1.Long-term Follow-up of Patients with Varicose Veins of the Lower Extremities Treated by Electrocoagulation
Yongkang DANG ; Haitao ZHAO ; Jianquan GUO
Chinese Journal of Minimally Invasive Surgery 2005;0(12):-
Objective To summarize the therapeutic efficacy of electrocoagulation for varicose veins of the lower extremities.Methods Totally 168 cases(238 limbs)of varicose veins of the lower extremities were treated with electrocoagulation in our department from April 2000 to April 2007.Through a small ankle incision,electrocoagulation probe was inserted ascendingly into the groin via the great saphenous vein.After high ligation of the great saphenous vein,the varicose veins and great saphenous trunk were electrocoagulated.Results The patients were discharged from hospital in one to two days after the operation.None of them had incisional infection.The ulcers at the ankle were healed in four weeks.Postoperative complications in this series,included Ⅰ degree burn injury in one limb,Ⅱ degree burn injury in one limb,superficial phlebitic pain in two limbs(two cases);and numbness around the ankle in 14 limbs(10 cases).Totally 148 cases with 208 limbs were followed up for 2 to 9 years with a mean of 6.6 years.During the period,the rate of recurrent varicosity was 3.4%(7/208);and healing rates of ache,dermatitis and eczema,ankle pigment,swelling around the calf and ankle were 95.3%(162/170),85.7%(12/14),41.7%(15/36)and 36.4%(16/44)respectively.Conclusion Electrocoagulation is a minimally invasive and effective method for the treatment of varicose veins of the lower extremities,with quick recovery and low rate of recurrence.
2.Mid term result of transcatheter thrombolysis for acute pulmonary embolism
Liu YANG ; Xuechao JIANG ; Jianquan GUO ; Yongtao BAO ; Yongkang DANG
Chinese Journal of General Surgery 2017;32(2):133-136
Objective Pulmonary embolism is a common cardiovascular emergency with the characteristics of high incidence,high mortality.This study compared pulmonary artery catheter thrombolysis with peripheral intravenous thrombolysis for acute pulmonary embolism in the mid-term clinical efficacy.Methods From June 2011 to September 2015,68 patients were given pulmonary artery interventional therapy,54 cases received peripheral intravenous thrombolysis;discharged patients were followed up for 3-12 months to evaluate the curative rate,effective rate,recurrence rate and the incidence of complications.Results Follow up rate was 79.5%.The cure rate of the treatment group was higher than that of the control group (47.3 % vs 23.8 %,P < 0.05);The significant effective rate of the treatment group was higher than that of the control group (81.8% vs 52.4%,P < 0.05);The incidence of Chronic pulmonary hypertension (1.8%) was lower than that of the control group (16.7%);There was no significant difference in improvement rate,recurrence rate and mortality.Conclusion The medium-term efficacy of pulmonary artery catheter directed thrombolysis is superior to that of peripheral intravenous thrombolysis;it can effectively reduce the incidence of chronic thromboembolic pulmonary hypertension.
3.Indwelling transpulmonary artery thrombolytic therapy for acute pulmonary embolism
Yongkang DANG ; Liu YANG ; Haitao ZHAO ; Jianquan GUO ; Yongtao BAO
Chinese Journal of General Surgery 2014;29(12):912-914
Objective To evaluate indwelling intrapulmonary artery catheter thromolysis for acute pulmonary embolism.Methods From June 2011 to June 2013 56 cases of acute pulmonary embolism were diagnosed by multi-row spiral CT and admitted at the Department of Vascular Surgery.The average age was (56 ± 11) years.Inferior vena cava filter was implanted and pulmonary angiography,catheter thrombectomy,indwelling pulmonary intraarterial thrombolytic therapy was performed.Postoperatively low molecular weight heparin and warfarin was given,dosage adjusted by prothrombin international normalized ratio at 2-3.Results Mean pulmonary arterial pressure (mPAP) decreased from (43 ± 7) mmHg to (22 ± 6) mmHg (P < 0.05),arterial partial pressure of oxygen (PO2) rose from (49 ± 8) mmHg to (83 ± 9) mmHg (P < 0.05).Clinical symptoms significantly relieved in 51 out of the 56 cases (91%).45 patients were followed up for an average of (15 ± 4) months,with one recurrence.There was no filter migration,vena cava thrombosis,chronic obstructive pulmonary disease and other complications.Conclusions Emergency pulmonary artery indwelling catheter thrombolysis is safe and effective therapy for acute pulmonary thromboembolism.
