1.Effects of periesophagogastric vascular ligation on FPP and incidence of rebleeding for patients with cirrhotic portal hypertension
Guang CHEN ; Wenjun ZHAO ; Zhenming QIU ; Zuchao LIN ; Zheke YU ; Shiming GU
China Modern Doctor 2015;(11):92-94
Objective To explore the effects of periesophagogastric vascular ligation on free portal pressure (FPP) and incidence of rebleeding for patients with cirrhotic portal hypertension. Methods A total of 60 patients with cirrhotic portal hypertension who were admitted to our hospital from October 2008 to October 2011 were selected and were allo-cated to observation group and control group according to their surgical methods, with 30 patients in each group. The observation group received periesophagogastric vascular ligation, while the control group received periesophagogastric devascularization. The curative effects of two different surgical methods in the two groups were compared. Results Vol-ume of bleeding during surgery, surgical time and other clinical indices in the observation group were all significantly smaller or shorter than those in the control group, and the differences were statistically significant (P<0.05);incidence of rebleeding and hepatic encephalopathy in the observation group were significantly lower than that in the control group, and the differences were statistically significant (P<0.05); FPP in the observation group was significantly lower than that in the control group, and the difference was statistically significant (P<0.05). Conclusion Periesophagogastric vascular ligation helps effectively lower FPP induced by cirrhotic portal hypertension, reduce incidence of rebleeding, and lower postoperative mortality and incidence of complications.
2.Study on the effect of addition or subtraction of Astragalus membranaceus and Draba nemorosa on CHF and changes of cardiac color ultrasound parameters
Lepin GE ; Meise LIN ; Zuchao JIANG ; Pengpeng CHEN ; Longmeng CAO ; Yan LI
China Modern Doctor 2024;62(12):67-72
Objective To analyze the efficacy of Astragalus membranaceus and Draba nemorosa in the treatment of chronic heart failure(CHF),the change of cardiac color ultrasound parameters and its predictive value for adverse end events.Methods A total of 92 patients with Qi-deficiency and blood-stasis combined with Shuiyin CHF treated in Wenzhou Hospital of Traditional Chinese Medicine from September 2019 to September 2021 were randomly selected and divided into two groups by random number table method,with 46 cases in each group.Patients in control group were received conventional Western medicine treatment,and patients in observation group were received the addition and subtraction treatment of Yiqi Huoxue Lishui prescription based on Astragalus membranaceus and Draba nemorosa.The clinical efficacy,TCM syndrome score,heart color ultrasound parameters and the incidence of adverse endpoint events within 6 months were compared between the two groups.Cardiac color doppler ultrasound parameters were compared between the occurrence group and the non-occurrence group,and receiver operating characteristic curve was drawn to analyze the predictive value of cardiac color Doppler ultrasound parameters for adverse end events.Results The total clinical effective rate of the observation group(95.65%)was higher than that of the control group(71.74%)(P<0.05).After treatment,palpitation,weakness,shortness of breath,lethargy and lip purple score in observation group were lower than those in control group(P<0.05).The left ventricular end-diastolic diameter(LVEDD)and left arial diameters(LAD)of the observation group were lower than those of the control group after treatment(P<0.05).After treatment,the left ventricular ejection fraction(LVEF)of the observation group was higher than that of the control group(P<0.05);The incidence of adverse endpoint events within 6 months in the observation group(2.17%)was lower than that in the control group(19.57%)(P<0.05).The LVEDD and LAD in the adverse end point event group were higher than those in the without adverse end point event group(P<0.05),and the LVEF was lower than that in the without adverse end point event group(P<0.05).The area under the curve(AUC)of LVEDD,LAD and LVEF combined to predict the occurrence of adverse endpoint events was 0.812,and the 95%CI confidence interval was 0.734-0.968;The sensitivity of combined detection(93.42%)was higher than that of single detection(71.52%,75.11%,79.62%)(P<0.05).The specificity of combined detection(82.27%)compared with that of single detection(70.19%,73.07%,77.28%)(P>0.05).Conclusion Supplementing qi and promoting blood circulation and rehydrating water based on Astragalus membranaceus and Draba nemorosa can effectively improve the cardiac function of CHF patients,alleviate symptoms such as palpitations and fatigue,and reduce the incidence of adverse endpoint events.In addition,the combined detection of cardiac ultrasound parameters can improve the prediction efficiency of adverse endpoint events,which has certain clinical value.