下腔静脉可回收滤器置入预防肺栓塞

目的:评价可回收下腔静脉滤器在下肢深静脉血栓患者中预防肺栓塞效果和安全性。方法:34例下肢深静脉血栓患者全部行下腔静脉滤器置入术,其中12例采用永久性Trap Ease Filter(TEF),16例采用可回收性OptEaseTMFilter(TEF),6例采用可回收性Gunther Tulip Filter(GTF)滤器,滤器均置于肾静脉水平以下的下腔静脉中。结果:34例滤器均经股静脉穿刺置入,16例可回收性OptEaseTMFilter中12例2周后经股静脉取出。6例可回收性Gunther Tulip Filter(GTF)滤器两周后经右颈内静脉取出。手术成功率100%。随访30例(随访时间:2~28个月),12例永久滤器病人中有1例出现倾斜,但角度小于15℃,1例下腔静脉血栓形成,术中术后未出现滤器移位,穿破管壁和肺栓塞。结论:可回收性下腔静脉滤器是预防肺栓塞安全、有效的方法之一,且并发症少。     

下腔静脉滤器置入术96例临床总结

目的探讨下腔静脉滤器置入术(IVCF)预防致命性肺动脉栓塞(PE)的疗效、相关并发症及处理。方法经股静脉途径放置下腔静脉滤器96例。结果术后随访4～36个月。96例IVCF无一例出现致命性肺栓塞,17例出现相关的并发症。结论下腔静脉滤器可以有效预防致命性肺动脉栓塞,并发症的发生率较高,相关并发症可以有效预防和处理。     

下腔静脉滤器在下肢深静脉血栓治疗中的意义

目的评价置入下腔静脉滤器预防下肢深静脉血栓脱落引起肺栓塞的价值及实行导管溶栓的方法.方法34例下肢深静脉血栓患者分别经右侧股静脉(26例)或右颈静脉(8例)置入波士顿公司的Greenfield滤器或巴德公司Simon's滤器.下腔静脉滤器置人后,将溶栓导管经右股静脉插人到左髂总静脉,经右颈内静脉插入到左髂总静脉进行溶栓.药物尿激酶100～150万u.结果下腔静脉滤器置入全部成功.溶栓经右侧股静脉26例,成功12例,成功率为47%;经颈静脉8例均成功.结论置人下腔静脉滤器防肺栓塞是操作简单、安全有效的方法.经颈静脉溶栓,成功率高,效果好,值得推广.     

下腔静脉滤器预防肺栓塞的临床应用

目的：评价置入下腔静脉滤器预防因下肢静脉血栓脱落引起肺栓塞的效果和安全性。材料与方法：１６例下肢深静脉血栓患者置入钛质Ｇｒｅｎｆｉｅｌｄｆｉｌｔｅｒ（ＴＫＧ）１２例,Ｂｉｒｄ’ｓｎｅｓｔｆｉｌｔｅｒ（ＢＮＦ）４例。滤器位于双肾静脉水平以下的腔静脉内。术后分别于１、６、１２个月摄腹部平片复查,观察滤器的位置、形态变化。结果：全部滤器经股静脉穿刺置入,经右股静脉１３例,左股静脉３例,无严重并发症发生。随访发现ＴＫＧ２例向足侧移位,１例向头侧移位,１例跨度增大,腹部ＣＴ,腔静脉造影发现滤器的１只脚穿透腔静脉壁,未出现任何症状;２例发生滤器偏斜,角度小于１５°。ＢＮＦ未见位置改变。无１例发生腔静脉阻塞或复发肺栓塞。结论：置入下腔静脉滤器预防肺栓塞是安全、有效的方法。     

下腔静脉滤器预防肺栓塞及其并发症

目的 探讨下腔静脉滤器置入术(IVCF)预防肺动脉栓塞(PE)的疗效、相关并发症及处理.方法70例下肢深静脉血栓患者,溶(取)栓术前均行下腔静脉滤器置入术:永久性Trap Ease滤器(TEF)20枚,永久性Vena Tech滤器(VTF)31枚,可回收性OptEase~(TM)滤器(OEF)13枚,临时性TempoⅡ滤器8枚;71枚位置在肾静脉开口下方,1枚位置在肾静脉开口上方.结果 术后随访8～72个月.70例中,无一例出现PE,6例出现相关的并发症.结论 下腔静脉滤器置入可以有效预防肺梗死,但应严格掌握适应证.     

