Changing common sense:Anti-platelet/coagulation therapy against cirrhosis

Until recently,anti-platelet/coagulation therapy had not been recommended for patients with cirrhosis.Although venous thrombosis is one of the representative complications of cirrhosis and ischemic disorders associated with atherosclerosis are not infrequent in cirrhotic patients,many clinicians have tended to hesitate to introduce anti-platelet/coagulation therapy to their patients.Undoubtedly,this is due to the increased risk of hemorrhagic diathesis in cirrhotic patients.However,accumulating evidence has revealed the benefits of anti-platelet/coagulation therapy for cirrhotic patients.In addition to the safety of the therapy carried out against cardiovascular diseases in cirrhotic patients,some clinical data have indicated its preventive effect on venous thrombosis.Moreover,the efficacy of antiplatelet/coagulation therapy against cirrhosis itself has been demonstrated both clinically and experimentally.The conceptual basis for application of anti-platelet/coagulation therapy against cirrhosis was constructed through two pathologic studies on intrahepatic thrombosis in cirrhotic livers.It may be better to use thrombopoietinreceptor agonists,which have been tested as a treatment for cirrhosis-related thrombocytopenia,in combination with anti-platelet drugs to reduce the risk of venous thrombosis.During the last decade,the World Journal of Gastroenterology,a sister journal of World Journal of Hepatology,has been one of the main platforms of active discussion of this theme.

Combined therapy with transcatheter arterial chemoembolization and percutaneous microwave coagulation for small hepatocellular carcinoma

AIM:To assess the efficacy of combined transcatheter arterial chemoembolization(TACE)and percutaneous microwave coagulation therapy(PMCT)for small hepatocellular carcinoma(HCC). METHODS:Thirty-five patients with a total of 41 HCC nodules(≤3 cm in diameter)were treated with TACE followed by computed tomograghy(CT)-guided percutaneous microwave coagulation therapy(PMCT) within 1-3 wk. RESULTS:By biopsies and enhanced CT scans, complete necrosis of the tumor and 3-5 mm of the surrounding non-cancerous area were observed in 34 foci.In seven foci,incomplete necrosis of the surrounding parenchyma was observed.Serum alpha- fetoprotein(AFP)levels returned to normal 10 d after treatment in 25 patients who originally had high serum AFP levels.The follow-up period was 6-31 mo,and all patients remained alive.One patient had a recurrence in the subsegments of the liver,and another patient had a recurrence near the original lesion. CONCLUSION:Combined therapy with TACE and PMCT is a safe and effective treatment without severe complications for small HCC.

An experience of hyperbaric oxygen and transurethral coagulation combination therapy for abnormal vessels and intractable macrohematuria due to pelvic arteriovenous malformations

A 78-year-old man was admitted to our hospital with a chief complaint of gross hematuria. The patient was diagnosed with pelvic arteriovenous malformations and repeated arterial embolization. A cystoscopy demonstrated that bladder trigone was covered by many clots. At the same time, bleeding mucosa at the right side of the bladder dome was confirmed. We administered hyperbaric oxygen therapy 7 days after admission. Macrohematuria recovered gradually and we then performed transurethral coagulation at the dome with failed mucosa 14 days after admission. Macrohematuria recovered completely and there was no recurrence during hospitalization. Thirty days after admission, we performed cystoscopy and found clear mucosa in the trigone. The patient was discharged 32 days after admission.

