抗凝祛聚法在选择性贲门周围血管离断术后预防门静脉血栓形成中的临床应用

目的:评价分析抗凝祛聚法在选择性贲门周围血管离断术后预防门静脉血栓形成中的临床疗效及安全性。方法:将我院2006年5月—2010年5月因肝炎后肝硬化门静脉高压症拟施行选择性贲门周围血管离断术的88例患者随机分为2组:抗凝组47例(早期使用抗凝祛聚法)与非抗凝组41例(同期常规使用药物组)进行对比分析,并利用彩色多普勒超声监测门静脉血栓形成情况。结果:88例患者均随访6个月以上,抗凝组术后门静脉血栓发生率为4.2%(2/47),明显低于非抗凝组的14.6%(6/41),差异有统计学意义(χ2=3.38,P<0.05)。术后1周2组间血小板(PLT)、凝血酶原时间(PT)、凝血酶时间(TT)、活化部分凝血酶原时间(APPT)、纤维蛋白原(FIB)比较差异无统计学意义(P>0.05)。结论:选择性贲门周围血管离断术后早期抗凝祛聚治疗能安全有效地降低门静脉血栓的发生率。

下腔静脉滤器置入结合溶栓抗凝祛聚综合治疗下肢深静脉血栓形成

目的 探讨下腔静脉滤器置入预防肺动脉栓塞结合溶栓抗凝祛聚治疗下肢深静脉血栓形成的效果。结果 无致死性肺动脉栓塞的发生，随诊6～10个月，全组9例病人，痊愈2例（22％），显效4例（45％），有效3例（33％），总有效率100％．9例下腔静脉滤器展开良好，无移位。结论 下腔静脉滤器置入结合溶栓、抗凝、祛聚治疗下肢深静脉血栓形成安全有效。

中西医结合治疗下肢深静脉血栓形成44例临床观察

目的:观察中西医结合治疗下肢深静脉血栓形成的疗效。方法:将84例患者随机分为治疗组44例,对照组40例。对照组采用溶栓、抗凝、祛聚治疗,治疗组在对照组基础上加用中医辨证分型论治。15天后观察疗效。结果:治愈率治疗组为29.5%,对照组为29.0%;总有效率治疗组为88.6%,对照组为70.0%。两组综合疗效比较,治疗组优于对照组。且治疗组在改善纤维蛋白原和凝血酶原时间方面优于对照组。结论:常规西医治疗结合中医辨证分型治疗下肢深静脉血栓形成能显著提高疗效。

门静脉高压症术后门静脉系统血栓形成的治疗

目的:探讨门静脉高压症术后门静脉系统血栓形成的病因、诊断、预防及治疗。方法:回顾分析11例门静脉高压症术后门静脉系统血栓形成病人的诊断和治疗方法。结果:11例病人经抗凝、溶栓、祛聚、手术治疗后,8例治愈,3例死亡。结论:门静脉高压症术后门静脉系统血栓形成是门静脉高压症术后严重的并发症,须及早诊断、预防及采取不同的治疗方法,方能避免此并发症发生并降低死亡率。

下肢深静脉血栓形成的诊治体会

目的探讨和分析对于治疗下肢深静脉血栓形成的诊治方法和病因。方法选取该院在2014年1月—2017年1月期间接受治疗的100例下肢深静脉血栓患者为该次的研究对象,对所有患者的临床资料进行回顾性的分析,将其按照随机数字表法分为对照组与研究组,每组各50例。对照组患者实施以抗凝、祛聚等为主的非手术治疗方式,研究组患者则采用手术治疗的方法。对两组患者分别进行不同方法治疗后的效果进行观察和对比。结果研究组患者治疗的总有效率明显的高于对照组,两组间相比,差异有统计学意义(P<0.05);研究组患者的并发症发生率显著低于对照组患者,两组间相比,差异有统计学意义(P<0.05)。结论对下肢深静脉血栓形成患者实施手术治疗的效果相较于非手术方法治疗的效果较为显著,对致死性肺动脉栓塞的发生具有很强的预防作用,同时患者的并发症相对较少,具有很高的安全性,但对患者及时实施抗凝、祛聚治疗能够对患者的患肢肿胀现象起到有效的缓解作用。

门静脉肠系膜上下静脉广泛血栓形成1例报告

门静脉、肠系膜上下静脉广泛血栓形成的病例少见。对其诊治。比较困难,现将我科遇到的一例报道如下:病例:女患、24岁。正常产后十六天,自觉腹部持续性痛。恶心、呕吐,在门诊按胃痉挛治疗,无明显效果。三天后腹痛加重,呈持续性剧痛,恶心呕吐不止,排少量干便一次,无其他症状。

Mucosal polymerase chain reaction for diagnosing Helicobacter pylori infection in patients with bleeding peptic ulcers

AIM: Helicobacter pylori (H pylon) has been linked to chronic gastritis, peptic ulcers, gastric cancer and MALT-lymphoma. Conventional invasive tests are less sensitive than non-invasive tests in diagnosing H pylori infection in patients with bleeding peptic ulcers. Polymerase chain reaction is a sensitive and accurate method for diagnosing H pylori infection. The aim of this study was to evaluate the diagnostic role of mucosai polymerase chain reaction for H pylori infection in patients with bleeding peptic ulcers. METHODS: In patients with bleeding, non-bleeding peptic ulcers and chronic gastritis, we checked rapid urease test, histology, bacterial culture and mucosai polymerase chain reaction fordetecting H pylori infection. Positive H pylori infection was defined as positive culture or both a positive histology and a positive rapid urease test. For mucosai polymerase chain reaction of H pylori, we checked vacA (s1a, s1b, s1c, s2, m1, m1T, m2), iceA1, iceA2. and cag A. RESULTS: Between October 2000 and April 2002,88 patients with bleeding peptic ulcers (males/females: 60/28, gastric ulcers/duodenal ulcers: 55/33), 81 patients with non-bleeding peptic ulcers (males/females: 54/27, gastric ulcers/duodenal ulcers: 45/36) and 37 patients with chronic gastritis (males/ females: 24/13) were enrolled in this study. In patients with bleeding peptic ulcers, non-bleeding peptic ulcers and chronic gastritis, 45 patients (51%), 71 patients (88%) and 20 patients (54%) respectively were found to have positive H pylori infection (P<0.001). In patients with bleeding peptic ulcers, non-bleeding peptic ulcers and chronic gastritis, polymerase chain reaction for H pylori infection was positive in 54 patients (61%), 70 patients (86%) and 20 patients (54%) respectively (P<0.001). The sensitivity, positive predictive value and diagnostic accuracy of mucosai polymerase reaction for H pylori infection were significantly lower in patients with bleeding peptic ulcers (84%, 79% and 81%) than in patients with non-bleeding peptic ulcers (99%, 99% and 98%) (P<0.001, P<0.01 and P<0.001 respectively). The sensitivity, negative predictive value and diagnostic accuracy of mucosal polymerase reaction for H py/ori were significantly lower in patients with bleeding peptic ulcers (84%, 83% and 81%) than in patients with chronic gastritis (100%, 100% and 100%) (P= 0.02, P= 0.02 and P=0.001). CONCLUSION: Mucosal polymerase chain reaction for detecting H pylori infection is not reliable in patients with bleeding peptic ulcers.