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Objective To understand the prevalence,treatment and influence factors of hypertension in maintenance hemodialysis (MHD) patients in Anhui Province.Methods A total of 2724 adult patients on MHD from January 1st 2014 to March 31st 2014 in 26 hospitals of southern,northern and central Anhui Province were investigated.Their demographic characteristics,primary disease,complications,medications,dialysis and laboratory examination were explored.The prevalence treatment rate and control rate of hypertension were analyzed.Associated factors for controlling hypertension [systolic blood pressure (SBP) ＜ 140 mmHg and diastolic blood pressure (DBP) ＜ 90 mmHg] were assessed by logistic regression analysis.Results (1) The prevalence of hypertension in the hemodialysis patients was 87.0％.Their treatment rate and control rate were 93.2％ and 23.9％ respectively.The average of SBP was (145.90±21.18) mmHg,and the DBP on average was (83.60± 12.21) mmHg.The most commonly used anti-hypertensive drug is calcium channel blocker (88.2％).Over one third (45.7％) of patients were treated with two kinds of anti-hypertensive drug,26.2％ with 1 kind,21.7％ with 3 kinds,and 6.4％ with 4 kinds or more.(2) Compared with non-hypertension patients,patients with hypertension have older age,higher body mass index (BMI),phosphorus,SBP and DBP,as well as lower hemoglobin and Kt/V (all P ＜ 0.05).(3) The multivariate logistic regression analysis showed that Ca ＞ 2.50 mmol/L (OR=2.084,95％CI 1.008-4.307,P=0.047) positively correlated with controlling hypertension,while smoke (OR=0.594,95％CI 0.356-0.911,P=0.046) and BMI 18.5 ～ 23.9 kg/m2 (OR=0.516,95％CI 0.293-0.907,P=0.022) negatively correlated with it.Conclusions High prevalence yet low control rate of hypertension in MHD patients in Anhui Province were observed.Hypocalcemia may be a protective factor for hypertension control,while smoke and BMI may be risk factors for it.
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Objective To evaluate the clinical effect of TAPAS intravascular closed catheter-directed thrombolysis combined with endovascular intervention treatment for Cockett syndrome complicated with deep venous thrombous of lower limbs. Methods The clinical data of 31 patients of Cockett syndrome complicated with deep venous thrombosis of lower limbs were retrospectively analyzed, and the patients were treated with TAPAS intravascular closed catheter-directed thrombolysis combined with endovascular intervention.Results Thirty patients were placed self-expandable stent,and 1 patient was treated by balloon dilation.The pain disappeared and the swelling decreased postoperatively.Twenty-two cases was cured (70.97%, 22/31), 7 cases showed excellence (22.58%, 7/31), and 2 cases showed effective (6.45%, 2/31), and there were no invalid patients. There was no pulmonary embolism and bleeding event during treatment. Conclusions The TAPAS intravascular closed catheter-directed thrombolysis combined with endovascular intervention treatment for Cockett syndrome complicated with deep venous thrombous of lower limbs is an effective and safe technique with satisfactory short term result.However,the long term clinical effect need to be further researched.
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Objective To investigate the efficacy of transilluminated powered phlebectomy (TIPP) and endovanous laser treatment(EVLT) combined with high ligation on treating varicose great saphenous vein.Methods A total of 238 cases with varicose great saphenous vein were divided into TIPP group (119 cases)and EVLT group (119 cases).The incidence of postoperative recovery and complications of the two groups were compared.Results There was no significant difference between the two groups on the surgery duration and postoperative recovery incident(P ＞ 0.05);the saphenous nerve injury incidence and skin impairment incidence of the TIPP group were significantly less than that of EVLT group (P ＜ 0.05);the amount of bleeding,subcutaneous hematoma incidence,and amount of surgical incision of TIPP group were significantly more than that of the EVLT group(P ＜ 0.05).Conclusions TIPP and EVLT combined with high ligation are two effective minimally invasive surgical approaches on treating varicose great saphenous vein.EVLT is with less surgical incision and less bleeding,and is more applicable for mild case;TIPP is with less operative trauma,and is more applicable for severe case.
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Objective To investigate the efficacy of endovenous laser combined with high ligation and traditional operation in treatment of great saphenous vein varicose.Methods One hundred and fifty-six cases of great saphenous vein varicose were divided into endovenous laser combined with high ligation(observation group,78 cases)and traditional operation(control group,78 cases)by table of random digits.The incidence of postoperative recovery and complications between two groups were compared.Result The operation time,amount of bleeding in operation,incidence of affected limb hematoma in observation group were significantly lower than those in control group[(42±5)min vs.(64±8)min,(30±8)ml vs.(50±5)ml,5.13％(4/78)vs.11.54％(9/78),P＜0.05].There was no significant difference between two groups of the postoperative recovery incidence and saphenous nerve injury incidence(P＞0.05).There was no affected limb deep venous thrombosis and great saphenous vein recanalization 1 year after operation.Conclusion Compared with the traditional operation,endovenous laser combined with high ligation has the same clinical efficacy,but less operation time,less amount of bleeding in operation,and less complication.