Effects of Ticagrelor on oxidative stress, coagulation function, platelet function and related factors in patients with coronary artery disease undergoing interventional therapy

Objective: To explore the effects of Ticagrelor on oxidative stress, coagulation function, platelet function and related factors in patients with coronary artery disease undergoing interventional therapy. Methods: A total of 140 patients with coronary artery disease who underwent percutaneous coronary intervention in our hospital from October 2016 to March 2018 were selected as the study subjects and were divided into control group (70 cases) and observation group (70 cases) by drawing lots. Both groups were treated with symptomatic routine therapy before operation. On this basis, the control group was treated with clopidogrel before operation, and the observation group was treated with Ticagrelor before operation on the basis of routine treatment. The changes of oxidative stress, coagulation index, platelet function and related factors were compared between the two groups before and after treatment. Results: Before treatment, there were no significant differences in oxidative stress factors, coagulation parameters, platelet parameters and related factors factors between the two groups. After treatment, the levels of MDA, MPAR, VEGF and MMP-9 in the two groups were lower than those before treatment, while the levels of SOD, APTT, TT and PT were higher than those before treatment;and the levels of MDA, MPAR, VEGF, MMP-9, APTT and PT in the observation group were significantly lower than those in the control group after treatment, while the levels fo SOD, TT and IPA in the observation group were significantly higher than those in the control group. Conclusions: Ticagrelor can better reduce oxidative stress injury, improve coagulation function and coronary stenosis, and inhibit platelet aggregation in patients with coronary heart disease undergoing PCI than clopidogrel. It has clinical popularization significance.

Role of argon plasma coagulation in treatment of esophageal varices

With the development of endoscopic therapy,argon plasma coagulation(APC)has been widely used by endoscopists.It has many advantages,such as simple to operate,low cost,and minimal invasiveness.Because of its capability of lesion ablation and hemostasis,APC has several indications in the gastrointestinal tract.One of them is esophageal varices.The aim of this review is to summarize the research on APC in this field to provide a reference for clinical practice.

Argon plasma coagulation for superficial esophageal squamous-cell carcinoma in high-risk patients

AIM: To evaluate the usefulness and safety of argon plasma coagulation (APC) for superficial esophageal squamous-cell carcinoma (SESC) in high-risk patients. METHODS: We studied 17 patients (15 men and 2 women, 21 lesions) with SESC in whom endoscopic mucosal resection (EMR), endoscopic submucosal dissection (ESD), and open surgery were contraindicated from March 1999 through February 2009. None of the patients could tolerate prolonged EMR/ESD or open surgery because of severe concomitant disease (e.g., liver cirrhosis, cerebral infarction, or ischemic heart disease) or scar formation after EMR/ESD and chemoradiotherapy. After conventional endoscopy, an iodine stain was sprayed on the esophageal mucosa to determine the lesion margins. The lesion was then ablated by APC. We retrospectively studied the treatment time, number of APC sessions per site, complications, presence or absence of recurrence, and time to recurrence.RESULTS: The median duration of follow-up was 36 mo (range: 6-120 mo). All of the tumors were macroscopically classified as superficial and slightly depressed type (0-Ⅱc). The preoperative depth of invasion was clinical T1a (mucosal cancer) for 19 lesions and clinical T1b (submucosal cancer) for 2. The median treatment time was 15 min (range: 10-36 min). The median number of treatment sessions per site was 2 (range: 1-4). The median hospital stay was 14 d (range: 5-68 d). Among the 17 patients (21 lesions), 2 (9.5%) had recurrence and underwent additional APC with no subsequent evidence of recurrence. There were no treatment-related complications, such as bleeding or perforation. CONCLUSION: APC is considered to be safe and effective for the management of SESC that cannot be resected endoscopically because of underlying disease, as well as for the control of recurrence after EMR and local recurrence after chemoradiotherapy.

