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1.
摘要 目的:探讨与分析超声引导下射频消融联合泡沫硬化治疗对下肢静脉曲张疼痛应激反应、血流动力学及凝血功能的影响。方法:2021年8月到2022年5月选择在本院诊治的下肢静脉曲张60例作为研究对象,根据简单分配原则把患者分为联合组与泡沫硬化组各30例。联合组给予超声引导下泡沫硬化联合射频消融治疗,泡沫硬化组给予超声引导下泡沫硬化治疗,观察与记录患者疼痛应激反应、血流动力学及凝血功能变化情况。结果:两组术后1 d的疼痛VAS评分都显著低于术前1 d(P<0.05),联合组也显著低于泡沫硬化组(P<0.05)。两组术后1 d的血清缓激肽(BK)、P物质(SP)含量都显著低于术前1 d(P<0.05),联合组也显著低于泡沫硬化组(P<0.05)。两组术后1周的血浆纤维蛋白原(Fib)、纤溶酶原激活物抑制物(PAI-1)都低于术前1 d(P<0.05),联合组也显著低于泡沫硬化组(P<0.05)。联合组术后1个月的总有效率为100.0 %,明显高于泡沫硬化组的86.7 %(P<0.05)。结论:相对于泡沫硬化,超声引导下射频消融联合泡沫硬化治疗下肢静脉曲张能改善患者的凝血功能,还能有效缓解疼痛,改善患者的血流动力学状况,提高总体治疗效果。  相似文献   

2.
摘要 目的:探讨血清脑钠肽(BNP)、超敏C反应蛋白(hs-CRP)、可溶性致瘤抑制素2(sST2)对阵发性心房颤动(AF)患者射频消融(RFA)术后复发的预测价值。方法:选择2016年1月至2020年12月我院收治的接受RFA术治疗的82例阵发性AF患者,术后随访12个月,根据术后是否复发分为复发组(25例)和未复发组(57例)。检测患者血清BNP、hs-CRP、sST2水平,收集临床相关资料,采用多因素Logistic回归模型分析影响阵发性AF患者RFA术后复发的因素,采用受试者工作特征(ROC)曲线分析血清BNP、hs-CRP、sST2预测阵发性AF患者RFA术后复发的价值。结果:复发组血清BNP、hs-CRP、sST2水平高于未复发组(P<0.05)。血清BNP、hs-CRP、sST2水平升高、AF病程增长是影响阵发性AF患者RFA术后复发的危险因素(P<0.05)。血清BNP、hs-CRP、sST2预测阵发性AF患者消融术后复发的曲线下面积分别为0.720、0.694、0.718,联合三者预测阵发性AF患者RFA术后复发的曲线下面积为0.866,高于BNP、hs-CRP、sST2单独预测。结论:阵发性AF患者血清BNP、hs-CRP、sST2水平升高是RFA术后复发的危险因素,联合检测血清BNP、hs-CRP、sST2水平有助于预测阵发性AF患者RFA术后复发。  相似文献   

3.
摘要 目的:探讨超声下腔内激光消融联合点式剥脱治疗大隐静脉曲张的效果和安全性观察。方法:选取我院血管外科在2019年1月到2021年12月收治的140例大隐静脉曲张患者作为研究对象。将所有患者依照住院号单双号进行分组,分为联合组与对照组,每组70例。对照组采用常规高位结扎联合抽剥术进行治疗,联合组采用超声下腔内激光消融联合点式剥脱进行治疗。对比两组手术指标、临床疗效、术前术后下肢深静脉瓣膜功能变化以及术后并发症的发生率。结果:联合组的手术耗时较对照组高,术中出血量、切口个数及住院时间均较对照组低(P<0.05);两组临床疗效分布对比有明显差异,且联合组显效率高于对照组(P<0.05);术后3个月两组VCT均有缩短,Vmax均有提升,且联合组术后3个月VCT较对照组短,Vmax较对照组高(P<0.05);联合组术后并发症较对照组低(P<0.05)。结论:对大隐静脉曲张患者采用超声下腔内激光消融联合点式剥脱方法治疗,与常规手术相比疗效更佳,且能够明显改善患者下肢静脉瓣膜功能,安全性高。  相似文献   

