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Objective:To evaluate the clinical significance of patent accessory hepatic vein (AHV) in treatment of Budd-Chiari syndrome (BCS) with hepatic vein occlusion.Methods:The clinical data of 21 BCS patients treated from Jan 2010 to June 2019 were retrospectively analyzed. All patients underwent AHV and IVC venography.Results:Angiography showed that the diameter of AHV was 6-13mm after the procedure, the angle between AHV and the distal end of IVC was (106.9±27.7)°, and 57.1% of the AHV were opened at the right side of IVC, 9.5% at the front, and 1.4% at the left side, respectively. The technical success rate was 100%. Thirteen patients with AHV disease underwent balloon dilatation angioplasty, and their preoperative AHV pressure dropped from (41.6±6.4) cm H 2O to (22.2±5.5) cm H 2O ( t=11.966, P<0.01). The preoperative AHV and intrahepatic IVC pressure decreased from (29.1±3.3) cm H 2O to (19.1±8.8) cm H 2O ( t=8.136, P<0.01) and from (25.5±6.1) cm H 2O to (13.8±4.0) cm H 2O ( t=5.536, P<0.01), respectively. All patients were of no symptom during follow up for 6 months and ultrasound showed that the patency rate of original lesion was 100%. Conclusion:A patent AHV helps alleviate the symptoms and blood congestion of BCS patients with hepatic vein obstruction.
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Objective To investigate the adverse reactions and survival rate of low dose of Oxaliplatin combined with transcatheter arterial chemoembolization in treatment of elderly patients with primary hepatic carcinoma.Methods A total of 84 patients with primary liver cancer were enrolled and randomly divided into low dose group and high dose group.Patients received 40 mg/m2 and 80 mg/m2 of Oxaliplatin respectively,and adverse reactions and survival rate were compared between the two groups.Results Incidence of nausea and vomiting was obviously lower and the number of patients with pain scale above 6 was significantly smaller in low dose group than in high dose group,with statistically significant differences (11.9％ vs.21.4％ and 28.6％ vs.78.6％,x2 =9.910,20.056,both P ＜ 0.05).White blood cell count was significantly higher and alanine aminotransferase (ALT) was significantly lower in low dose group than in high dose group after treatment (t =13.447,6.774,both P＜0.05).1 year and 3 year survival rate was 69.05％ and 30.95％ in low dose group and 61.9％ and 21.43％ in high dose group,respectively,with no statistically significant difference (x2 =0.474 and 0.985,P=0.491 and 0.321).Conclusions Low dose of Oxaliplatin combined with transcatheter arterial chemoembolization in the treatment of elderly patients with primary hepatocellular carcinoma is worth to be promoted in clinical application because it does not affect the patient survival rate and the toxic effects of the chemotherapy are very little.
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Objective: To investigate the influence of the closed re-infusion of intestinal juice and EN on the treatment of intestinal fistula.Methods: The study group was composed of 21 patients of intestinal fistula from October 2004 to December 2006.The fistulae was in the 50 cm of the proximate jejunum and caused by trauma and operatin.The leak amount of intestinal juice was more than 1 000 mL.The protein level in serum and the absorption rates of the glucose,fat and nitrogen after the reinfusion of the intestinal juice were measured.Resutls: The protein level in serum and the absorption rates of the glusose,fat and nitrogen was increased after the re-infusion of the intestinal juice.Conclusion: The absorption of the glucose,fat and nitrogen in EN and the protein level in serum can be increased after the closed re-infusion of the intestinal juice.
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Objective To evaluate the effects(mortality, amputation rate, the length and expense of hospital stay, etc)of the obstructing blood flow interventional embolectomy and simple interventional embolectomy for acute lower limb arterial embolism. Methods 79 cases of acute lower limb arterial embolism including 23 cases of two sites puncturing and obstructing blood flow interventional embolectomy and 56 cases treated by simple interventional embolectomy were retrospeetively analyzed and compared. Results Embolisms were removed in all 79 cases and arteries were reopened successfully. The mortality and the amputation rates of the simple and the obstructing blood flow embolectomies were 5.36%,19.6%, and 4.35%, 8.70% respectively. Conclusion Two sites puncturing and obstructing blood flow interventional embolectomy for acute lower limb arterial embolism is simple, safe and effective, comparing with the simple interventional embolectomy, with lower amputation rate, quicker recovery and lower expense, however with no statistical significance in mortalities.