Analysis on the therapeutic effects of integrated traditional Chinese and Western medicine on ulcerative colitis and its effects on coagulation function and inflammatory factors

Objective:To analyze the therapeutic effects of Integrated Traditional Chinese and Western Medicine on ulcerative colitis (UC) and its effects on coagulation function and inflammatory factors.Methods: 220 cases of patients with UC were selected as the research subjects and randomly divided into the observation group and the control group, 110 cases were included into each group. The patients in the control group were treated with single western medicine, while the patients in the observation group were treated with enema treatment of traditional Chinese Medicine. The clinical therapeutic effects of the two groups were evaluated and compared. The blood coagulation indexes of the activated partial thromboplastin time (APTT), prothrombin time (PT), the plasma fibrinogen (Fib), the D dimer (D-D) of two groups patients who in the treatment were detected and compared. The serum tumor necrosis factor (TNF-α), interleukin-6 (IL-6), interleukin-8 (IL-8) levels of the patients in the two groups were measured and compared.Results: The clinical efficiencies of the observation group and the control group were 97% and 75%, the clinical efficiencies and the therapeutic effects of the observation group were better than those in the control group, there were statistically significant differences between the two groups. The plasma Fib levels and the plasma D-D levels after the treatment of the patients in the two groups were significantly lower than those before the treatment, the difference was statistically significant. The plasma Fib levels and the plasma D-D levels after the treatment of the patients in the observation group were lower than those in the control group, the difference was statistically significant. The serum inflammatory factors levels after the treatment of the patients in the two groups were significantly lower than those before the treatment, the difference was statistically significant. The serum inflammatory factors levels after the treatment of the patients in the observation group were lower than those in the control group, the difference is powerful and have statistically significant.Conclusion: The application of Integrated Traditional Chinese and Western Medicine in the treatment of UC can improve the therapeutic effect significantly, correct imbalance of the patients' coagulation dissolution function, reduce the degree of inflammatory reaction, which benefits to promote of the patients' rehabilitation, reduce the incidence of complications and improve the prognosis of patients.

氯吡格雷预防冠心病介入治疗后心血管不良事件效果观察

目的探索冠心病患者介入治疗后预防性应用氯吡格雷对其心血管不良事件的干预效果。方法将2021年4月—2023年4月于青海红十字医院行冠心病介入治疗的112例患者作为研究对象,采用随机数字表法将所有患者平均分为噻氯匹定组与氯吡格雷组,每组56例。噻氯匹定组患者预防性应用噻氯匹定治疗,氯吡格雷组患者预防性应用氯吡格雷治疗,比较两组患者的心血管不良事件发生率、临床效果、治疗前与治疗24 h后血小板聚集率与血栓素B2指标变化、治疗满意度。结果氯吡格雷组患者心血管不良事件发生率(3.57%)低于噻氯匹定组(14.29%),治疗总有效率(96.43%)高于噻氯匹定组(86.71%)(χ^(2)=3.9529,P=0.0468;χ^(2)=3.9529,P=0.0468);两组患者凝血功能指标比较差异无统计学意义(P>0.05);治疗前两组患者血栓素B2及血小板聚集率比较差异无统计学意义(P>0.05);治疗24 h后两组患者血栓素B2及血小板聚集率均下降,氯吡格雷组患者治疗24 h后血栓素B2[(42.38±6.23)pg·mL^(-1)vs(66.23±5.72)pg·mL^(-1)]及血小板聚集率[(25.39±4.17)pg·mL^(-1)vs(30.26±3.76)pg·mL^(-1)]低于噻氯匹定组(t=3.2581,P=0.0253);氯吡格雷组患者治疗满意率(92.86%)高于噻氯匹定组(78.57%)(χ^(2)=4.6667,P=0.0308)。结论冠心病介入治疗患者预防性应用氯吡格雷可较好预防患者术后发生心血管不良事件,提升治疗效果,患者较为认可。

