急性下肢深静脉血栓手术取栓与介入取栓的疗效分析

Objective To study the short- and long-term results for acute deep vein thrombosis (DVT) of the lower extremity treated by surgical thrombectomy and interventional thrombectomy. Methods One hundred and thirty-six acute DVT cases treated by surgical thrombectomy or interventional thrombectomy from March 2000 to August 2008 were reviewed. There were 80 patients treated by surgical thrombectomy. Among them, 30 cases were male, 50 cases were female, aged from 26 to 81 years with a mean of (58 ± 14 ) years. The other 56 cases were treated by interventional thrombectomy. Among them, 25 cases were male, 31 cases were female, aged from 22 to 92 years with a mean of (57 ±17) years. All the 136 patients received district anticoagulation with heparin and thrombolysis with urokinase after operation. Results After operation, the circumference difference between bilateral thigh in intervention group were less than that in surgical group [ (0. 8 ±1. 3) cm vs. ( 1. 5 ± 1. 7) cm, P =0.002]. The circumference difference of bilateral calf had no significant difference [(0. 7 ± 1. 1 ) cm vs. ( 1. 0 ±1. 1) cm, P = 0. 152]. The average hospital stay in intervention group was shorter than that in surgical group [(7±4) dm. (15±7) d, P =0. 000 ]. The morbidity of complications in intervention group was less than that in surgical group (8. 9% vs. 32. 5% , P -0. 000). One hundred and eight patients were followed up, who was 79.4% of the total patients, and were followed up for an average of (46 ± 29) months. The circumference difference of thigh and calf, the symptom grade, the pigmentation, varicose veins, intermittent claudication and ulceration between the two groups had no significant difference(P > 0. 05). Conclusion Compared with surgical group, intervention group has a better short-term effect, shorter hospital stays, less complications and similar long-term result.     

腰椎间盘突出症术后的中远期疗效分析

Objective To investigate retrospectively the long-term results of discectomy for patients with lumbar intervertebral disc herniation. Methods From July 1988 to May 2003, 273 cases of 1040 patients with lumbar intervertebral disc herniation undergone surgical treatment in our hospital were followed up. All patients were divided three groups according the time of follow-up. The follow-up time was three years as middle follow-up group (Ⅰ), five years as longer follow-up group(Ⅱ) and ten years and more as sup-longer follow-up group (Ⅲ). Sixty-eight cases(24.91%) were in group Ⅰ, including 42 males and 26 females, with the average age of 43.7 years (14-63 years). The group Ⅱ included 141 cases (51.65%), 92 males and 49 females, with the average age of 46.1 years (18-76 years). As group ⅡⅢ, 64 cases (23.44%) were included 46 males and 18 females, with the average age of 43.5 years (20-63 years). The standards Scoring System of Chinese Spinal Association (CSA) and Japan Orthopaedic Association (JOA) were used for investigation. Results According to CSA system, the total good and excellent rate of surgical treatment for lumbar intervertebral disc herniation was 89.0%. The percentage of the satisfactory of the group Ⅰ, Ⅱ, Ⅲ were 92.6%, 91.5% and 79.7% respectively. There was significant difference between group Ⅰ and group Ⅱ, Ⅲ. The score of JOA were 24.75±5.08, 22.43±6.55, 21.64±7.18 postoperatively, with significant difference between group Ⅰ and group Ⅱ, Ⅲ. Conclusion The mid-term results of surgery for patients with lumbar iutervertebral disc herniation is good, and the good and excellent rate decreases gradually with the follow-up time. The results were similar to each other for evaluation between the standard of CSA and JOA.     

腰椎间盘突出症术后的中远期疗效分析

Objective To investigate retrospectively the long-term results of discectomy for patients with lumbar intervertebral disc herniation. Methods From July 1988 to May 2003, 273 cases of 1040 patients with lumbar intervertebral disc herniation undergone surgical treatment in our hospital were followed up. All patients were divided three groups according the time of follow-up. The follow-up time was three years as middle follow-up group (Ⅰ), five years as longer follow-up group(Ⅱ) and ten years and more as sup-longer follow-up group (Ⅲ). Sixty-eight cases(24.91%) were in group Ⅰ, including 42 males and 26 females, with the average age of 43.7 years (14-63 years). The group Ⅱ included 141 cases (51.65%), 92 males and 49 females, with the average age of 46.1 years (18-76 years). As group ⅡⅢ, 64 cases (23.44%) were included 46 males and 18 females, with the average age of 43.5 years (20-63 years). The standards Scoring System of Chinese Spinal Association (CSA) and Japan Orthopaedic Association (JOA) were used for investigation. Results According to CSA system, the total good and excellent rate of surgical treatment for lumbar intervertebral disc herniation was 89.0%. The percentage of the satisfactory of the group Ⅰ, Ⅱ, Ⅲ were 92.6%, 91.5% and 79.7% respectively. There was significant difference between group Ⅰ and group Ⅱ, Ⅲ. The score of JOA were 24.75±5.08, 22.43±6.55, 21.64±7.18 postoperatively, with significant difference between group Ⅰ and group Ⅱ, Ⅲ. Conclusion The mid-term results of surgery for patients with lumbar iutervertebral disc herniation is good, and the good and excellent rate decreases gradually with the follow-up time. The results were similar to each other for evaluation between the standard of CSA and JOA.     

