目的:探讨颈动脉(CA)、股动脉(FA)的内—中膜厚度(IMT)及其血流参数对高血压病的诊断价值。方法:对52例原发性高血压病患者利用高频超声进行CA、FA的IMT检查,并与45例正常对照组结果进行对比研究。结果:高血压组的受检者CA、FA的内中膜厚度较正常对照组的明显增厚,差异有统计学意义(Plt;0.01)。高血压组的受检者CA、FA内径较正常对照组增宽,有显著性差异(Plt;0.01)。高血压组与正常对照组的血流速度测量:高血压组CA、FA平均流速(MV)、加速度时间(AT)明显低于正常对照组,差异有统计学意义(Plt;0.01)。高血压组的CA收缩/舒张期血流速度比值(S/D),搏动指数(PI)、阻力指数(RI),均高于正常对照组,差异有统计学意义(Plt;0.01〉。高血压组的FA收缩/舒张期血流速度比值(S/D)、搏动指数(PI)、阻力指数(RI)与正常对照组比较差异无统计学意义。高血压组与正常对照组钙斑形成比较差异有统计学意义(Plt;0.01)。结论:高血压病的CA、FA内—中膜及血流参数均有不同程度改变,超声检查对临床预警和防治具有重要意义。
Drug addiction has been one of the serious social problems. The peripheral phlebitis caused by drug injection is common, but the occurrence of pseudoaneurysm with infection of femoral artery from injection injury was rarely reported in China. From January 1995 to March 1996, six cases of injury of femoral artery with infection from heroine injection were admitted. The characteristics of the injury were described. The therapeutic measures and details of attention to be needed were discussed. It was concluded that this type of injury was different from the injury caused in agricultural, industrial or traffic accidents. The treatment of choice depended upon the type of injury.
ObjectiveTo investigate the effectiveness and safety of esophageal ultrasound-guided percutaneous femoral artery closure of ventricular septal defect (VSD).MethodsThe clinical data of 24 patients with congenital VSD in our hospital from March 2017 to December 2019 were retrospectively analyzed, including 6 males and 18 females, with a median age of 12 (3-42) years, weight of 32 (12-91) kg, and VSD diameter of 4 (3-7) mm. There were 3 patients with VSD combined with atrial septal defect.ResultsTwenty-four patients successfully underwent interventional closure of percutaneous femoral artery under esophageal ultrasound guidance, and the position and shape of the occluders were good. The operation time was 45 (39-54) min, and the waist size of the occluders was 7 (5-12) mm. Among the patients, 14 patients used symmetric ventricular occlusion devices, 8 patients used asymmetric ventricular occlusion devices, and 2 patients used ventricular occlusion muscle occluders. Small amount of residual shunt occurred in 2 patients after the operation and it disappeared 3 months after the operation. One patient with right bundle branch block, which disappeared after 1 week of observation. There were no complications such as occluder closure, pericardial effusion or valve regurgitation during the perioperative period. During the follow-up period [3-18 (9.25±5.04) months], no serious complication occurred.ConclusionTransesophageal ultrasound-guided transfemoral artery occlusion for VSD is simple and safe, and it avoids the damage of radiation and contrast medium. It has advantages over traditional percutaneous interventional occlusion therapy.
ObjectiveTo investigate the clinical efficacy and application value of percutaneous interventional treatment for structural heart diseases under guidance of ultrasound.MethodsThe clinical data of 1 010 patients with structural heart diseases treated by transcutaneous ultrasound-guided occlusion in our hospital from December 2, 2015 to December 31, 2019 were retrospectively reviewed, including 360 males and 650 females, aged 1-50 years. There were 692 patients of atrial septal defect (603 with central type, 9 combined with arterial catheter, 80 with ethmoid type), 116 patent foramen ovale, 25 ventricular septal defects (3 combined with atrial septal defect), 132 patent ductus arteriosus, 32 pulmonary valve stenosis (3 combined with atrial defect), 1 main pulmonary artery window, and 3 aneurysm rupture of aortic sinus. All patients were diagnosed by transthoracic echocardiography (TTE) before operation. Treatment was accomplished intraoperatively through TTE or transesophageal echocardiography (TEE) via the femoral artery or femoral vein. After operation, echocardiography, electrocardiogram and chest radiograph were reexamined.ResultsSatisfactory results were obtained in 1 005 patients, and 1 patient failed to seal the ventricular defect and was repaired under direct vision, occluder detachment occurred in 5 patients after operation (3 patients of atrial septal defects underwent thoracotomy for Amplatzer device and were repaired, 1 patient of atrial septal defects was closed after removing Amplatzer device, 1 patient of patent ductus arteriosus underwent thoracotomy for Amplatzer device and was sutured), mild pulmonary valve regurgitation occurred after balloon dilation in 2 patients with pulmonary stenosis, a small amount of residual shunt was found in 2 patients with ventricular defect, which disappeared after 3 months of follow-up, and 1 patient of right bundle branch block occurred and disappeared after 1 week. After follow-up of 1-24 months, 3 patients of ethmoidal atrial septal defect were reexamined with mild shunt. The occluder was in good position and the pressure difference of pulmonary valve was significantly reduced. There was no complication such as hemolysis, arrhythmia, embolism or rupture of chordae tendinae.ConclusionPercutaneous transfemoral artery and vein guided by TTE or TEE is safe and effective, with little trauma, no radiation or contrast agent damage, and has significant clinical efficacy and application values.