4.
摘要 目的:探讨肝动脉灌注化疗栓塞(TACE)联合射频消融(RFA)对中晚期肝癌患者生存率、肝功能和T淋巴细胞亚群的影响。方法:选取2014年7月~2018年4月期间我院收治的中晚期肝癌患者126例,根据随机数字表法将患者分为对照组和研究组,各63例。对照组给予TACE治疗,研究组则在对照组的基础上联合RFA治疗,比较两组患者疗效、生存率、肝功能、T淋巴细胞亚群及不良反应情况。结果:研究组治疗后临床总有效率为69.84%(44/63),显著高于对照组患者的50.79%(32/63)(P<0.05)。两组患者治疗后丙氨酸氨基转移酶(ALT)、总胆红素(TBIL)、天门冬氨酸氨基转移酶(AST)均较治疗前降低,且研究组低于对照组(P<0.05)。两组治疗后CD4+、CD4+/CD8+较治疗前降低,但研究组高于对照组(P<0.05);CD8+较治疗前升高,但研究组低于对照组(P<0.05)。两组不良反应发生率比较差异无统计学意义(P>0.05)。研究组患者1年、2年生存率均高于对照组(P<0.05)。结论:TACE联合RFA治疗中晚期肝癌患者,安全性较好,疗效较好,可有效改善患者肝功能,减轻机体免疫抑制,提高患者生存率。  相似文献   

5.
摘要 目的:为提高治疗效率,本研究对髂静脉压迫综合征合并下肢深静脉血栓患者的导管接触溶栓同期球囊扩张+支架治疗方案和分期治疗方案进行比较。方法:以65例髂静脉压迫综合征合并下肢深静脉血栓患者为研究对象,根据治疗方法分为研究组和对照组,研究组32例,进行导管接触溶栓同期球囊扩张+支架治疗,对照组33例,进行导管接触溶栓分期球囊扩张+支架治疗。以治疗前后患者大腿围、小腿围、血管通畅评分,手术指标(住院时间、住院次数、溶栓时间及穿刺次数),并发症(血栓复发、出血以及肺栓塞)及深静脉血栓后遗症为指标,考察两组疗效。结果:两组患者大腿围、小腿围和静脉畅通评分在治疗前均无显著差异(P>0.05),经过治疗,两组大腿围、小腿围和静脉畅通评分均显著改善(P<0.05),但两组间各项指标无显著差异(P>0.05)。研究组患者住院时间、住院次数、溶栓时间及穿刺次数均显著低于对照组(P<0.05)。研究组血栓复发0例,对照组血栓复发4例,有显著差异(P<0.05);研究组出血1例,肺栓塞0例,对照组出血2例,肺栓塞0例,两组出血和肺栓塞情况比较,无显著差异(P>0.05)。研究组PTS发生率为6.25 %,显著低于对照组的18.18 %(P<0.05)。结论:导管接触溶栓同期球囊扩张+支架治疗方案对髂静脉压迫综合征合并下肢深静脉血栓有良好的疗效。  相似文献   

6.
目的 反映某省三级甲等综合性医院住院患者静脉输液现状,为《全国医疗服务价格项目规范(2012年版)》静脉输液项目价格调整提供参考。方法 采用调查表的方式对7家三级甲等综合性医院部分科室268位住院患者静脉输液组数及收费水平进行调查。结果 (1)268位住院患者共计住院3456天,静脉输液共计11246次(含续点),人均静点次数为41.96次,日均静点次数为3.25次;共使用普通输液器4906个,三通788个,人肝素帽32个。(2)268位住院患者静脉输液项目合计日均收费18.45元/日,其中项目本身日均收费12.7元/日,占合计日均收费的68.85%,三种耗材日均收费合计5.75元/日,占合计日均收费的31.15%。讨论 静脉输液项目价格调整应进一步体现护理人员的技术劳务因素;静脉输液项目价格调整应考虑低值易耗品价格因素;兼顾原则性和灵活性,适当考虑对某些特殊专科予以特别考量。  相似文献   