腰椎间盘突出症术后的中远期疗效分析

Objective To investigate retrospectively the long-term results of discectomy for patients with lumbar intervertebral disc herniation. Methods From July 1988 to May 2003, 273 cases of 1040 patients with lumbar intervertebral disc herniation undergone surgical treatment in our hospital were followed up. All patients were divided three groups according the time of follow-up. The follow-up time was three years as middle follow-up group (Ⅰ), five years as longer follow-up group(Ⅱ) and ten years and more as sup-longer follow-up group (Ⅲ). Sixty-eight cases(24.91%) were in group Ⅰ, including 42 males and 26 females, with the average age of 43.7 years (14-63 years). The group Ⅱ included 141 cases (51.65%), 92 males and 49 females, with the average age of 46.1 years (18-76 years). As group ⅡⅢ, 64 cases (23.44%) were included 46 males and 18 females, with the average age of 43.5 years (20-63 years). The standards Scoring System of Chinese Spinal Association (CSA) and Japan Orthopaedic Association (JOA) were used for investigation. Results According to CSA system, the total good and excellent rate of surgical treatment for lumbar intervertebral disc herniation was 89.0%. The percentage of the satisfactory of the group Ⅰ, Ⅱ, Ⅲ were 92.6%, 91.5% and 79.7% respectively. There was significant difference between group Ⅰ and group Ⅱ, Ⅲ. The score of JOA were 24.75±5.08, 22.43±6.55, 21.64±7.18 postoperatively, with significant difference between group Ⅰ and group Ⅱ, Ⅲ. Conclusion The mid-term results of surgery for patients with lumbar iutervertebral disc herniation is good, and the good and excellent rate decreases gradually with the follow-up time. The results were similar to each other for evaluation between the standard of CSA and JOA.     

腰椎间盘突出症术后的中远期疗效分析

Objective To investigate retrospectively the long-term results of discectomy for patients with lumbar intervertebral disc herniation. Methods From July 1988 to May 2003, 273 cases of 1040 patients with lumbar intervertebral disc herniation undergone surgical treatment in our hospital were followed up. All patients were divided three groups according the time of follow-up. The follow-up time was three years as middle follow-up group (Ⅰ), five years as longer follow-up group(Ⅱ) and ten years and more as sup-longer follow-up group (Ⅲ). Sixty-eight cases(24.91%) were in group Ⅰ, including 42 males and 26 females, with the average age of 43.7 years (14-63 years). The group Ⅱ included 141 cases (51.65%), 92 males and 49 females, with the average age of 46.1 years (18-76 years). As group ⅡⅢ, 64 cases (23.44%) were included 46 males and 18 females, with the average age of 43.5 years (20-63 years). The standards Scoring System of Chinese Spinal Association (CSA) and Japan Orthopaedic Association (JOA) were used for investigation. Results According to CSA system, the total good and excellent rate of surgical treatment for lumbar intervertebral disc herniation was 89.0%. The percentage of the satisfactory of the group Ⅰ, Ⅱ, Ⅲ were 92.6%, 91.5% and 79.7% respectively. There was significant difference between group Ⅰ and group Ⅱ, Ⅲ. The score of JOA were 24.75±5.08, 22.43±6.55, 21.64±7.18 postoperatively, with significant difference between group Ⅰ and group Ⅱ, Ⅲ. Conclusion The mid-term results of surgery for patients with lumbar iutervertebral disc herniation is good, and the good and excellent rate decreases gradually with the follow-up time. The results were similar to each other for evaluation between the standard of CSA and JOA.     

