联合术式治疗大隐静脉曲张298例分析

我院2000年2月-2005年6月采用联合术式治疗大隐静脉曲张298例342条肢体,取得了满意的效果,现报告如下。     

覆膜支架治疗锁骨下动脉假性动脉瘤1例

锁骨下动脉假性动脉瘸较为少见,其在外周动脉瘤中约占1％。2013年4月11日．我科采用覆膜支架治疗1例浚病病人,效果满意。现报告如下。     

缺血后适应信号转导通路的研究进展

缺血后适应是人体天然的内源性保护机制,作用是减轻引起再灌注损伤的多种起始因素,以减轻缺血组织损伤,减少细胞凋亡,缩小梗死面积。本文对参与缺血后适应信号转导通路的细胞外信号物质、细胞内信号转导酶和信号转导分子等的最新研究进行综述。     

线粒体通透性转换孔在缺血后适应减轻兔肠缺血再灌注损伤中的作用

目的 观察线粒体通透性转换孔(mPTP)在缺血后适应减轻兔小肠缺血再灌注(I/R)损伤中的作用.方法 将新西兰兔40只随机分为假手术组(Sham组)、L/R组、缺血后适应组(IPO组)、mPTP抑制剂环孢素A组(CsA组)、IPO+ mPTP开放剂苍术甙组(IPO+ Atr组).分别干预后采集各组兔部分小肠组织标本,苏木素-伊红(HE)染色,检测小肠组织丙二醛(MDA)活性,提取肠线粒体,检测mPTP开放,Chiu氏6级评分法观察肠黏膜损伤,原位缺口末端标记法(TUNEL)法检测肠上皮细胞凋亡.结果 与Sham组比较,I/R组mPTP开放明显增加(I/R组3.53±0.36比Sham组1.37 ±0.16,P＜ 0.05);MDA活性明显增高[I/R组(0.98±0.14) nmol/mg比Sham组(0.34±0.03) nmol/mg,P＜0.05];肠黏膜损伤评分明显增高[I/R组(4.66±0.41)分比Sham组(0.92±0.58)分,P＜0.05];肠细胞凋亡指数明显增高[I/R组(60.34±6.02)％比Sham组(4.65±1.68)％,P＜0.05].与I/R组比较,IPO组和CsA组mPTP开放明显减少(IPO组2.32 ±0.23、CsA组2.62±0.18比I/R组3.53 ±0.36,P＜0.05);MDA活性明显减低[IPO组(0.55 ±0.04) nmol/mg、CsA组(0.62±0.06) nmol/mg比I/R组(0.98 ±0.14) nmol/mg,P＜0.05];肠黏膜损伤评分明显减低[IPO组(3.25±0.27)分、CsA组(3.52 ±0.55)分比I/R组(4.66 ±0.41)分,P＜0.05];肠细胞凋亡指数明显减低[IPO组(28.33±3.20)％、CsA组(20.49±4.10)％比I/R组(60.34±6.02)％,P＜0.05],与IPO组比较,IPO+ Atr组mPTP开放明显增加(IPO+ Atr组1.05±0.16比IPO组2.32±0.23,P＜0.05);MDA活性明显增高[IPO +Atr组(1.08±0.18) nmol/mg比IPO组(0.55±0.04) nmol/mg,P＜0.05];肠黏膜损伤评分明显增加[IPO+ Atr组(4.57±0.32)分比IPO组(3.25±0.27)分,P＜0.05];肠细胞凋亡指数明显增加[IPO+ Atr组(40.35±2.18)％比IPO组(28.33±3.20)％,P＜0.05].结论 缺血后适应能减轻兔肠I/R损伤,其机制可能与抑制mPTP开放有关.     

