ABSTRACT
Objective:To explore the value of real-time shear wave elastography (SWE) in staging of common femoral venous thrombosis (CFVT). Methods: Totally 92 patients with unilateral CFVT were divided into acute phase (1-14 d, n=41), subacute phase (15-30 d, n=24) or chronic phase (>30 d, n=27) according to the time of complaint. Young's modulus mean values and two-dimensional (2D) ultrasound scores were compared among the three phases. ROC curve was used to evaluate the diagnostic effect of 2D ultrasound and SWE for acute and chronic CFVT. Results: 2D ultrasound scores and Young's modulus values were significantly different among the three phases (P<0.001), and the differences between each two phases were all statistically significant (all P<0.05). AUC of SWE in diagnosing acute CFVT was 0.916 (P<0.05), and the cutoff Young's modulus value was 13.50 kPa, with the sensitivity of 85.37% and specificity of 82.35%. AUC of 2D ultrasound for diagnosing acute CFVT was 0.800 (P<0.05), and the cutoff ultrasound score was 2.00, with the sensitivity of 75.61% and specificity of 66.67%. AUC of the two methods for diagnosing acute CFVT had significant difference (P<0.001). AUC of SWE in diagnosing chronic CFVT was 0.917 (P<0.05), and the cutoff Young's modulus value was 16.40 kPa, with the sensitivity of 85.19% and specificity of 87.69%. AUC of 2D ultrasound in diagnosing chronic CFVT was 0.842 (P<0.05), and the cutoff ultrasound score was 2.03, with the sensitivity of 87.21% and specificity of 69.23%. AUC of these two methods for diagnosing chronic CFVT had significant difference (P=0.010). Conclusion: Real-time SWE can be used to judge the clinical stage of CFVT, and its diagnostic efficiency may be better than conventional ultrasonography.
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Objective To evaluate pigtail catheter mashing thrombosis combined with catheter directed thrombolysis in the treatment of acute iliofemoral venous thrombosis complicated by Cockett syndrome in the left lower limbs.Method Data of 137 cases of acute iliofemoral venous thrombosis complicated with Cockett syndrome in left lower limb by interventional therapy from January 2007 to October 2012 were analyzed retrospectively.Inferior vena cava filters were placed in all of the patients.Patients were divided into two groups:Group A (n =81) treated with catheter directed thrombolysis only,Group B (n =56) treated with pigtail catheter mashing thrombosis combined with catheter directed thrombolysis.After operation,patients were treated by anticoagulation with urokinase and heparin calcium,and then warfarin for 6 to 1 2 months.Results The thrombolysis time in group B was significantly shorter than that in group A (P ＜0.01),the dosage of urokinase was significantly less than that in group A(P ＜ 0.01).The venous patency score in group B after therapy was significantly better than in group A (P ＜ 0.01).121 patients were followed up for 10-60 months.There were no pulmonary embolism.Conclusions Pigtail catheter mashing thrombosis combined with catheter directed thrombolysis in the treatment of acute iliofemoral venous thrombosis complicated with Cockett syndrome in left lower limb can improve thrombolytic efficiency,shorten thrombolysis time,reduce the use of urokinase.
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Objective To evaluate clinical application of Kngel patch in treating recurrent inguinal her-nia. Methods The clinical data of 65 patients with 77 sides recurrent inguinal hernia performed open preperitoneal inguinal hernia repairs from January 2005 to June 2009 were analyzed retrospectively. Kugel hernia patches were used in the operations. Results The operating time for unilateral hernia expended 40 ～ 150(76.5±20. 4) min. Postoperative pain was minimal and no incision infection appeared. The postopera-tive complications were 4 cases of uroschesis,6 cases of inguinoscrotal seroma, 2 cases of inguinoscrotal he-matoma and 3 cases of serotal hydrops. No serious complications such as sensation of foreign body, inguinal chronic pain and recurrence were observed during the follow-up of 3 to 54 months. Conclusions Open preperitoneal hernia repair with Kngel patch for adult recurrent inguinal hernia reparation is rational and fea-sible.