老年早期非小细胞肺癌采用经皮微波凝固疗法后预后不良的影响因素分析

目的分析采用经皮微波凝固疗法(PMCT)预后不良的影响因素。方法选取2019年1月至2022年1月在江苏省徐州市第一人民医院治疗的老年早期非小细胞肺癌(NSCLC)患者85例,脱落7例,最终纳入78例患者行PMCT治疗,随访6个月,按照疗效分为预后良好组和预后不良组。收集并比较两组临床资料,包括性别、年龄、术前肺功能[肺活量(VC)、用力肺活量(FVC)、第一秒用力呼气量(FEV1)、最大通气量(MVV)]、系统免疫炎症营养指数(SII)、肿瘤原发位置、病理分型、病理分期、病灶直径、分化程度、术后化疗的情况,通过多因素logistic回归分析明确PMCT治疗老年早期NSCLC预后不良的危险因素。结果预后良好组69例,预后不良组9例。预后不良组年龄>70岁、SII>500、病理分期Ⅱ期、病灶直径>4 cm、分化程度低、术后未化疗的比重高于预后良好组,FEV1水平低于预后良好组,差异有统计学意义(P<0.05)。多因素logistic回归分析显示,年龄>70岁(OR=2.145,95%CI=1.143~4.025)、FEV1<81.67 L(OR=2.592,95%CI=1.263~5.319)、SII>500(OR=2.168,95%CI=1.250~3.760)、病理分期Ⅱ期(OR=3.421,95%CI=1.064~10.999)、病灶直径>4 cm(OR=2.538,95%CI=1.056~6.100)、分化程度低(OR=2.563,95%CI=1.243~5.285)、术后未化疗(OR=3.156,95%CI=1.319~7.551)是PMCT治疗后预后不良的危险因素(P<0.05)。结论年龄、FEV1、SII、病理分期、病灶直径、分化程度、术后是否接受化疗是PMCT治疗后预后不良的影响因素,可用于患者治疗后预后情况的预测。

经痛汤治疗原发性痛经寒凝血瘀证临床观察

目的 通过观察经痛汤治疗寒凝血瘀证原发性痛经的临床疗效,探究经痛汤的作用机制。方法 选取2022年2月—2023年2月就诊于辽宁中医药大学附属医院妇科门诊的原发性痛经且证属寒凝血瘀证患者60例,按照随机数字表法随机分为2组,各30例。观察组采用经痛汤治疗,对照组患者采用空白安慰剂。治疗3个月经周期后,对比2组中医证候积分、VAS评分及经期口服芬必得的次数。结果 治疗3个月经周期后,观察组中医证候积分及VAS评分均降低,差异具有统计学意义(P<0.05);与对照组比较,观察组评分降低明显,差异具有统计学意义(P<0.05),观察组治疗期间服用芬必得次数明显少于对照组(P<0.05)。结论 经痛汤治疗寒凝血瘀证原发性痛经的临床疗效显著。

痛经汤与隔药灸治疗寒凝血瘀型原发性痛经临床观察

目的分析痛经汤联合隔药灸治疗寒凝血瘀型原发性痛经的临床效果。方法选取南昌市洪都中医院2020年5月—2022年5月收治的62例寒凝血瘀型原发性痛经患者作为研究对象,采用随机数字表法将其分为参照组与研究组,各31例。参照组给予痛经汤治疗,研究组在参照组基础上加用隔药灸治疗。比较两组治疗前后中医证候积分、血清前列腺素F2α。结果治疗后,研究组中医证候积分为(7.63±2.57)分,低于参照组的(9.25±2.95)分,差异有统计学意义(P<0.05)。治疗后,研究组血清前列腺素F2α水平低于参照组,差异有统计学意义(P<0.05)。结论采用痛经汤联合隔药灸治疗寒凝血瘀型原发性痛经患者,可改善其中医症状,降低其前列腺素水平。