山东半岛成人肾下下腔静脉直径与长度测量及其意义

Objective To measure the diameter and length of infrarenal inferior vena cava (IVC)in Shandong Peninsula adult through digital subtraction angiography ( DSA) for better vena cava filter (VCF) choice and placement. Methods From April 2008 to June 2010, 83 discontinuous patients (49 males and 34 females, mean age 56. 4 years) with deep venous thrombosis ( DVT) of lower extremity were placed VCF through DSA according to ACCP-8. During operation, diameter and length of infrarenal IVC were measured. At the same time, the renal vein location and the type of the IVC were identified to help the VCF choice. Results All the VCFs were placed successfully, no complications occurred. The diameter of infrarenal IVC was 10 to 26 mm with a mean of (19 ±5) mm. The average length from beginning of IVC to the lower renal vein was (10. 6 ±2. 8) cm. The renal vein was located between the first and second lumbar vertebra, the IVC beginning was located between the fourth and fifth lumbar vertebra. Conclusions Diameter and length measurement of infrarenal IVC is helpful to the VCF selection and the domestic VCF research. Vena cava angiography is very important to the accurate placement of VCF.     

一例大面积急性坏死性筋膜炎多次误诊的教训

病例,男,65岁,于1994年11月7日入院。10天前于肛门右侧发现一疖肿,疼痛,伴寒战及发热,诊为肛旁疖行消炎治疗,后疼痛渐向阴囊扩展。5天前,阴囊胀痛较重,又诊为阴囊炎和睾丸炎,B超检查于左侧阴囊内探及大量气体,提示为腹股沟斜疝嵌顿,以嵌顿疝收住院。入院后查体:T38.2℃,P 85次/分,     

逆行穿刺并支架置入术治疗急慢性肠系膜上动脉缺血病例报告并文献复习

目的 评价逆行开放性肠系膜动脉支架置入术（retrograde open mesenteric stenting,ROMS）治疗肠系膜上动脉（superior mesenteric artery,SMA）闭塞性疾病的可行性、适用范围及优缺点。方法 回顾2019年2月1日至2021年8月11日在青岛大学医学院附属烟台毓璜顶医院血管外科接受ROMS治疗的4例急性和慢性肠系膜缺血患者的临床资料。CT血管造影（computedtomography angiography,CTA）判断SMA起始端闭塞,运用ROMS技术逆向开通SMA闭塞段并置入支架;对仍然失活的肠管行一期切除;术后给予静脉营养、抗感染及抗血小板等综合治疗。复查CTA随访SMA通畅情况。结果 采用该技术共治疗4例SMA缺血病人。术中均顺利开通闭塞段SMA,并置入支架。其中1例术中同期行部分小肠切除术。4例均顺利康复,术后3个月复查CTA示：支架形态及位置良好,SMA血流通畅。结论 在正向开通SMA闭塞性病变失败的情况下,ROMS是一种有效的治疗肠系膜缺血的技术,但其操作相对复杂,有一定的创伤,需严格把握适应证。     

腹膜后副脾1例报告

腹膜后副脾１例报告杨典东，杨牟患者女，４０岁。６个月前无明显诱因出现上腹部疼痛，以进食后明显，疼痛持续４０～６０分钟后可自行缓解，无其它症状。体查：上腹部未触及包块，有深压痛，无反跳痛，移动性浊音（－）。上消化道钡餐检查未发现异常。Ｂ超检查发现腹膜后...     

山东半岛成人肾下下腔静脉直径与长度测量及其意义

Objective To measure the diameter and length of infrarenal inferior vena cava (IVC)in Shandong Peninsula adult through digital subtraction angiography ( DSA) for better vena cava filter (VCF) choice and placement. Methods From April 2008 to June 2010, 83 discontinuous patients (49 males and 34 females, mean age 56. 4 years) with deep venous thrombosis ( DVT) of lower extremity were placed VCF through DSA according to ACCP-8. During operation, diameter and length of infrarenal IVC were measured. At the same time, the renal vein location and the type of the IVC were identified to help the VCF choice. Results All the VCFs were placed successfully, no complications occurred. The diameter of infrarenal IVC was 10 to 26 mm with a mean of (19 ±5) mm. The average length from beginning of IVC to the lower renal vein was (10. 6 ±2. 8) cm. The renal vein was located between the first and second lumbar vertebra, the IVC beginning was located between the fourth and fifth lumbar vertebra. Conclusions Diameter and length measurement of infrarenal IVC is helpful to the VCF selection and the domestic VCF research. Vena cava angiography is very important to the accurate placement of VCF.