Transjugular intrahepatic portosystemic shunt for palliative treatment of portal hypertension secondary to portal vein tumor thrombosis

AIM: To evaluate the palliative therapeutic effects of transjugular intrahepatic portosystemic shunt (TIPS) in portal vein tumor thrombosis (PVTT) complicated by portal hypertension. METHODS: We performed TIPS for 14 patients with PVTT due to hepatocellular carcinoma (HCC). Of the 14 patients, 8 patients had complete occlusion of the main portal vein, 6 patients had incomplete thrombosis, and 5 patients had portal vein cavernous transformation. Clinical characteristics and average survival time of 14 patients were analysed. Portal vein pressure, ascites, diarrhoea, and variceal bleeding and circumference of abdomen were assessed before and after TIPS. RESULTS: TIPS was successful in 10 cases, and the successful rate was about 71%. The mean portal vein pressure was reduced from 37.2 mmHg to 18.2 mmHg. After TIPS, the ascites decreased, hemorrhage stopped and the clinical symptoms disappeared in the 10 cases. The average survival time was 132.3 d. The procedure failed in 4 cases because of cavernous transformation in portal vein and severe cirrhosis. CONCLUSION: TIPS is an effective palliative treatment to control hemorrhage and ascites due to HCC complicated by PVTT.     

恶性肿瘤患者与血栓症

血栓症是恶性肿瘤患者的一种常见并发症,直接影响患者的预后。恶性肿瘤可通过多种机制导致血栓形成,而血栓形成又促进了恶性肿瘤的生长和转移。这类血栓症的表现随血栓形成部位的不同而不同,多同时伴有恶性肿瘤的原发表现。90%以上的恶性肿瘤患者可出现凝血系统相关指标异常。恶性肿瘤患者凝血功能正常时,不必进行预防性抗血栓治疗。当凝血功能异常时,预防性治疗的必要性尚无定论,但对于接受手术的恶性肿瘤患者,预防性治疗能显著降低静脉血栓发病率。抗血栓形成药物,如低分子肝素,可控制血液的高凝状态,减少恶性肿瘤患者血栓症的发病率。恶性肿瘤患者一旦确诊有血栓形成就必须进行抗凝治疗,皮下应用低分子肝素已经成为急性血栓症的一线治疗药物。低分子肝素和丙酮苄羟香豆素还可以抑制肿瘤生长和转移,延长肿瘤患者的生存时间。     

Evaluation of triple anti-platelet therapy by modified throm- belastography in patients with acute coronary syndrome

Most cases of acute coronary syndrome （ACS） involve coronary atherosclerosis and plaque rupture, as well as subsequent thrombosis. The initial thrombotic events leading to red thrombus formation are platelet adherence and aggregation. Platelets play a very important role during the establishment and progression of a thrombosis in a coronary artery. Therefore, in recent years guidelines have been developed in an effort to strengthen antiplatelet therapy in ACS, but unfortunately the methods to evaluate platelet activity and the strength of platelet inhibition are lacking.     

10例肺动脉内膜剥脱术的观察和护理

目的肺动脉内膜剥脱术是慢性肺血栓栓塞症治疗的一种有效手段.方法通过对10例行肺动脉内膜剥脱术患者的术前、术后观察和护理进行总结.结果其护理与一般的心脏直视手术护理有相似之处,但其术后辅助呼吸、呼吸道的管理有别于普通的心脏直视术后护理.结论术后积极抗凝预防再次栓塞是术后成功的关键.     

头晕与脑血栓症有关吗？

我因头疼头晕就医,通过检查医生认为我患有脑血栓症、高脂血症、高血压等。为什么脑血栓能引起头晕,像我这种情况该如何吃药,生活中注意些什么？     

抵克力得预防重组人促红细胞生成素诱发顽固性高血压和血 …

目的：研究抵克力得预防重组人促红细胞生成素（ｒＨｕＥＰＯ）治疗维持性血液透析患者肾性贫血所诱发的顽固性高血压和血栓症的机制和疗效。方法：将１７例患者随机分为两种,治疗组１０例,在ｒＨｕＥＰＯ治疗同时使用抵克力得,对照组７例,只使用ｒＨｕＥＰＯ。两组均治疗１２周,然后比较治疗前后两组血液学及血流动力学指标的改变及临床疗效。结果：对照组血红蛋白（Ｈｂ）、红细胞压积（ＨＣＴ）、平均血压（ＭＢＰ）和血小板     

老年急性下肢深静脉血栓患者的患病危险因素分析

目的:调查与分析老年急性下肢深静脉血栓(DVT)的患病危险因素。方法:连续选择近期住院的77例老年急性下肢DVT患者,设计专项调查问卷,调查与分析患病危险因素,并与71例同期来院体检的老年人(对照组)比较。结果:77例老年急性下肢DVT患者平均患病危险因素频度为6.79±2.18,明显高于对照组(1.24±0.56),P<0.01。老年DVT组的冠心病、高血压、糖尿病、高脂血症、癌症、感染性疾病、血液系统疾病、脑卒中和肾功能不全患病例数均明显多于对照组,前者遭遇外伤和骨折也明显增加,接受各种相关治疗(大手术、深静脉穿刺、脱水治疗和止血治疗)例数明显增多,长期卧床、吸烟和有肺血栓栓塞症家族史者也明显多于对照组(P均<0.01~0.05)。结论:老年急性下肢DVT患者常常合并有多种慢性病,遭遇外伤和骨折频度大,接受各种相关治疗者增加,长期卧床、吸烟和有肺血栓栓塞症家族史例数居多。     

Incidence of deep venous thrombosis after primary total joint arthroplasty in low risk popultion

Objective To research the incidence of deep venous thrombosis （DVT） in low risk population after total hip or knee arthroplasty. Methods Between February 2003 to April 2005,136 patients undergoing selective primary total joint arthroplasty were included in the study. Patients with high risk factors of thromboembolic disease were ruled out. There were 73 cases 76 hips in total hip arthroplasty group and 63 cases 72 knees in total knee arthroplasty group.     

用西蒙得木油治疗血栓症、关节炎和疼痛等

在一定压力下压榨粉碎的西蒙得木种子得到第一相油，再用更高的压力压榨得到第二相油。每种油都经过不同程度的过滤。第一相油可用于药物。含西蒙得木油50％和水杨