经肘下腔静脉滤器置入术六例

目的 探讨经肘下腔静脉滤器置入的方法及并发症的防治.方法 2004年10月至2006年5月我科收治的下肢深静脉血栓形成(DVT)患者中,有6例采取经肘静脉穿刺下腔静脉滤器置入.6例均经右肘正中静脉或贵要静脉穿刺,将SNF(Simon nitinol filter,Bard)沿90 cm长鞘置人下腔静脉.结果 6例手术均1次成功,用时平均25 rain.除1例肘部穿刺点有轻度红肿外,其余均愈合良好,无出血或血肿,无静脉炎.滤器位置准确,无偏斜.患者均无肺栓塞发生.结论 经肘下腔静脉滤器置人术穿刺容易,创伤小,术后患者无需卧床制动,有利丁DVT的治疗.同时,对于经股静脉穿刺有禁忌的DVT患者,经肘下腔静脉滤器置入更不失为较好的替换选择.     

经颈股静脉双向入路取出植入40天后的永久滤器一例

下腔静脉滤器常被用于下肢深静脉血栓患者以预防肺栓塞。我科接收1例下肢深静脉血栓患者滤器置入术后继发下腔静脉血栓。溶栓成功后,为避免滤器长期置入而引起的并发症,采取经颈股静脉双向入路成功取出植入40 d后的永久滤器(Cordis TrapEase)1枚,现报道如下。     

腔静脉滤器置入术预防肺动脉栓塞

目的 评价腔静脉滤器置入术预防肺动脉栓塞的临床效果。方法 对13例深静脉血栓溶栓过程中应用腔静脉滤器置入预防肺动脉栓塞的临床结果进行分析。结果 全部13例患者,上腔1例,下腔12例,其中肾静脉开口上方1例,肾静脉开口下方11例,均成功进行了腔静脉滤器置入术,随访6～16个月,无肺梗塞发生,亦无滤器移位、出血等相关并发症。结论 腔静脉滤器置入是预防肺动脉栓塞的有效方法。     

下腔静脉Günther Tulip滤器倾斜发生机制的体外研究

目的 采用体外下腔静脉(IVC)模型探讨经股静脉Günther Tulip滤器(GTF)置入发生倾斜的机制.方法 体外IVC模型由悬吊于透明、分叉玻璃管中的1支直径25 mm、长10 cm涤纶人工血管及2支直径10 mm、长10 cm涤纶人工血管构成.经股静脉GTF置入分为两组:右直组GRS)(n ＝ 100)和左直...     

经股静脉锁骨下静脉血栓清除术的临床应用价值

目的探讨经股静脉锁骨下静脉血栓清除术的有效性。方法急性锁骨下静脉血栓16例经右股静脉置入上腔静脉滤器;然后送入9～12 F长鞘和球囊导管抽吸和拖拉血栓;残存狭窄者采用经皮血管腔内成形术或静脉内支架置入术。术后行抗凝及溶栓治疗。结果16例经股静脉锁骨下静脉血栓清除术治疗均获得成功,其中置入支架2枚。表现为锁骨下静脉通畅,患肢肿胀消退。随访3.5～30.0个月,未见症状性复发。未发生严重并发症。结论 经股静脉锁骨下静脉血栓清除术是治疗锁骨下静脉血栓的安全、有效的方法。     

Knee injury and Osteoarthritis Outcome Score (KOOS) - validation of a Swedish version

The Knee injury and Osteoarthritis Outcome Score (KOOS) is a self-administered instrument measuring outcome after knee injury at impairment, disability, and handicap level in five subscales. Reliability, validity, and responsiveness of a Swedish version was assessed in 142 patients who underwent arthroscopy because of injury to the menisci, anterior cruciate ligament, or cartilage of the knee. The clinimetric properties were found to be good and comparable to the American version of the KOOS. Comparison to the Short Form-36 and the Lysholm knee scoring scale revealed expected correlations and construct validity. Item by item, symptoms and functional limitations were compared between diagnostic groups. High responsiveness was found three months after arthroscopic partial meniscectomy for all subscales but Activities of Daily Living.     

