 81.5% (P < 0.001) in comparison with control group, after treatment it was lowered somewhat. The gender differences of patients for the average sICAM-1 concentration was not noted. In ascending TP sICAM-1 higher level preoperatively and its normalization on 7th day postoperatively were observed in patients, admitted to in surgical unit and operated 3-5 days after the beginning of disease. In patients, to whom conservative treatment was performed initially (anti-inflammatory and thrombolytic therapy), but its efficacy was minimal, the content of cell adhesion molecules preoperatively and before the treatment did not differ. Positive dynamic of index was revealed after the intervention. The results of investigation trust the important role of cell adhesion in pathogenesis of an acute TP of the lower extremities subcutaneous veins and perspective of application of the sICAM-1 method determination in dynamic of the patients treatment to estimate the surgical efficacy intervention.     

Acute thrombosis of lower extremities. Risk factors,methods of prevention and treatment

The results of treatment of 526 patients with an acute venous thrombosis of the lower extremities aged from 23 to 70 years, including 140 (36.3%) men and 376 (63.7%) women, were analyzed. The main etiological factors of thrombosis were physical overload, operations with subsequent immobilization, trauma of lower extremities, pregnancy and delivery, tumor of small pelvis and of other localization. In 65 patients an acute venous thrombosis was complicated by thromboembolism of pulmonary artery (TEPA), 2 patients died before initiation of treatment. Conduction of conservative therapy in 314 (94.4%) patients with thrombosis of the lower extremities deep veins using fraxiparine (fraxiparine forte) have allowed to achieve considerable improvement of their state. In 80 patients with thrombosis of subcutaneous veins was performed ligature of mouth for prophylaxis of TEPA, in all of them good clinical result was noted. High efficacy of fraxiparine application in prophylactical dosage for prevention of the venous thromboembolism occurrence was noted.     

手动负压抽吸联合血管化淋巴结移植治疗继发性下肢淋巴水肿的疗效分析

目的 探讨手动负压抽吸联合血管化淋巴结移植治疗继发性下肢淋巴水肿的临床疗效。方法 回顾性分析2018年11月至2021年11月接受联合治疗的12例妇科恶性肿瘤术后继发性下肢淋巴水肿患者的临床资料。患肢大腿采用手动负压抽吸减容,同时取锁骨上血管化淋巴结移植至患侧小腿。比较治疗前后患肢周径变化;记录治疗前后丹毒发作情况及生活质量的改变。结果 患肢大腿抽取脂肪组织500～1 200 mL,平均（917±196） mL。术后患肢周径明显减小（P<0.05）。治疗后随访期间所有患者均无丹毒发作,主观症状均较术前明显好转。结论 手动负压抽吸联合血管化淋巴结移植治疗下肢淋巴水肿疗效确切,值得推广。     

Surgical technologies in the treatment of varicose veins of the lower extremities complicated with trophic ulcer

Results of an open randomized study of staged treatment of 94 patients suffering from varicose veins of the lower extremities with open infected trophic ulcers of the shank were analyzed. All the patients were divided into 3 groups depending on the treatment variant. Based on this study, clinical efficacy of early correction of upper vertical venous-venous reflux is substantiated. Efficacy of CO(2) laser application for sanation of trophic venous ulcers and practical importance of their auto-venous plastic reconstruction are demonstrated. Thus, up-to-date technologies provide differential treatment in patients with trophic venous ulcers.     

Change in the oxygen regimen in the skin of the extremities after the subcutaneous administration of nitrous oxide]

The work deals with the study of the skin oxygen rate in obliterating diseases of the lower extremities. In 40 patients the skin oxygen tension was studied in the first web space of the foot. 19 of these patients were the control group. In the main group (21 patients) nitrous oxide was injected in the subcutaneous fat of the lower extremities within the complex of the conservative treatment. In obliterating arterial diseases of the lower extremities the disorders of the tissue oxygen rate, particularly pronounced in the late stages of the pathological process, were found. The subcutaneous injections of nitrous oxide improved the regional blood flow in the low extremities.     

Surgical treatment of sequelae of nerve trunk injuries of the lower limbs

The authors have analysed the results of surgical treatment of 63 patients with consequences of traumatic injuries of the nerves of the lower extremities. Characteristic peculiarities of the injuries of the nerves of the lower extremities are noted. The possibilities of reconstructive microsurgery in the treatment of severe traumatic lesions in this contingent of the patients are demonstrated.     

Pathogenesis and treatment strategies for lymphorrhea and lymphocele after vascular surgeries on the lower extremities

From 1995 to 2003 lymphatic complications (lymphorrhea and lymphocele) after different vascular surgeries on the lower extremities were seen in 57 (4.6%) patients. All the methods of therapeutic and surgical treatment of lymphorrhea and lymphocele are presented. Problems of surgical policy and some aspects of pathogenesis of these complications are regarded. Ethiopathogenetic classification of lymphatic complications is proposed. Creation of lymphovenous anastomosis is regarded as the most promising method. This surgery was performed in 31 patients, efficacy was 96.8%. The method permits one to stop inflow of lymph into lymphatic cavity and to avoid lymphedema after surgery. Other methods of treatment have various efficacy.     