腰椎间盘突出症术后的中远期疗效分析

Objective To investigate retrospectively the long-term results of discectomy for patients with lumbar intervertebral disc herniation. Methods From July 1988 to May 2003, 273 cases of 1040 patients with lumbar intervertebral disc herniation undergone surgical treatment in our hospital were followed up. All patients were divided three groups according the time of follow-up. The follow-up time was three years as middle follow-up group (Ⅰ), five years as longer follow-up group(Ⅱ) and ten years and more as sup-longer follow-up group (Ⅲ). Sixty-eight cases(24.91%) were in group Ⅰ, including 42 males and 26 females, with the average age of 43.7 years (14-63 years). The group Ⅱ included 141 cases (51.65%), 92 males and 49 females, with the average age of 46.1 years (18-76 years). As group ⅡⅢ, 64 cases (23.44%) were included 46 males and 18 females, with the average age of 43.5 years (20-63 years). The standards Scoring System of Chinese Spinal Association (CSA) and Japan Orthopaedic Association (JOA) were used for investigation. Results According to CSA system, the total good and excellent rate of surgical treatment for lumbar intervertebral disc herniation was 89.0%. The percentage of the satisfactory of the group Ⅰ, Ⅱ, Ⅲ were 92.6%, 91.5% and 79.7% respectively. There was significant difference between group Ⅰ and group Ⅱ, Ⅲ. The score of JOA were 24.75±5.08, 22.43±6.55, 21.64±7.18 postoperatively, with significant difference between group Ⅰ and group Ⅱ, Ⅲ. Conclusion The mid-term results of surgery for patients with lumbar iutervertebral disc herniation is good, and the good and excellent rate decreases gradually with the follow-up time. The results were similar to each other for evaluation between the standard of CSA and JOA.     

腰椎间盘突出症术后的中远期疗效分析

Objective To investigate retrospectively the long-term results of discectomy for patients with lumbar intervertebral disc herniation. Methods From July 1988 to May 2003, 273 cases of 1040 patients with lumbar intervertebral disc herniation undergone surgical treatment in our hospital were followed up. All patients were divided three groups according the time of follow-up. The follow-up time was three years as middle follow-up group (Ⅰ), five years as longer follow-up group(Ⅱ) and ten years and more as sup-longer follow-up group (Ⅲ). Sixty-eight cases(24.91%) were in group Ⅰ, including 42 males and 26 females, with the average age of 43.7 years (14-63 years). The group Ⅱ included 141 cases (51.65%), 92 males and 49 females, with the average age of 46.1 years (18-76 years). As group ⅡⅢ, 64 cases (23.44%) were included 46 males and 18 females, with the average age of 43.5 years (20-63 years). The standards Scoring System of Chinese Spinal Association (CSA) and Japan Orthopaedic Association (JOA) were used for investigation. Results According to CSA system, the total good and excellent rate of surgical treatment for lumbar intervertebral disc herniation was 89.0%. The percentage of the satisfactory of the group Ⅰ, Ⅱ, Ⅲ were 92.6%, 91.5% and 79.7% respectively. There was significant difference between group Ⅰ and group Ⅱ, Ⅲ. The score of JOA were 24.75±5.08, 22.43±6.55, 21.64±7.18 postoperatively, with significant difference between group Ⅰ and group Ⅱ, Ⅲ. Conclusion The mid-term results of surgery for patients with lumbar iutervertebral disc herniation is good, and the good and excellent rate decreases gradually with the follow-up time. The results were similar to each other for evaluation between the standard of CSA and JOA.     

腰椎间盘突出症术后的中远期疗效分析

Objective To investigate retrospectively the long-term results of discectomy for patients with lumbar intervertebral disc herniation. Methods From July 1988 to May 2003, 273 cases of 1040 patients with lumbar intervertebral disc herniation undergone surgical treatment in our hospital were followed up. All patients were divided three groups according the time of follow-up. The follow-up time was three years as middle follow-up group (Ⅰ), five years as longer follow-up group(Ⅱ) and ten years and more as sup-longer follow-up group (Ⅲ). Sixty-eight cases(24.91%) were in group Ⅰ, including 42 males and 26 females, with the average age of 43.7 years (14-63 years). The group Ⅱ included 141 cases (51.65%), 92 males and 49 females, with the average age of 46.1 years (18-76 years). As group ⅡⅢ, 64 cases (23.44%) were included 46 males and 18 females, with the average age of 43.5 years (20-63 years). The standards Scoring System of Chinese Spinal Association (CSA) and Japan Orthopaedic Association (JOA) were used for investigation. Results According to CSA system, the total good and excellent rate of surgical treatment for lumbar intervertebral disc herniation was 89.0%. The percentage of the satisfactory of the group Ⅰ, Ⅱ, Ⅲ were 92.6%, 91.5% and 79.7% respectively. There was significant difference between group Ⅰ and group Ⅱ, Ⅲ. The score of JOA were 24.75±5.08, 22.43±6.55, 21.64±7.18 postoperatively, with significant difference between group Ⅰ and group Ⅱ, Ⅲ. Conclusion The mid-term results of surgery for patients with lumbar iutervertebral disc herniation is good, and the good and excellent rate decreases gradually with the follow-up time. The results were similar to each other for evaluation between the standard of CSA and JOA.     

