Elderly patients with acute biliary pancreatitis Treatment _2118

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Elderly patients with acute biliary pancreatitis Treatment
 
 
Catheter thrombolysis of lower extremity deep venous thrombosis Vascular Surgery, Shandong Provincial Hospital (250021) Jing Yong Wu Xuejun Zhang Zhen Yue Zhang eleven species of Venus [Key words venous thrombosis,You are not allowed to view links. Register or Login, lower extremity; ultrasound guidance; thrombolysis [Key Words】 R654 .4 [Document code] A [Article ID] 1005-6483 (2004} 03-0190-02 deep vein thrombosis (deepvenousthrombosis. DVT) has become one of the clinical frequently-occurring disease. DvT late deep venous insufficiency can occur in other a series of disease, seriously affecting the patient's quality of life. The commonly used treatment methods tend to non-surgical therapy, including thrombolysis, anticoagulation,You are not allowed to view links. Register or Login, removal of polyethylene and other drug treatment. venous embolectomy because of trauma, postoperative recurrence of results easily poor. our hospital from December 2002 began to use ultrasound guided catheter thrombolysis in the treatment of deep venous thrombosis, and achieved good results. reported below. clinical data of a general information on a total of 27 patients in this group, male l7 cases , l0 female, mean age 40.6 years (29 to 70 years). of both lower extremities DVT inferior vena cava thrombosis in 5 cases, left lower extremity deep vein thrombosis l8 cases. the right lower extremity deep vein thrombosis in 4 cases. which central DVT8 cases. mixed DvT19 cases. a history of average 7.9d days (2 ~ 3ld). after 12 cases. trauma in 3 cases, 12 patients without incentive. Preoperative venous ultrasound, venography diagnosis. same line is not set 21 cases of tube thrombolysis of deep venous thrombosis in the control group patients, average age 41.2 years, history of average 8.2d. Second, Hui Pu 4500 ultrasound equipment (SONOS4500. vascular pattern PvExam), linear array probe ( C3540), needle holder (needle through the 18G),You are not allowed to view links. Register or Login, Infusion catheter (Cordis Corporation, straight head-end side of the hole), sheath catheter, guide wire, the anterior wall of the needle (18G). Third, the treatment 1. under vena cava filter placement: line catheter thrombolysis before the recommendations in the line of the inferior vena cava filter placement. filter into the contralateral femoral vein route choice, if the bilateral DVT. path generally choose the right jugular vein. filter types according to Choose the inferior vena cava diameter. diameter  28mm time. Select Birdnest filter. generally placed in the top of the filter below the renal vein 1crn plane. 2. tube method: prior to catheter ultrasound examination to the tibiofibular vein and inferior vena cava. According to thrombosis range, location, choose the jugular vein, femoral vein, popliteal vein or posterior tibial vein cannulation site. this group of patients with femoral vein catheter in 3 cases, Luo venous catheter 23 cases. tibial venous catheter in 1 case, 1 case of jugular vein catheterization (3d after the change from the popliteal vein catheter). catheter sheath, catheter thrombolysis select the same model (both 5F), popliteal vein catheter in 7 cases, shares vein in 3 cases (all 5F). select a different type (catheter sheath 6F, Infusion catheter 5F). popliteal vein catheter in 16 cases. tibial vein catheter thrombolysis only. puncture at regular disinfection, sterile shop hole towels, lines of local anesthesia. shares were popliteal vein ultrasound (linear probe C3540) vein puncture position, the anterior wall of the needle (18G) needle back through the ultrasonic probe holder into the needle, puncture the vein under ultrasound guidance ( Seldinger technique), into catheter sheath, the catheter sheath into the guide wire to the proximal end of thrombus, under the guidance of the guide wire catheter thrombosis to thrombolysis within the distal end. incision posterior tibial vein catheterization. will sheath, thrombolysis catheter fixed to prevent prolapse of thrombolysis catheter. 3. delivery method: ① catheter thrombolysis group: The thrombolysis catheter and syringe pump connection, sheath, catheter thrombolysis models of different persons,You are not allowed to view links. Register or Login, both sheath connection with the micro-injection pump. According to coagulation by infusion of urokinase thrombolysis catheter, each 5 to 10 million U. at 4 - 6h during pump, 3 to 4 times a day, heparin 20mg, 2h the pump. 2 times a day. 1 times prolonged prothrombin time, fibrinogen less than 1g were suspended administration of 1. thrombosis after ultrasound changes every day. thrombolysis catheter at thrombolysis. vein recanalization, it will dissolve catheter tied back about 20cm (thrombolysis catheter side holes range in length 15cm), treatment options remain unchanged. until the thrombolysis catheter exit the body. Exit to continue anticoagulation therapy after thrombolysis catheter. ② control group: 30 million u urokinase dissolved in intravenous infusion in 250ml normal saline, 1 time / day; heparin 40mg,You are not allowed to view links. Register or Login, intravenous infusion. 2 times / day. urokinase, heparin dosage adjusted according to coagulation values, urokinase total control in the 200 to 300 million U, heparin 3 ~ 5d can be changed after the oral anticoagulant. Fourth, the standard observation