7.
摘要 目的:对比分析经外环下精索静脉结扎术与腹股沟显微精索静脉结扎术对精索静脉曲张患者的精液质量及性激素水平的影响。方法:113例研究对象,随机分为观察组(n=57)和对照组(n=56),对照组给予腹股沟显微精索静脉结扎术,观察组给予经外环下精索静脉结扎术,对比其精液质量、性激素水平以及并发症发生率。结果:术后半年,两组患者精子密度等相关指标均显著提高,且观察组均较对照组高(P<0.05);两组患者术后血清促卵泡激素(follicle-stimulating hor-mone,FSH)、血清睾酮(testoster-one,T)、黄体生成素(luteinizing hormone,LH)浓度水平比较,观察组显著较对照组低(P<0.05),术后血清T水平显著升高,观察组显著高于对照组(P<0.05);两组患者术后2周内并发症发生情况比较,观察组低于对照组(P<0.05)。结论:相比于腹股沟显微精索静脉结扎术,经外环下精索静脉结扎术更有利于患者精子质量的提高,改善性激素水平,降低患者并发症发生率,值得推广应用。  相似文献   

8.
目的:观察下肢静脉性溃疡患者穿静脉功能不全情况,探讨超声定位下肢穿静脉结扎对下肢静脉性溃疡术后疗效的影响。方法:40例大隐静脉曲张患者随机分成两组:A组采用大隐静脉高位结扎、静脉腔内微波射频闭合术及超声定位穿静脉结扎治疗,B组采用大隐静脉高位结扎和静脉腔内微波射频闭合术治疗。观察两组患者治疗后静脉性溃疡的愈合时间、复发率及瓣膜功能不全穿静脉数量部位,并比较两组患者临床预后评分。结果:术前两组瓣膜功能不全穿静脉数量分别是47条和44条,两组比较差异无统计学意义(P=0.5520)。术后两组愈合时间分别是(7.5±4.389)周和(11.6±6.489)周,两组比较差异具有统计学意义(P=0.048)。两组临床预后评分分别为(2.3±0.6)分和(1.1±1.5)分,两组比较差异具有统计学意义(P=0.042)。结论:多普勒超声可有效检测定位瓣膜功能不全的下肢穿静脉,在超声定位下行大隐静脉高位结扎、静脉腔内微波射频闭合术联合穿静脉结扎治疗下肢静脉性溃疡的疗效优于穿静脉不结扎。  相似文献   

9.
摘要 目的:对比超声及数字减影血管造影机(Digital subtraction angiography,DSA)引导泡沫硬化治疗下肢静脉曲张的临床治疗效果。方法:选取我院2015年10月到2020年10月共收治的120例下肢静脉曲张患者,将其随机分为观察组与对照组,每组60例,对照组患者应用DSA引导硬化治疗,观察组患者应用超声引导硬化治疗,对比两组患者的治疗效果,精神健康成分(Mental health components,MCS)、躯体健康成分(Physical health components,PCS)与疾病严重程度量表(Clinical severity of venous disease,VCSS)评分,住院时间与手术时间,不良反应发生情况。结果:观察组患者治疗总有效率96.67 %,高于对照组治疗总有效率86.67 %,组间对比有统计学差异(P<0.05);两组患者治疗前MCS、PCS与VCSS评分对比无明显差异(P>0.05),治疗后,观察组患者MCS评分高于对照组,VCSS评分低于对照组,组间对比,差异具有统计学意义(P<0.05);观察组患者的住院时间与手术时间,高于对照组的住院时间与手术时间,组间对比,差异具有统计学意义(P<0.05);观察组患者不良反应总发生率5.00 %,低于对照组患者不良反应发生率20.00 %,组间对比,差异具有统计学意义(P<0.05)。结论:超声引导下进行下肢静脉曲张硬化治疗有显著效果,能够治愈或降低静脉曲张分级,提升静脉曲张患者的精神、躯体健康,促进患者早日康复。  相似文献   

