1.The surgical treatment of varicose veins of lower extremity with primary deep venous insufficiency
Chinese Journal of General Surgery 1993;0(01):-
0.05). ConclusionsWhen varicose veins of the lower extremity with deep vein insufficiency exists, patients should undergo high ligation and stripping of the great saphenous vein, additional correction of the deep vein reflux provides no further effect.
2.Application and progress of surgical nutrition
Chinese Journal of General Surgery 2001;0(08):-
Nutrition support is extensively used in many clinical fields. The rest energy requirement in Chinese is only 5021~5858kJ/d.In our country 40% to 50% of hospitalized patients need nutrition support.In nutrition support,attention should be paied to :(1)The energy giving to the patient should be appropriate;(2)hormone resistance;(3)immunonut rition.
3.Medical rescue and emergency management of natural disasters
Guoxiang ZHAO ; Shengyong WANG
Chinese Journal of Disease Control & Prevention 2008;0(05):-
China is one of the countries with most serious natural disasters lose all over the world.Natural disasters are a public emergency.Human society can't avoid the natural disasters today,so the global target of a struggle is to reduce the loss of natural disasters.The natural disasters loss will be reduced to a minimum,once the system is established of medical rescue and emergency management by the government.
4.Chemical lumbar sympathectomy for the treatment of lower limb ischemia
Guoxiang DONG ; Jun ZHAO ; Jingyuan LUAN
Chinese Journal of General Surgery 1993;0(01):-
0.05). Neuralgia of the lower limb was complicated in 3 (8%)cases. 31 cases were followed up from 3 months to 9 years. 24 out of the 26 patients experincing immediate post-CLS relief remained asymptomatic, and 2 suffered symptom deterioration necessitating major amputation. ConclusionsCLS is a simple procedure with less complication offering an alternative for the treatment of lower limb ischemia.
5.Complications of thrombectomy for deep vein thrombosis of the lower extremity
Guoxiang DONG ; Jingyuan LUAN ; Jun ZHAO
Chinese Journal of General Surgery 2001;0(09):-
Objective To evaluate the complicatio ns after thrombectomy for deep vein thrombosis (DVT) of the lower extremity. Methods Thrombectomy was under taken for 143 patients using Fogarty catheter, then local thrombolysis and antic oagulation was undertaken by a indwelling catheter in the great saphenous vein. Results The total recurren ce rate of DVT was 12.6%(18/143), whereas the early recurrence rate without loc al thrombolysis and anticoagulation was 29.8%(14/47). The recurrence rate was 1 8.9%(14/74) against the background of Cockett syndrome, and 5.8%(4/69) withou t Cockett syndrome. Other complications included lymphatic fistula in 4 cases (2 .8%), pulmonary embolism, vena cava thrombosis, massive haemorrhage, and incisi onal infection in one each, death ensued in 3 (2.1%). ConclusionsThe recurrence rate of DVT could be low ered by management of the stenosis or occlusion of common iliac vein and local thrombolysis and anticoagulation. Thrombectomy should be the first choice of the rapy for DVT.
6.Long-term result of thrombectomy and thrombolysis for acute mixed deep vein thrombosis of the lower extremity
Jingyuan LUAN ; Guoxiang DONG ; Jun ZHAO
Chinese Journal of General Surgery 2008;23(3):193-196
Objective To study the long-term result of thrombectomy and thrombolysis for acute mixed deep vein thrombosis(DVT)of the lower extremity. Methods Clinical data of 142 patients treated for acute mixed DVT from September,1991 to June,2005 were reviewed.There were 77 patients treated by thrombectomy.Among these 77 patients there were 49 patients whose common iliac vein was occluded or stenosis.All the 77 patients received territorial transfusion with urokinase and hepafin after operation.The other 65 cases were treated by systemic thrombolysis with urokinase and heparin. Results Two weeks after thrombectomy or thrombolysis,the circumference difference between bilateral limbs was occlusive from (4.3±2.2)cm to(0.6±0.5)cm in thrombectomy group,and from(3.9±2.5)cm to(1.6±0.9)cmin thrombolysis group(t=-8.346,P=0.000).Patients were followed up for an average of(49±42)months.The circumference difference between bilateral limbs was reduced to(0.5±0.4)cm in thrombectomy group and(1.4±1.3)cm in thrombolysis group respectively(t=-5.764,P=0.000).The sequela morbidity in thrombectomy group was less than that in thrombolysis group(P<0.05).The morbidity of edema,pigmentation,and ulcer was 29.9%,15.6%,0%in thrombectomy group and 50.8%,84.6%,6.2%in thrombolysis group.In thrombectomy group,89.6%veins regained patency and 72.7%valves had normal function compared with that in thrombolysis group 30.8%and 9.2%(Z=-8.502.P=0.000).The cure rate was 70.1%in thrombectomy group and 30.8%in thrombolysis group (Z=-4.740.P=0.000).Mortality rate was 3.9%in thrombectomy group,while there was no inhospital death in thrombolysis group. Conclusions For the treatment of acute mixed DVT.especially in protecting the normal valve function,thrombectomy was significantly superior to that of thrombolysis except for causing some mortality.