腔内治疗急性肺栓塞的效果及对预后的影响

目的:探究急性肺栓塞采取腔内治疗的效果及对凝血指标的影响。方法:选取2020年10月—2022年10月在山东国欣颐养集团枣庄中心医院治疗的急性肺栓塞患者92例,应用随机数字表法将其分为对照组(n=46)及观察组(n=46)。对照组接受静脉溶栓治疗,观察组接受腔内治疗。对比两组近期疗效、肺动脉高压、肺动脉开通情况(Miller指数)、炎症因子[C反应蛋白(CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)]、凝血功能指标[凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)]。结果:观察组治疗总有效率高于对照组,差异有统计学意义(P<0.05)。治疗前,两组肺动脉高压、Miller指数相较,差异均无统计学意义(P>0.05);治疗后,两组肺动脉高压、Miller指数较治疗前均降低,且观察组均低于对照组(P<0.05)。治疗前,两组CRP、IL-6、TNF-α比较,差异均无统计学意义(P>0.05);治疗后,两组CRP、IL-6、TNF-α较治疗前均降低,且观察组均低于对照组(P<0.05)。治疗前,两组PT、APTT、FIB相较,差异均无统计学意义(P>0.05);治疗后,两组PT、APTT较治疗前均延长,FIB均降低,且观察组PT、APTT均长于对照组,FIB低于对照组(P<0.05)。结论:急性肺栓塞患者采取腔内治疗,疗效显著,降低炎症反应,改善凝血功能。

四联疗法配合消化内镜治疗消化性溃疡出血的效果及对凝血指标的影响

目的:探讨四联疗法配合消化内镜治疗消化性溃疡出血(PUB)的效果及对凝血指标的影响。方法:选取2022年6月—2023年5月岑溪市人民医院收治的76例PUB患者,根据不同治疗方案分为联合组与常规组,各38例。常规组予以四联疗法治疗,联合组在四联疗法基础上予以消化内镜治疗,比较两组治疗效果。结果:联合组出血量少于常规组,止血时间、溃疡愈合时间早于常规组,差异有统计学意义(P<0.05)。治疗后,两组凝血酶时间(TT)、凝血酶原时间(PT)、D-二聚体(D-D)、国际标准化比值(INR)均低于治疗前,且联合组均低于常规组,差异有统计学意义(P<0.05)。治疗前,两组胃泌素-17水平比较,差异无统计学意义(P>0.05);治疗后,两组胃泌素-17水平均高于治疗前,且联合组明显高于常规组,差异有统计学意义(P<0.05)。联合组不良反应总发生率低于常规组,差异有统计学意义(P<0.05)。结论:四联疗法联合消化内镜治疗PUB的效果确切,可有效改善机体凝血功能,快速止血以减少出血量,不良反应发生率低,安全性较高。

复方中草药香包吸入改善大学生痛经的随机对照研究

目的探讨吸入复方中草药香包改善大学生寒凝血瘀型痛经的疗效及安全性。方法将100名寒凝血瘀型痛经大学生采用分层随机分组法分为对照组和试验组各50名。对照组给予健康教育和安慰剂香包吸入,试验组给予健康教育和复方中草药香包吸入,每晚睡觉时将香包悬挂于侧墙且距鼻30 cm处,持续3个月经周期。结果对照组46名、试验组48名大学生完成本研究。组间比较,干预后腹痛视觉模拟量表、Cox痛经症状评分表、疼痛灾难化量表评分及疗效差异有统计学意义(均P<0.05);两组在研究过程中均未报告不良反应。结论复方中草药香包吸入有利于减轻寒凝血瘀型痛经大学生腹痛程度、缓解痛经症状、降低疼痛灾难化水平。

一例免疫抑制状态骨髓炎患者的抗感染治疗用药分析和药学监护

目的免疫抑制状态的骨髓炎患者的抗菌药物给药方法及临床药师在参与药物治疗中的作用。方法临床药师参与1例免疫抑制状态混合细菌感染患者抗感染治疗的全过程,基于病原菌的药敏结果、抗菌药物特性等分析抗菌药物的品种选择及替加环素初始给药剂量、给药方式的调整。结果患者感染得到控制,未发生明显的不良反应。结论在免疫抑制骨髓炎患者的治疗中,临床药师发挥专业优势,可协助医师优化抗感染治疗方案,提高临床疗效。