ObjectiveTo discuss the feasibility about the using of transcatheter aortic valve implantation (TAVI) in severe aortic valve stenosis chinese patients, then to make more exploration and accumulate enough experience. MethodsWe selected 10 out-patients with severe aortic valve stenosis and calcified with 9 males and 1 females at age of 76.4 (65-81) years in our hospital from January 2011 to March 2014. All the patients can't tolerate traditional open surgery through preoperative evaluation. So we chose the Sepian TX system, balloon dilated transcatheter aortic valve, to treat them via transfemoral approach. ResultsTen patients accomplished TAVI successfully. One patient was assisted by the left-ventricular puncture. No complication occurred. The function of aortic valve after TAVI improved significantly. The hospital stay time was 3-5 days. The patients were followed up for 3-34 months. One patient died of pulmonary cancer during the following-up. ConclusionTranscatheter balloon dilated aortic valve replacement can be used in chinese severe aortic valve stenosis patient, but more accurate preoperative preparation, evaluation, and operation are needed.
ObjectiveTo investigate the clinical efficacy of sarpogrelate hydrochloride in preventing restenosis after femoral artery stent implantation. MethodsTwo hundreds and fifty-one cases of ischemic disease of lower extremity (286 affected limbs in total) who got treatment in our hospital were collected, and were divided into prevention group(125 cases with 146 affected limbs) and control group(126 cases with 140 affected limbs) according kinds of medicine. At the basement of medicine in control group, cases of prevention group got treatment of sarpogrelate hydrochloride in addition. Comparison of related indexed was performed by SPSS 17.0 software. ResultsCompared with before treatment in prevention group, only foot skin ulcer and gangrene score decreased(P<0.05), and there were no significant difference on other indexes included visual anafogue scales(VAS), intermittent claudication distance score, ankle brachial index (ABI), and vascular stenosis score(P>0.05). But in control group, compared with before treatment, foot skin ulcer and gangrene score and ABI value decreased(P<0.05), the VAS score, intermittent claudication distance score, and vascular stenosis score increased(P<0.05). There were significant difference on the difference between after treatment and before treatment of all 5 indexes(P<0.05), that the changed value of foot skin ulcer and gangrene score was higher in prevention group, but lower on other 4 indexes. There were no untoward effect happened during treatment. ConclusionClinical effect of sarpogrelate hydrochloride in the prevention of restenosis of the femoral artery after stent implantation was significantly, and it can keep related indexes stable.
OBJECTIVE: To explore the relationship between the properties of compliance and the change of structure of components in anastomosed arteries. METHODS: The arterial pressure and diameter of femoral arteries of dogs were measured in vivo before and after arterial anastomosis in different time intervals to deduce the arterial compliance. The anastomosed arteries were removed and evaluated through light microscopic examination and various staining methods, the relative contents of elastin, collagen and smooth muscles were measured through image analysis system. RESULTS: The compliance of arteries was gradually decreased after anastomosis with peak-time on the 14th day. The content of elastin at different time had no significant difference, while the content of collagen increased gradually, the ratio of them was increased. CONCLUSION: The property of compliance of anastomosed arteries is closely related to the contents of the structural components.
ObjectiveTo explore the safety and effectiveness of different interventional approaches for the treatment of patent ductus arteriosus (PDA) in children.MethodsThe children (≤7 years) who underwent interventional treatment for PDA from 2019 to 2020 in our hospital were retrospectively included. The patients were divided into 3 groups according to the procedures: a conventional arteriovenous approach group, a simple venous approach group, and a retrograde femoral artery approach group. The clinical efficacy of the patients was compared. Results A total of 220 patients were included. There were 78 males and 142 females, with an average age of 3.21±1.73 years, weight of 14.99±5.35 kg, and height of 96.19±15.77 cm. The average diameter of the PDA was 3.35±1.34 mm. A total of 85 patients received a conventional arteriovenous approach, 104 patients received a simple venous approach, and 31 patients received a retrograde femoral artery approach. The diameter of PDA in the retrograde femoral artery group was smaller than that in the other two groups (3.44±1.43 mm vs. 1.99±0.55 mm; 3.69±1.17 mm vs. 1.99±0.55 mm, P<0.001); the contrast medium usage [40 (30, 50) mL vs. 20 (20, 30) mL; 35 (25, 50) mL vs. 20 (20, 30) mL, P≤0.001] and operation time [32 (26, 44) min vs. 25 (23, 30) min; 29 (25, 38) min vs. 25 (23, 30) min, P<0.05] in the simple venous approach group were significantly less or shorter than those in the other two groups; the length of hospital stay of the conventional arteriovenous group was longer than that in the other two groups [3 (3, 5) d vs. 4 (3, 6) d; 4 (3, 5) d vs. 4 (3, 6) d, P<0.05]. There was no significant difference in postoperative complications.ConclusionIt is safe and effective to close PDA through simple venous approach. The retrograde femoral artery approach has the advantage of simplifying the surgical procedure for PDA with small diameters.