Endovascular management of carotid-cavernous fistulas

Objective To investigate endovascular treatment of traumatic direct carotid-cavernous fistulas （CCF） and their complications such as pseudoaneurysms. Methods： Over a five-year period, 22 patients with traumatic direct CCFs were treated endovascularly in our institution. Thirteen patients were treated once with the result of CCF occluded, 8 twice and 1 three times. Treatment modalities included balloon occlusion of the CCF, sacrifice of the ipsilateral internal carotid artery with detachable balloon, coll embolization of the cavernous sinus and secondary pseudoaneurysms, and covered-stem management of the pseudoaneurysms. Results All the direct CCFs were successfully managed endovascularly. Four patients developed a pseudoaneurysm after the occlusion of the CCF with an incidence of pseudoaneurysm formation of 18.2% （4/22）. A total number of 8 patients experienced permanent occlusion of the ICA with a rate of ICA occlusion reaching 36.4% （8/22）. Followed up through telephone consultation from 6 months to 5 years, all did well with no recurrence of CCF symptoms and signs. Conclusion Traumatic direct CCFs can be successfully managed with endovascular means. The pseudoaneurysms secondary to the occlusion of the CCFs can be occluded with stent-assisted coiling and implantation of covered stents.     

The acutely limping child

Acute limping may be the result of multiple pathologies in children. The differential diagnosis varies based on the age of the child. Irrespective of age, the initial imaging work-up includes AP and frog leg radiographs of the pelvis and ultrasound; MRI may sometimes be helpful. In children less than 3 years, infections and trauma are most frequent. MRI is the imaging modality of choice when osteomyelitis is clinically suspected. Between the ages of 3 and 10 years, transient synovitis of the hip and Legg-Calvé-Perthes disease are main considerations but infection, inflammation and focal bony lesions are also considered. In children over 10 years, slipped capital femoral epiphysis also is considered.     

Do Balance Board Training Programs Reduce the Risk of Ankle Sprains in Athletes?

Introduction Ankle sprains are the most common musculo-skeletal injury that occurs in athletes,particularly in sports that require jumping and landing on one foot such as soccer,and basketball(1-4).These injuries often result in significant time loss from participation,long-term disability,and have a major impact on health care costs and resources(5-8).     

High Intensity Interval Training:New Insights

KEY POINTS ·High-intensity interval training(HIT)is characterized by repeated sessions of relatively brief，intermittent exercise.often performed with an“a11 out”effort or at an intensity close to that which elicits peak oxygen uptake(i.e.，≥90%of VO2 peak).     

Developmental validation of the PowerPlex(®) ESI 16 and PowerPlex(®) ESI 17 Systems: STR multiplexes for the new European standard

In response to the ENFSI and EDNAP groups’ call for new STR multiplexes for Europe, Promega^® developed a suite of four new DNA profiling kits. This paper describes the developmental validation study performed on the PowerPlex^® ESI 16 (European Standard Investigator 16) and the PowerPlex^® ESI 17 Systems. The PowerPlex^® ESI 16 System combines the 11 loci compatible with the UK National DNA Database^®, contained within the AmpFlSTR^® SGM Plus^® PCR Amplification Kit, with five additional loci: D2S441, D10S1248, D22S1045, D1S1656 and D12S391. The multiplex was designed to reduce the amplicon size of the loci found in the AmpFlSTR^® SGM Plus^® kit. This design facilitates increased robustness and amplification success for the loci used in the national DNA databases created in many countries, when analyzing degraded DNA samples. The PowerPlex^® ESI 17 System amplifies the same loci as the PowerPlex^® ESI 16 System, but with the addition of a primer pair for the SE33 locus. Tests were designed to address the developmental validation guidelines issued by the Scientific Working Group on DNA Analysis Methods (SWGDAM), and those of the DNA Advisory Board (DAB). Samples processed include DNA mixtures, PCR reactions spiked with inhibitors, a sensitivity series, and 306 United Kingdom donor samples to determine concordance with data generated with the AmpFlSTR^® SGM Plus^® kit. Allele frequencies from 242 white Caucasian samples collected in the United Kingdom are also presented. The PowerPlex^® ESI 16 and ESI 17 Systems are robust and sensitive tools, suitable for the analysis of forensic DNA samples. Full profiles were routinely observed with 62.5 pg of a fully heterozygous single source DNA template. This high level of sensitivity was found to impact on mixture analyses, where 54–86% of unique minor contributor alleles were routinely observed in a 1:19 mixture ratio. Improved sensitivity combined with the robustness afforded by smaller amplicons has substantially improved the quantity of data obtained from degraded samples, and the improved chemistry confers exceptional tolerance to high levels of laboratory prepared inhibitors.