R值与APTT监测指导下对肿瘤合并脓毒症凝血功能障碍患者行抗凝治疗的效果比较

目的探讨R值与活化部分凝血活酶时间(APTT)监测指导下对肿瘤合并脓毒症凝血功能障碍患者行抗凝治疗的有效性及安全性。方法选择2019年1月至2022年1月收治的80例肿瘤合并脓毒症凝血功能障碍患者作为研究对象,以随机数字表法将其分为A组与B组,每组40例。A组在R值指导下行抗凝治疗,B组在APTT指导下行抗凝治疗。比较两组的治疗效果及安全性。结果两组的机械通气时间无明显差异(P>0.05);A组的ICU住院时间、凝血四项指标恢复正常时间均短于B组,肝素使用剂量低于B组(P<0.05)。治疗5 d时,两组的C反应蛋白(CRP)、细胞黏附分子-1(ICAM-1)水平均明显降低,胆碱酯酶(CHE)水平升高,且A组优于B组(P<0.05)。两组治疗期间的不良事件发生率无明显差异(P>0.05)。结论R值与APTT监测指导下对肿瘤合并脓毒症凝血功能障碍患者行抗凝治疗均能获得满意效果且有着较高安全性,但R值监测指导下行抗凝治疗能够缩短凝血四项指标恢复正常时间,降低肝素使用剂量,也能快速恢复CRP、ICAM-1、CHE水平,可作为首选监测指标。

卡前列素氨丁三醇注射液联合子宫填塞球囊导管治疗产后出血的效果

目的分析产后出血患者在接受卡前列素氨丁三醇注射液治疗时,联合应用子宫填塞球囊导管球囊压迫的止血效果,以及对凝血功能及不良反应的影响。方法选取福清市第二医院妇产科2019年1月—2023年1月收治的产后出血患者80例,随机分为对照组(n=40)与研究组(n=40)。对照组采用卡前列素氨丁三醇注射液联合创面缝合治疗,研究组采用卡前列素氨丁三醇注射液联合子宫填塞球囊导管球囊压迫治疗。比较2组的止血效果、凝血功能及不良反应情况。结果研究组的止血成功率(95.0%)显著高于对照组(77.5%)(P<0.05)。相比于对照组,研究组的手术操作时间及住院时间均更短(P<0.05),而输血量及24 h出血量则更少(P<0.05)。与对照组治疗后相比,研究组的纤维蛋白原(fibrinogen,FIB)水平更高(P<0.05),而凝血酶原时间(prothrombin time,PT)、活化部分凝血酶原时间(activated partial thromboplastin time,APTT)则更低(P<0.05)。研究组的术后感染、失血性休克、术后发热等不良反应发生率(10.0%)明显少于对照组(35.0%)(P<0.05)。结论在选择卡前列素氨丁三醇注射液治疗产后出血患者的前提下,联合应用子宫填塞球囊导管球囊压迫治疗操作简单方便,手术操作时间明显缩短,止血效果显著提升;而且能对患者凝血功能进行显著改善,不良反应少,具有较高的安全性。