Lasers in the treatment of arterial occlusive diseases of the limbs]

The authors have analysed the initial results of treatment in 64 patients suffering obliterating diseases of arteries of upper and lower extremities by means of irradiation with a helium-neon laser the least electric resistance points. The control over the results of treatment is exercised basing on findings of thermovision study and patients' subjective sensations. The best results were gained in treatment of patients with Reynaud diseases and obliterating endarteritis. The therapy employed yielded an insignificant effect in various forms of atherosclerosis of the lower extremities.     

Plasmapheresis in the treatment of critical stages of ischemia in diabetic angiopathy of the lower extremities

The authors have used gravitation plasmapheresis in the treatment of 26 patients with diabetic angiopathies of lower extremities. It was established that continuous gravitation plasmapheresis facilitated the immediate correction of most of the altered biochemical and coagulation parameters of blood, in patients with diabetes mellitus. The use of rheopolyglucinum is followed by stable central hemodynamics and stabilization of the general state of the patients during continuous plasmapheresis which allows to recommend rheopolyglucinum as the main plasma-substituting solution for fractionation of blood in patients with diabetic angiopathies. The gravitation plasmapheresis used in the treatment of critical degrees of ischemia in patients with diabetic angiopathies of lower extremities is thought by the authors to allow to preserve the extremity or to make the level of its amputation lower in most patients.     

Some peculiarities of the treatment of burns of the lower extremities]

The results of treatment in 323 patients with burns of the lower extremities according to the materials of the CITO Burn Department for a 10-year period are reported. The authors described the method of treatment of circular burns of the lower extremities, based on suspension of the latter by needles stretched between arches, in Ilizarov apparatuses and by gauze bands supporting plaster dressings. The method is simple, convenient and facilitates the management of patients and obviates burn wound compression, prevents fusion of transplanted grafts due to compression and would permit to obtain favourable results of the treatment in the shortest time.     

Experience of application of lymphotropic methods in the treatment of lower extremity veins]

Experience of treatment of 368 patients with disease of veins of lower extremities was summarized. In patients with an acute thrombophlebitis and chronic venous insufficiency of lower extremities significant disorders of microhemo- and lymphatic circulation, manifesting as venous or lymphatic stasis, were noted. Conduction of lymphotropic therapy have promoted microcirculation improvement, elimination of interstitial oedema and signs of inflammation, permitting to shorten the stationary treatment period.     

急性下肢动脉缺血溶栓治疗的临床研究

目的 总结溶栓治疗对急性下肢动脉缺血的疗效及其安全性.方法 回顾性分析2009年1月～201 1年12月收治43例急性下肢动脉缺血患者的临床资料,均进行动脉腔内溶栓治疗,其中27例进行导管直接溶栓,6例导管直接溶栓前行血管内球囊扩张,7例导管直接溶栓后进行血管内球囊扩张和支架置入,溶栓前后均进行球囊扩张有3例.腔内溶栓治疗无效转而手术取栓13例.结果 30例(69.8％)患者血管再通及肢体保存,但其中1例因出血并发症死亡,发生脑梗死1例.8例(18.6％)截肢,均为移植物血栓形成.1例肢体坏死但未行截肢.4例溶栓无效但肢体未坏死而最终采取药物保守治疗.结论 溶栓治疗对急性下肢动脉缺血总体安全有效,可优先考虑,根据病情的需要采取综合治疗方案.     

下肢静脉曲张伴溃疡患者的病因分析和疗效观察

目的 探讨下肢静脉曲张伴溃疡（C6级）患者的常见病因和治疗效果,为临床诊治提供参考。方法 收集2020年7月至2021年12月深圳市第二人民医院收治的84例下肢静脉曲张伴溃疡患者的临床资料（共86条患肢）,汇总患者的下肢静脉彩色多普勒超声和顺行造影检查数据,观察患肢的髂静脉压迫情况、深静脉瓣膜反流情况和穿通支静脉反流情况。对患者给予综合治疗,比较治疗前后患者的静脉临床严重程度评分（VCSS）,观察治疗效果。结果 下肢静脉曲张伴溃疡患者中,髂静脉压迫患肢62条（72.1%）;深静脉瓣膜反流患肢47条（54.7%）;穿通支静脉反流患肢64条（74.4%）。溃疡患者在术后3个月的随访期内,经过规律换药,溃疡均得到了愈合,随访期内溃疡未再发。所有患者的术后VCSS为（5.83±1.19）分,低于术前的（11.86±1.89）分,差异有统计学意义（P<0.05）。结论 下肢静脉曲张伴溃疡患者中存在较高比例的髂静脉压迫、深静脉瓣膜反流、穿通支静脉反流,经过综合治疗后疗效显著。     

Efficacy and tolerance of low molecular weight heparin in the prevention of deep venous thrombosis during non-emergent total hip arthroplasty. A prospective, multicenter trial

A multicenter prospective trial was conducted on 149 patients to test the efficacy and tolerance of low molecular weight heparin (LMWH) in the preventive treatment of deep venous thrombosis consecutive to total hip arthroplastic surgery. An original dose-adjusted protocol was tested, whereby the patients were injected a single dose of LMWH daily, determined on a weight and operation date basis; the prophylactic efficacy of this protocol was assessed by bilateral phlebography performed systematically on the 10th postoperative day. Only 12.9% of patients developed deep venous thrombosis of the lower extremities, and the thrombus formation site was proximal in 3.6% of cases. These rates are low compared with published data and considering the diagnostic criterion used. The low incidence of premature treatment withdrawal and hemorrhagic complication (2%) cases is indicative of the good tolerance of this preventive treatment.