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Objective@#To assess the efficacy and safety of thrombolytic treatment with reteplase in patients with intermediate-risk acute pulmonary embolism.@*Methods@#Ten consecutive patients with intermediate-risk acute pulmonary embolism who received thrombolytic treatment with reteplase at Thrombosis and Vascular Medicine Center, Fuwai Hospital from March to November in 2016 were included.Vital signs, right ventricular diameter, systolic pulmonary artery pressure, and biochemical markers were assessed before and after thrombolytic therapy with reteplase, and bleeding complications were also observed during 3 months follow up.@*Results@#(1) For the efficacy outcomes: at 48 hours after thrombolytic treatment with reteplase, echocardiography-derived diameter of right ventricular was significant reduced from (27.9±3.8) mm to (24.8±2.6) mm (P=0.03), systolic pulmonary artery pressure decreased from (63.9±21.6) mmHg(1 mmHg=0.133 kPa) to (34.4±19.8) mmHg (P=0.02). Heart rate and breathing rate were also decreased significantly (both P<0.05), blood pressure remained unchanged post therapy.Hypoxemia was quickly corrected with an significant elevation of PaO2 and SaO2 ((65.2±14.3) mmHg vs. (80.0±9.6) mmHg, P=0.006; (90.8±3.5)% vs. (95.2 ±1.6)%, P=0.002 respectively). PaCO2 was also increased significantly (P<0.05). Serum NT-proBNP and cTnI were decreased significantly (both P<0.05). There was no recurrent pulmonary embolism or deep-vein thrombosis during the 3 months follow-up. (2) For the safety outcomes: a thrombolytic relevant hemoptysis (about 70 ml) occurred in 1 patient, and was controlled by PCC therapy.No other clinically relevant events were observed during thrombolytic treatment. Eight patients were followed more than 3 months, there was no major bleeding complication or death during the follow up period.@*Conclusion@#Treatment of intermediate-risk acute pulmonary embolism with reteplase is effective and safe and there are no obvious side effects.
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<p><b>OBJECTIVE</b>To evaluate whether intraoperative autologous donation (IAD) can reduce perioperative blood transfusion for patients underwent mitral valve replacement (MVR).</p><p><b>METHODS</b>A total of 318 patients received implementation of IAD from January 2011 to December 2013 were analyzed retrospectively, and compared with 517 patients of the previous 36-month period (from January 2008 to December 2012). The method of small-volume retrograde autologous priming, strict blood transfusion standard along with IAD together constituted a progressive blood-saving strategy. Statistical methods including Students' t-test, Pearson's χ(2) test, Kruskal-Wallis analysis and multivariate Logistic regression model were used for comparisons of the data.</p><p><b>RESULTS</b>There were no significant difference between IAD group and non-IAD group considering preoperative patient demographics, characteristics and preoperative comorbidities. However, IAD group significantly reduced number of patients transfused with intra/post-operative packed red-blood cell (PRBC) (55(17.0%) vs. 215 (42.1%), χ(2)=53.0, P=0.000), and had significantly reduced postoperative chest tube output (150(380) ml vs. 700(660) ml, H=195.648, P=0.000), length of stay ((16±6) d vs. (20±8)d, t=9.60, P=0.000). But hematocrit were lower in IAD group (30%±5% vs.33%±4% at end of operation, t=7.76, P=0.000; 30%±4% vs. 32%±5% at discharge, P=0.000, t=3.86). Multivariate logistic aggression analysis revealed that age, IAD and smoking history were factors influencing the probability of intra or postoperative blood transfusion.</p><p><b>CONCLUSION</b>Implementation of blood conservation strategies based on intraoperative autologous donation in mitral valve replacement surgery can significantly reduce intra/postoperative blood transfusion as well as postoperative complications.</p>
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Humans , Blood Transfusion, Autologous , Bloodless Medical and Surgical Procedures , Cardiac Surgical Procedures , Methods , Hematocrit , Logistic Models , Mitral Valve , General Surgery , Postoperative Complications , Retrospective StudiesABSTRACT
[Objective]To study the therapeutic results of the endovenous laser treatment(EVLT) of varicose veins in lower limbs. [Method]97 cases (111 limbs) were performed with EVLT or EVLT with high ligation of the great saphenous veins according to the clinical manifestations, phlebography and ultrasound. [Results]All patients were followed-up 3~24 months with satisfactory results,without recurrence of varicosity. [Conclution]EVLT is a safe, effective, reliable and minimally invasive treatment for varicosity in lower limbs.
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Objective To summarize our preliminary experience on diagnosis and treatment of aorta pseudoaneurysms due to deceleration injury. Methods Retrospective analysis was made on 8 cases of aorta pseudoaneurysms due to deceleration injury regarding its clinical findings, imagines and surgical operations or endografting treatment. Results Diagnosis was confirmed by imaging examinations. Among two cases who refused a surgery one died and the other lost follow-up after discharge. Surgery was successful in the remaining six cases including two cases treated by open surgery and four cases by intervensive endografting. Conclusions Aorta pseudoaneurysms due to deceleration injury can be correctly diagnosed by imaging examinations. Aorta pseudoaneurysms should be treated timely since spontaneous cure is almost impossible. Traditional surgical operations is effective, however, endografting is a relatively safe, less traumatic procedure.
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Objective To evaluate therapeutic results of radiofrequency endovenous obliteration (RFO) for the treatment of varicose veins of the lower limbs. Methods Fifty six cases (56 limbs) of primary greater saphenous vein tributary varicose veins were randomly assigned to RFO group (n=28) and conventional stripping operation group (n=28). In RFO group, the wall of the greater saphenous vein was treated at 85℃ with the catheter to occlude the whole length of the vein. The other 28 cases underwent stripping procedure. The scattered superficial varicose veins in calf in both groups were managed by phlebectomy. The number of surgical incision, postoperative pain, average hospital days and the short-term results were compared. Results Patients in RFO group have less surgical incisions and less postoperative pain, without subcutaneous hematoma. The average hospital stay was 2.5?1.00 days in RFO group compared to 4.14?0.85 days in stripping operation group. Conclusions RFO effectively obliterates the whole length of the great saphenous vein and is of less trauma,faster recovery, and less scars.