10.
摘要 目的:对比腹腔镜肝切除术、经皮射频消融术(RFA)治疗原发性小肝癌的效果,并分析预后的影响因素。方法:本研究收集我科2016年8月~2018年8月期间收治的160例原发性小肝癌患者的病例资料,根据治疗方式将患者分为A组(腹腔镜肝切除术,80例)和B组(RFA,80例)。对比两组围术期指标、肝功能指标、并发症发生率及预后情况。对所有患者进行为期3年的随访,记录患者生存情况,经单因素及多因素Logistic回归分析预后的影响因素。结果:B组的术中出血量、住院总费用少于A组,平均手术时间、住院时间短于A组(P<0.05)。两组术后3 d丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)以及总胆红素(TBIL)水平升高,甲胎蛋白(AFP)水平下降,组内不同时间点对比差异有统计学意义(P<0.05)。两组术后并发症发生率组间对比,无统计学差异(P>0.05)。两组死亡率组间对比无统计学差异(P>0.05)。根据患者的预后情况将160例患者分为死亡组(n=32)和存活组(n=128)。研究证明AFP≥20 ng/mL、肿瘤多发、微血管癌栓、白蛋白<35 g/L、凝血酶原时间≥13 s、Child-Pugh分级为B级是原发性小肝癌患者预后的危险因素(P<0.05)。结论:原发性小肝癌采用RFA或腹腔镜肝切除术治疗,均可获得较好的临床效果,且安全可靠,RFA在术中出血量、住院总费用、手术时间、住院时间方面略占优势。此外,凝血酶原时间、肿瘤数目、白蛋白、微血管癌栓、Child-Pugh分级、AFP是原发性小肝癌患者预后的影响因素。  相似文献   

11.
Norbormide is a vasoconstrictor of rat peripheral arteries and a relaxant in rat aorta. To characterise norbormide actions within the rat vascular tree we have investigated its effects on the contractile function of rings from several arteries and veins. A maximal norbormide concentration (50 microM) failed to contract thoracic aorta and carotid artery, whereas in pulmonary artery, abdominal aorta, iliac, caudal, and femoral arteries it induced a contractile effect that was respectively 4.8 +/- 0.6, 18.4 +/- 1.5, 39 +/- 5, 144 +/- 7, and 260 +/- 22% of that induced by 90 mM KCl. In pulmonary, carotid, and iliac arteries, and in thoracic and abdominal aorta, 50 microM norbormide inhibited KCl-induced responses. Norbormide (50 microM) contracted all veins investigated. The effect, expressed as % of KCl-induced contraction, was 121 +/- 25, 154 +/- 14.5, 154 +/- 18.2, 203 +/- 19, and 267 +/- 33 for pulmonary vein, thoracic and abdominal vena cava, iliac and jugular veins, respectively. In jugular vein, as previously shown in rat caudal artery, norbormide contraction was abolished in Ca2+-free medium, was unaffected by the Ca2+ channel blocker nifedipine, and was relaxed by SK&F 96365, a blocker of store-operated Ca2+ channels. In conclusion: i) rat veins represent the main target for contractile norbormide action; ii) in both artery and veins norbormide contractions are generally inversely related to the calibre of the vessel; iii) norbormide-induced contraction is mediated by the same mechanism/s in arteries and veins; iiii) in norbormide-contracted arteries the drug activates both contractile and relaxing mechanisms.  相似文献   

12.
In this brief review an attempt has been made to discuss some of the important features of the vascular anatomy of angiospermous leaves, especially those related to assimilate transport. Accordingly, emphasis has been placed on the small or minor veins, which are closely related spatially to the mesophyll, and which play a major role in the uptake and subsequent transport of photosynthates from the leaf. The small veins are enclosed by bundle sheaths that intervene between the mesophyll and vascular tissues and greatly increase the area for contact with mesophyll cells. In the minor veins of dicotyledonous leaves, parenchymatic cells having organelle-rich protoplasts and numerous cytoplasmic connections with sieve elements dominate quantitatively. It is these so-called intermediary cells that apparently are directly involved with the loading of assimilates into the sieve elements. In the maize leaf the small and intermediate bundles have two types of sieve tubes, relatively thin-walled ones that have numerous cytoplasmic connections with companion cells, and thick-walled ones that lack companion cells but have numerous connections with vascular parenchyma cells. The companion cell-sieve tube complexes are virtually isolated symplastically from other cells of the vascular bundle and from the bundle sheath. Thick-walled sieve tubes similar to those in the maize leaf have been recorded in the leaves of other grasses.  相似文献   