4.Clinical Effect of Abdominal Total Hysterectomy on Uterine Fibroids and Serum VEGF, IL-6 and IL-8 Levels
Zhangxia CUI ; Miao DANG ; Yongkang YANG ; Xiaocai ZHANG ; Jing YANG
Progress in Modern Biomedicine 2017;17(27):5275-5278
Objective:To research the clinical effect of abdominal total hysterectomy on the patients with uterine fibroids and the serum vascular endothelial growth factor (VEGF) and interleukin 6 (IL-6),interleukin 8 (IL-8) levels.Methods:106 cases of patients with uterine fibroids from February 2014 to February 2016 were divided into the control group and the research group according to the lottery method,the control group was treated with total abdominal hysterectomy,while the research group was given abdominal total hysterectomy treatment,the operation time,blood loss,anal exhaust time,length of hospital stay,changes of serum VEGF,IL-6,IL-8,Follicle stimulating hormone (FSH),estradiol (E2) levels,resistance to seedling le tube hormone (AMH) before and after the surgery as well as the occurrence of complications were compared between two groups.Results:The operation time,blood loss,length of hospital stay,anal exhaust time of research group were significantly shorter than those of the control group (P<0.05).Before surgery,the serum levels of VEGF,IL-6,IL-8,FSH,E2,AMH showed no difference between two groups (P>0.05).After the operation,the serum levels of IL-6,IL-8,E2,AMH of research group were lower than those of the control group (P<0.05),the serum level of FSH in research group was higher than that of the control group (P<0.05).The serum level of VEGF showed no difference between the two groups (P>0.05).The incidence rate of complications in research group was lower than that of the control group (P<0.05).Conclusion:Abdominal total hysterectomy showed similar effect with the abdominal hysterectomy in the treatment of uterine fibroids patients,but the abdominal full hysterectomy induced less trauma,promoted the recovery of ovarian function after surgery,which might be related to the decrease of serum IL-6,IL-8 and VEGF levels.
5.Rivaroxaban and interventional therapy for acute pulmonary embolism
Yongkang DANG ; Xuechao JIANG ; Liu YANG ; Jianquan GUO ; Yongtao BAO ; Xiangyang TONG
Chinese Journal of General Surgery 2018;33(10):853-856
Objective To explore the safety and efficacy of rivaroxaban after interventional treatment of pulmonary embolism.Methods Patients with acute pulmonary embolism undergoing pulmonary indwelling catheter thrombolysis at Chifeng Municipal Hospital from Jun 2016 to Jun 2017 were divided into a group of 23 patients,who afterwards receiving rivaroxaban as a long-term anticoagulant,and that of 45 patients treated with traditional anticoagulant therapy (low molecular weight heparin bridged warfarin).Results The short and mid-term follow-up for the cure rate in the rivaroxaban group was higher than that in the traditional anticoagulation group (60.9% vs.35.6%,P <0.05,and 73.9% vs.44.4%,P <0.05).The incidence of adverse reactions such as bleeding (4.3%) was significantly lower than that of the heparin warfarin group (28.9%),there was no recurrence of venous thromboembolism (VTE) in the rivaroxaban group,and 3 cases in the traditional anticoagulant group;there was no death in either group.Conclusions In the interventional treatment of acute pulmonary embolism,single-agent oral rivaroxaban is equivalent to low-molecular-weight heparin-bridged warfarin;rivaroxaban can effectively reduce pulmonary embolism and the occurrence of bleeding complications after endovascular intervention.