7.Lower extremity deep venous insufficiency and Cockett syndrome.
Guoxiang DONG ; Xuan LI ; Jun ZHAO
Chinese Journal of Practical Surgery 2001;21(5):276-277
Objective This study was To investigate the incidence rate of Cockett syndrome and relationship between Cockett syndrome and varicose veins and deep venous incompetence of the left lower extremities.Methods 73 patients(100 legs) with varicose veins of the lower extremities were investigated by descending deep venography and iliography preoperatively.Results There were 35(47.9%) cases with abnormalities of the left common iliac vein (ALCIV)in all the cases.There were 31 cases with this conditions in the patients with varicose veins of the left or both lower extremity.While in the patients with varicose veins of the only right lower extremity,there were only 4 cases with ALCIV.In contrast,there was a significant difference between groups(χ2=9.8641,P=0.0017).In the patients with ALCIV,14 cases with Ⅲ or Ⅳ grade of deep venous incomptence were found, and only 6 cases with deep venous incompetence in the patients without ALCIV.There was a significant difference(χ2=5.3688,P=0.0205).Conclusion Cockett's syndrome frequently occurs in varicose veins of the left lower extremity.There is a relationship between them.Cockett's syndrome might be one of the causes for the deep venous incompetence of the left leg.
8.Sympathectomy for Raynaud disease
Guoxiang DONG ; Nengwei ZHANG ; Jun ZHAO
Chinese Journal of Minimally Invasive Surgery 2001;0(01):-
Objective To study the effect of thoracoscopic sympathectomy and/or chemical lumbar sympa- thectomy performed on patients with Raynaud disease. Methods Five patients, 1 male,4 females, aged from 30 to 65(mean 45. 3 ). Raynaud phenomenon appeared only on both hands in one patient, only on feet with a toe gangrene in another one , the other 3 cases on all limbs. Thoracoscopic symathectomy was performed for those whose hands were af- fected and chemical lumbar sympathectomy(12-3 ) was pererformed for those whose feet were affected. Results All patients were followed up from 12 to 48 months(mean 24 months). All experinced improvement with hands warm and satisfactory results after thoracoscopic sympathectomy. However, the original symptoms reccurred in two patients after postoperatire six months. All 4 patients performed chemical lumbar sympathectomy experienced improved symptoms with feet warm and satisfactory results and the symptoms did not recur up to now. The sympathectomy showed different results for hands and for feet. Conclusions Thoracoscopic sympathectomy for hands affected by Raynaud disease has efficiency temporarily, but is not satisfactory. The chemical lumbar sympathectomy for the feet affected by Raynaud disease has dramatically disappearence of symptoms and the results are very good
9.Chemical thoracic sympathectomy for Raynaud disease
Guoxiang DONG ; June ZHAO ; Jingyuan LUAN
Chinese Journal of Minimally Invasive Surgery 2001;0(03):-
Objective To investigate the therapeatic effects of chemical thoracic sympathectomy (CTS) for Raynaud disease. Methods A niddle was injected into the first or second thoraic vertebra from back. A X-ray examination was performed to definite the position of the niddle tip. One millilitre of urographine was injected to determine if it was infused into thoracic cavity. If not, 2 ml of 5% phenol was injected and the niddle was removed. Results Within 10 minutes both pairs of the hands of the two patients with Raynaud's disease turned into flushing and warm from pallor and cool after CTS. Ice-water test changed to negative. Conclusions CTS is of simple, microinvasive and low cost procedure for Raynaud's disease.
10.Inferior vena cava filter placement guided by color-ultrasonography
Jun ZHAO ; Jingfu LI ; Guoxiang DONG
Chinese Journal of Minimally Invasive Surgery 2001;0(03):-
Objective To report an improved method, color-ultrasonography-guided inferior vena cava (IVC) filter placement, for preventing the pulmonary embolism (PE) caused by the deep venous thrombosis (DVT). Methods Color-ultrasonography-guided IVC filter insertion was performed in 9 patients with DVT of lower limb, 1 of which also had PE accompanied with at the time of admission. Out of the 9 patients, 5 patients underwent embolectomy immediately after the filter placement while the other 4 patients were treated conservatively. Results The placements were all completed successfully. Follow-up observations for 1~7 months (mean 2 months) found no complications or occurrence of PE. No recurrence of PE was found in the patient already with PE. Conclusions The color-ultrasonography-guided IVC filter placement can effectively prevent PE caused by DVT. The method is suitable for severe, immovable patients, as well as patients with renal insufficiency and being allergic to intravenous contrast, and is safe, convenient, cheap and prone to popularization.