利伐沙班对心力衰竭合并心房颤动患者凝血因子及预后情况的效果观察

目的观察利伐沙班对心力衰竭(HF)合并心房颤动(AF)患者凝血因子及预后情况的影响。方法采用前瞻性研究,纳入平顶山市第二人民医院2021年1月—2022年4月期间收治的123例HF合并AF患者,以数字随机表法将入组患者分为常规组(61例)和试验组(62)例,两组均行起搏器植入术(CRTD)治疗,常规组予以常规抗凝治疗辅助CRTD,试验组予以利伐沙班辅助CRTD,所有患者术后均开展一年随访,比较两组患者治疗前后的抗Xa凝血因子、心肌损伤标志物、心功能指标变化情况,以及术后血栓栓塞、心血管死亡事件发生情况。结果治疗前,两组患者的Xa凝血因子,心肌损伤标志物,心功能指标比较差异无统计学意义(P>0.05);在不同抗凝方案下,观察组治疗1 d后的抗Xa凝血因子为(130.44±20.18)IU/mg,治疗3 d后的抗Xa凝血因子为(115.36±20.77)IU/mg,治疗7 d的抗Xa凝血因子为(90.25±20.44)IU/mg,均低于常规组[(145.33±20.19)IU/mg、(128.45±20.16)IU/mg、(103.34±20.17)IU/mg],差异有统计学意义(P<0.05)。治疗后,试验组的肌酸激酶同工酶为(7.52±2.16)U/L,心肌肌钙蛋白Ⅰ为(0.52±0.12)ng/mL,乳酸脱氢酶为(126.41±20.45)U/L,均低于常规组[(8.44±2.28)U/L、(0.94±0.31)ng/mL、(140.33±20.25)U/L],差异有统计学意义(P<0.05)。治疗后,观察组的左室射血分数为(56.12±10.41)%,高于常规组(50.24±10.33)%,左室舒张末期内径为(47.11±10.25)mm,左室舒张末期容积为(36.72±10.43)mL,均低于常规组(53.28±10.14)mm、(42.77±10.36)mL,差异有统计学意义(P<0.05)。随访期间,试验组的血栓栓塞事件发生率为4.84%(3/62),心血管死亡事件发生率为3.23%(2/62),均低于常规组[19.67%(12/61)、14.75%(9/61)],差异有统计学意义(P<0.05)。结论利伐沙班辅助CRTD能有效增强HF合并AF患者的抗Xa凝血因子活性,对减轻心肌损伤、改善心功能并降低血栓栓塞或心血管死亡风险均有积极意义。

雷火灸治疗寒凝血瘀型痛性糖尿病神经病变临床观察

目的:观察雷火灸治疗寒凝血瘀型痛性糖尿病神经病变的临床疗效。方法:选取符合纳入标准的寒凝血瘀型糖尿病神经病变伴有疼痛的患者60例,随机分为两组各30例。对照组采用口服降糖药加甲钴胺片治疗,治疗组在对照组基础上加用雷火灸治疗。观察两组患者治疗前后疼痛评分表(VAS)、多伦多评分表(TCSS)、中医证候积分及糖化白蛋白(GA)、空腹血糖、C肽水平。结果:治疗后,两组VAS评分、TCSS评分、中医证候积分及GA水平均降低,C肽水平均升高,且治疗组较对照组改善更明显,差异具有统计学意义(P﹤0.05)。结论:雷火灸在改善寒凝血瘀型糖尿病神经病变疼痛症状方面疗效较好。

间隙性压力治疗系统对乳腺癌术后下肢深静脉血栓形成的预防效果

目的探讨间隙性压力治疗系统对乳腺癌术后下肢深静脉血栓形成(DVT)的预防作用。方法选择2020年5月至2022年6月于医院行乳腺癌根治术后患者120例,根据治疗方法不同,分为对照组与试验组,每组60例。对照组予踝泵运动治疗,试验组在对照组基础上采用间隙性压力治疗系统治疗,两组治疗均>7 d。比较两组下肢血流动力学指标(股静脉和足背静脉血流速度)、凝血功能指标[血清活化部分凝血活酶时间(APTT)和D-二聚体]、术后7 d内DVT发生情况。结果治疗后3 d,两组下肢股静脉和足背静脉血流速度快于治疗前,且试验组快于对照组,差异有统计学意义(P<0.05)。治疗后3 d,两组血清APTT水平较治疗前上升,D-二聚体水平较治疗前下降,差异有统计学意义(P<0.05),且试验组血清APTT水平高于对照组,D-二聚体水平低于对照组,差异有统计学意义(P<0.05)。治疗后7 d内,试验组DVT发生率低于对照组,差异有统计学意义(P<0.05)。结论间隙性压力治疗系统用于乳腺癌术后,不仅可加快股静脉和足背静脉血流速度,改善下肢血流动力学指标,且可改善凝血功能,降低下肢DVT的发生率。