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.

Child, Preschool ; Humans ; Influenza A Virus, H1N1 Subtype ; Influenza, Human ; virology ; Male

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.

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.

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.

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.

Objective To summarize the clinical application of the Tempofilter Ⅱ temporary caval filter.Methods The Tempofilter Ⅱ temporary caval filter was employed in 24 patients from April 2002 to August 2006.Before the implantation,we performed color ultrasonography to detect the extent of thrombus and the situation of inferior vena cava,renal vein,and access vein(right internal jugular vein).Under the guidance of color ultrasonography and X-ray fluoroscopy(free of contrast agent),the temporary filter was placed in the inferior vena cava distal of the renal vein orifice through a guide wire by using the Seldinger technique.Results The filter was successfully implanted and removed in all the 24 patients.The duration of placement was 5 days～6 weeks(mean,16.8 days).Filter thrombosis occurred in 4 patients at 3 days ～ 2 weeks after operation.The thrombi(

Objective To study the causes, prevention and treatment of secondary thrombosis after vena cava filter placement. Methods We summarized the clinical experience regarding 7 cases of secondary thrombosis of the inferior vena cava from December 2001 to June 2004 in this hospital. Results Two patients underwent thrombectomy, 1 patient received interventional thrombolytic therapy, and the rest of 4 patients received conservative treatment. All the treatment had obtained good results. No pulmonary embolism took place in the study. Conclusions Thrombosis secondary to filtration can be completely prevented by adhering strictly to the indications of filter placement and conducting supplementary anticoagulation therapy. Interventional therapy is the first choice for the treatment of secondary thrombosis after filter placement.

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

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.