13.
The orbitotemporal venous sinuses accompany the intracranial branches of the stapedial artery. These sinuses are large in primitive primates and drain the extensive territories supplied by the stapedial artery as well as the brain. The orbit is drained by a wide cranio-orbital sinus which empties into the postglenoid emissary vein. Also emptying into the postglenoid vein is the petrosquamous sinus. The latter diverts cerebral blood from the transverse sinus and also drains the temporalis muscle. Emptying into both the cranio-orbital and petrosquamous sinuses are meningeal tributaries, which drain the cranial side wall and the dura mater. The relatively small sinus communicans runs in the angle between the petrosal bone and the cranial side wall. It commences at the postglenoid vein and connects the distal end of the petrosquamous sinus to the pterygoid venous plexus. In humans, the orbitotemporal sinus system is greatly modified. Its remnants persist for the most part as "middle meningeal veins." The system no longer drains the orbit, the temporal fossa, or the brain. The petrosquamous sinus becomes attenuated or obliterated along part or all of its length. The postglenoid vein vanishes. The cranio-orbital sinus is reduced in diameter and its connection to the orbit is feeble or absent. During development, the posterior end of the cranio-orbital sinus migrates inferiorly along the sinus communicans. In most individuals, this migration ceases at the foramen spinosum, site of the emissary vein of the sinus communicans. Meningeal tributaries are relatively large in humans, and drain principally into the cranio-orbital sinus or sphenoparietal sinus. The sphenoparietal sinus is an evolutionary novelty restricted to hominoids and is frequently developed in only Homo and Pongo.  相似文献   

14.
Korn R 《Planta》2006,224(4):915-923
Tracheid analysis was carried out on the veinlets and minor veins of the coleus (Solenostemon scutellarioides [L.] Codd) leaf. Third- to fifth-order, or minor, veins average 3.4 tracheids in tandem and they bipartition islets when these enclosed islets reach a critical size; both these features of vein length and islet size contribute to a self-similar process of vein pattern generation. An areole was calculated to be initially comprised of about ten cells making the patterning event for vein formation requiring only a few cells. An algorithmic model developed here for minor vein formation includes five production rules, and this computer model explains the 3–4 tracheids per minor vein, presence of isolated tracheids, the structure of veinlets, and the elaborate branching patterns of veinlets in coleus and other plants.  相似文献   

15.
In this image case we describe a relatively rare vascular malformation known of as Thebesian veins, which in some cases could cause cardiac ischemia and ventricular arrhytmias.  相似文献   

16.
Veins in the cardiovascular system may collapse if the internal pressure is less than the external pressure. Such collapse or buckling will have important consequence in terms of the rate of blood flow. Here a steady, parallel unidirectional flow as an exact solution of the continuity and the Navier Stokes equations is constructed. Various stages of the deformation process of the elastic tube (before contact of opposite sides occurring), from an ellipse to a `strongly buckled' configuration, are obtained in analytical forms as a by-product of the calculations. The pressure – area and the pressure – flow rate diagrams computed numerically from the model agree with the trends measured experimentally. Partial Financial Support has been provided by the Research Grants Council Contract HKU 7184/04E.  相似文献   

17.
兔肺静脉肌袖心肌细胞动作电位的特性和一些离子流机制   总被引:3,自引:0,他引:3  
Ding HY  Yang XC  Liu XL  Liu TF  Bao RF 《生理学报》2006,58(2):129-135
研究兔肺静脉肌袖心肌细胞(cardiomyocytes from rabbit pulmonary vein sleeves, PVC)动作电位的特性和一些离子流机制——内向整流钾电流(IKl)、瞬时外向钾电流(ITo)和非选择性阳离子流(I NSCC),并与左心房心肌细胞(left atrial cardiomyocytes,LAC)进行比较。采用全细胞膜片钳技术,记录动作电位和上述各离子流。发现PVC动作电位时程(action potential duration,APD)较LAC的明显延长,并可以诱发出第二平台反应。PVC上存在I NSCC. PVC的IKl、I To和I NSCC电流密度均较LAC的明显减小。PVC和LAC存在复极离子流的差异,这种差异构成了两者动作电位差异的基础,进而可能成为肺静脉肌袖致心律失常特性的重要离子流机制。  相似文献   

