ABSTRACT
Objective To investigate the efficacy of treatment of intracranial venous sinus thrombosis using systemic anticoagulation combined with endovascular intervention.Methods From May 2014 to January 2017,the clinical data of 52 patients with cerebral venous sinus thrombosis diagnosed with DSA and treated with micro catheter thrombolysis at the Department of Neurology,the Second Hospital of Hebei Medical University were analyzed retrospective.The microcatheters were indwelled for 3-14 d.The dosage of urokinase ranged from 10-20 thousand U/h,13 patients were also treated with balloon dilatation,and 1 was also treated with stent-assisted treatment.The results of imaging data and 6-month telephone follow-up were analyzed.The prognosis was evaluated with the modified Rankin scale (mRS) and National Institutes of Health Stroke Scale (NIHSS).Results In 52 patients admitted to hospital,the whole brain DSA showed sagittal sinus thrombosis in 34 cases,transverse-sigmoid sinus transitional zone thrombosis in 31 cases,inferior sagittal sinus thrombosis in 2 cases,straight sinus thrombosis in 3 cases,and cortical vein thrombosis in 14 cases.Angiography before discharge showed complete patency of the venous sinus in 9 cases,most patency in 42 cases,partial patency in 1 cases,the symptoms were relieved,and neurological function scores were improved at discharge in 48 cases.There were no obvious changes in 3 cases,and 1 case aggravated.The mRS and NIHSS scores before and after treatment were compared.The difference was statistically significant (Z =5.45 and 3.03 respectively,all P ＜ 0.05).Forty-eight patients were followed up for 6 months by telephone,no symptoms related to venous sinus thrombosis were found.Three patients died,and 1 died of traumatic intracranial hemorrhage.Conclusions Endovascular intervention is an effective and safe treatment for intracranial venous sinus thrombosis.It can be used as an alternative treatment scheme of internal medicine for patients of ineffective anticoagulation.
ABSTRACT
Objective To explore the clinical effect of the open and laparoscopic surgery in the treatment of ectopic pregnancy to retain the clinical efficacy of reproductive function analysis. Methods Four hundred and fifty-six patients with ectopic pregnancy were selected as our subjects. Two hundred and eleven cases were served as laparotomy group( open),and 245 cases were laparoscopic group( laparoscopic). The data of intraoperative blood loss,operative time,postoperative anal exhaust time,average hospital stay,tubal patency rate,intrauterine pregnancy rate and again repeat ectopic pregnancy rate were recorded. Results Patients in two groups were successfully completed surgery. The operative time,intraoperative blood loss,postoperative anal exhaust time,average hospitalization time were(55. 1 ± 13. 5)min,(63. 5 ± 18. 3)ml,(25. 7 ± 5. 6)h,(6. 1 ± 2. 0)d respectively in laparotomy group,and(41. 3 ± 15. 5)min,(41. 1 ± 13. 3)ml,(13. 5 ± 5. 1)h,(3. 6 ± 1. 4)d respectively in laparoscopic group,and the differences were significant( t =2. 045,2. 263,3. 131, 3. 152,P﹤0. 05). The tubal patency rate,intrauterine pregnancy,ectopic pregnancy rate in laparotomy group were 81. 0%( 171/211 ),59. 7%( 126/211 ) and 26. 5%( 56/211 ) respectively,and 75. 5%( 185/245 ), 53. 5%( 131/245 ) and 22. 9%( 56/245 ) respectively in laparoscopic group,and the differences were not significant(χ2 =2. 254,2. 130,1. 242;P ﹥0. 05 ). Conclusion Laparoscopic surgery in the treatment of ectopic pregnancy is superior to laparotomy in terms of small trauma,less bleeding,faster recovery,shorter hospitalization time,and postoperative tubal patency rate.