Carcinoma, Hepatocellular ; complications ; drug therapy ; pathology ; Chemoembolization, Therapeutic ; methods ; Female ; Humans ; Liver Neoplasms ; complications ; drug therapy ; pathology ; Male ; Neoplastic Cells, Circulating ; Portal Vein ; pathology ; Stents ; Venous Thrombosis ; complications ; pathology

BACKGROUND/AIMS: Portal-vein thrombosis (PVT) develops in 10-25% of cirrhotic patients and may aggravate portal hypertension. There are few data regarding the effects of anticoagulation on nonmalignant PVT in liver cirrhosis. The aim of this study was to elucidate the safety, efficacy, and predictors of response to anticoagulation therapy in cirrhotic patients. METHODS: Patients with liver cirrhosis and nonmalignant PVT were identified by a hospital electronic medical record system (called BESTCARE). Patients with malignant PVT, Budd-Chiari syndrome, underlying primary hematologic disorders, or preexisting extrahepatic thrombosis were excluded from the analysis. Patients were divided into two groups (treatment and nontreatment), and propensity score matching analysis was performed to identify control patients. The sizes of the thrombus and spleen were evaluated using multidetector computed tomography. RESULTS: Twenty-eight patients were enrolled in this study between 2003 and 2014: 14 patients who received warfarin for nonmalignant PVT and 14 patients who received no anticoagulation. After 112 days of treatment, 11 patients exhibited significantly higher response rates (complete in 6 and partial in 5) compared to the control patients, with decreases in thrombus size of >30%. Compared to nonresponders, the 11 responders were older, and had a thinner spleen and fewer episodes of previous endoscopic variceal ligations, whereas pretreatment liver function and changes in prothrombin time after anticoagulation did not differ significantly between the two groups. Two patients died after warfarin therapy, but the causes of death were not related to anticoagulation. CONCLUSIONS: Warfarin can be safely administered to cirrhotic patients with nonmalignant PVT. The presence of preexisting portal hypertension is a predictor of nonresponse to anticoagulation.
Aged ; Anticoagulants/*therapeutic use ; Female ; Humans ; Liver Cirrhosis/complications/*diagnosis ; Male ; Middle Aged ; Portal Vein ; Propensity Score ; Severity of Illness Index ; Tomography, X-Ray Computed ; Venous Thrombosis/complications/*drug therapy/pathology ; Warfarin/therapeutic use

OBJECTIVETo observe the clinical curative effects of lower extremity deep venous thrombosis (DVT) postoperative fracture treated by maixuekang capsule and low molecular heparin calcium (Subilin).

METHODFrom Feb 2008 to Apr 2010, 214 cases of lower extremity DVT postoperative fracture were randomly divided into experimental group and control group. The 107 cases of them were treated by maixuekang capsule based on the comprehensive treatment.

RESULTThe 89 cases were cured and improved in the observation group, but 18 cases were ineffectiveness. The 66 cases were cured and improved in the control group, but 41 cases were ineffectiveness. Maixuekang capsule group had 83. 18% (89/107) total effective rate and 61.68% (66/107) total effective rate in the control group. There was significant difference between the two groups (P < 0.05). After the treatment, the perimeter between the suffered limb and the healthy one was significantly reduced, the blood rheology examination had been improved significantly. There was also significant difference between the two groups (P < 0.05).

CONCLUSIONMaixuekang capsule for lower extremity deep vein thrombasis has good effect It has both thrombolytic and anticoagulant effects for lower extremity DVT postoperative fracture treated by maixuekang capsule and low molecular heparin calcium (Subilin). It's a recommended treatment.

Adolescent ; Adult ; Aged ; Capsules ; Female ; Fractures, Bone ; surgery ; Hemodynamics ; drug effects ; Heparin, Low-Molecular-Weight ; adverse effects ; pharmacology ; therapeutic use ; Humans ; Lower Extremity ; injuries ; surgery ; Male ; Middle Aged ; Postoperative Complications ; drug therapy ; pathology ; physiopathology ; Treatment Outcome ; Venous Thrombosis ; drug therapy ; pathology ; physiopathology ; Young Adult

Portal vein thrombosis is an uncommon but an important cause of portal hypertension. The most common etiological factors of portal vein thrombosis are liver cirrhosis and malignancy. Albeit rare, portal vein thrombosis can also occur in the presence of local infection and inflammation such as pancreatitis or cholecystitis. A 52-year-old male was admitted because of general weakness and poor oral intake. He had an operation for colon cancer 18 months ago. However, colonic stent had to be inserted afterwards because stricture developed at anastomosis site. Computed tomography taken at admission revealed portal vein thrombosis and inflammation at colonic stent insertion site. Blood culture was positive for Escherichia coli. After antibiotic therapy, portal vein thrombosis resolved. Herein, we report a case of portal vein thrombosis with sepsis caused by inflammation at colonic stent insertion site which was successfully treated with antibiotics.
Anti-Bacterial Agents/therapeutic use ; Cholecystitis/etiology ; Colonic Neoplasms/pathology/therapy ; Escherichia coli/isolation & purification ; Escherichia coli Infections/drug therapy/etiology ; Humans ; Inflammation/*etiology ; Liver/diagnostic imaging ; Male ; Middle Aged ; Pancreatitis/etiology ; Portal Vein ; Sepsis/*diagnosis/drug therapy/microbiology ; Sigmoidoscopy ; Stents/*adverse effects ; Tomography, X-Ray Computed ; Venous Thrombosis/complications/*diagnosis