18.
The aim of the study was to investigate the existence of valves in small peripheral coronary veins of porcine hearts. The study was performed on 20 porcine hearts using standard histological methods. The veins in the subepicardial and intramyocardial regions of the anterior and posterior parts of the interventricular septum and in the wall of the right atrium were studied. Valves were present in intramyocardial veins (diameter of 75–180 μm), in the veins located just beneath the external surface of the myocardium (diameter 120–170 μm) and in the terminal segments of the ventricular veins (diameter 250 μm) opening into the stems of the anterior interventricular vein and middle cardiac vein. Valves were also recorded in most veins of the subepicardial space. The described rich presence of valves in the small coronary veins may contribute to a better comprehension of their hemodynamic properties. These findings may also help to improve the understanding of the efficacy of retrograde application of medications, a novel technique in cardiology and cardiac surgery.  相似文献   

19.
The development of pulmonary vein stenosis has recently been described after radiofrequency ablation (RF) to treat atrial fibrillation (AF). The purpose of this study was to examine expression of TGFβ1 in pulmonary vein stenosis after radiofrequency ablation in chronic atrial fibrillation of dogs. About 28 mongrel dogs were randomly assigned to the sham-operated group (n = 7), the AF group (n = 7), AF + RF group (n = 7), and RF group (n = 7). In AF or AF + RF groups, dogs underwent chronic pulmonary vein (PV) pacing to induce sustained AF. RF application was applied around the PVs until electrical activity was eliminated. Histological assessment of pulmonary veins was performed using hematoxylin and eosin staining; TGFβ1 gene expression in pulmonary veins was examined by RT-PCR analysis; expression of TGFβ1 protein in pulmonary veins was assessed by Western blot analysis. Rapid pacing from the left superior pulmonary vein (LSPV) induced sustained AF in AF group and AF + RF group. Pulmonary vein ablation terminated the chronic atrial fibrillation in dogs. Histological examination revealed necrotic tissues in various stages of collagen replacement, intimal thickening, and cartilaginous metaplasia with chondroblasts and chondroclasts. Compared with sham-operated and AF group, TGFβ1 gene and protein expressions was increased in AF + RF or RF groups. It was concluded that TGFβ1 might be associated with pulmonary vein stenosis after radiofrequency ablation in chronic atrial fibrillation of dogs. Shufeng Li and Hongli Li contributed equally to the work.  相似文献   

20.
目的:探讨食管静脉曲张(EV)采用内镜下套扎术(EVL)和硬化剂(EVS)治疗对患者近远期并发胃底静脉曲张(GV)以及门脉高压性胃病(PHG)并发症的影响。方法:抽选我院肝硬化上消化道出血后接受内镜下治疗的患者97例为研究对象,其中19例予以内镜下EVS治疗,78例行内镜下EVL治疗,随访1年,观察治疗3个月、6个月、1年后并发GV、PHG的近远期概率。结果:治疗3个月后,本组患者GV、PHG等并发症的发生率为17.5%(17/97)、39.2%(38/97),与治疗前比较差异无显著性(P0.05);治疗6个月后,本组患者GV、PHG等并发症的发生率为32%(31/97)、70.1%(68/97),与治疗前相比,并发人数显著增加(P0.05);治疗1年后,GV、PHG的发生率为42.3%(41/97)、88.7%(86/97),并发人数显著高于治疗前(P0.05)。结论:内镜下EVS、EVL治疗在消退食管曲张静脉和良好地控制出血的同时,还可增加PHG、GV的并发几率,值得临床重视预防。  相似文献   

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