腰椎间盘突出症术后的中远期疗效分析

Objective To investigate retrospectively the long-term results of discectomy for patients with lumbar intervertebral disc herniation. Methods From July 1988 to May 2003, 273 cases of 1040 patients with lumbar intervertebral disc herniation undergone surgical treatment in our hospital were followed up. All patients were divided three groups according the time of follow-up. The follow-up time was three years as middle follow-up group (Ⅰ), five years as longer follow-up group(Ⅱ) and ten years and more as sup-longer follow-up group (Ⅲ). Sixty-eight cases(24.91%) were in group Ⅰ, including 42 males and 26 females, with the average age of 43.7 years (14-63 years). The group Ⅱ included 141 cases (51.65%), 92 males and 49 females, with the average age of 46.1 years (18-76 years). As group ⅡⅢ, 64 cases (23.44%) were included 46 males and 18 females, with the average age of 43.5 years (20-63 years). The standards Scoring System of Chinese Spinal Association (CSA) and Japan Orthopaedic Association (JOA) were used for investigation. Results According to CSA system, the total good and excellent rate of surgical treatment for lumbar intervertebral disc herniation was 89.0%. The percentage of the satisfactory of the group Ⅰ, Ⅱ, Ⅲ were 92.6%, 91.5% and 79.7% respectively. There was significant difference between group Ⅰ and group Ⅱ, Ⅲ. The score of JOA were 24.75±5.08, 22.43±6.55, 21.64±7.18 postoperatively, with significant difference between group Ⅰ and group Ⅱ, Ⅲ. Conclusion The mid-term results of surgery for patients with lumbar iutervertebral disc herniation is good, and the good and excellent rate decreases gradually with the follow-up time. The results were similar to each other for evaluation between the standard of CSA and JOA.     

腰椎间盘突出症术后的中远期疗效分析

Objective To investigate retrospectively the long-term results of discectomy for patients with lumbar intervertebral disc herniation. Methods From July 1988 to May 2003, 273 cases of 1040 patients with lumbar intervertebral disc herniation undergone surgical treatment in our hospital were followed up. All patients were divided three groups according the time of follow-up. The follow-up time was three years as middle follow-up group (Ⅰ), five years as longer follow-up group(Ⅱ) and ten years and more as sup-longer follow-up group (Ⅲ). Sixty-eight cases(24.91%) were in group Ⅰ, including 42 males and 26 females, with the average age of 43.7 years (14-63 years). The group Ⅱ included 141 cases (51.65%), 92 males and 49 females, with the average age of 46.1 years (18-76 years). As group ⅡⅢ, 64 cases (23.44%) were included 46 males and 18 females, with the average age of 43.5 years (20-63 years). The standards Scoring System of Chinese Spinal Association (CSA) and Japan Orthopaedic Association (JOA) were used for investigation. Results According to CSA system, the total good and excellent rate of surgical treatment for lumbar intervertebral disc herniation was 89.0%. The percentage of the satisfactory of the group Ⅰ, Ⅱ, Ⅲ were 92.6%, 91.5% and 79.7% respectively. There was significant difference between group Ⅰ and group Ⅱ, Ⅲ. The score of JOA were 24.75±5.08, 22.43±6.55, 21.64±7.18 postoperatively, with significant difference between group Ⅰ and group Ⅱ, Ⅲ. Conclusion The mid-term results of surgery for patients with lumbar iutervertebral disc herniation is good, and the good and excellent rate decreases gradually with the follow-up time. The results were similar to each other for evaluation between the standard of CSA and JOA.     

Surgical venous thrombectomy.

Rehabilitation of the technique of venous thrombectomy is justified, but, in order for this technique to be effective, it must only be performed in selected cases. In the authors' view it is of the utmost value in young patients when the venous thrombosis occurs accidentally, after traumatism or surgery and when a diagnostic is made without delay.     

Rotarex经皮机械血栓切除术与开放取栓治疗急性下肢动脉血栓形成

目的 对比Rotarex经皮机械血栓切除术(PMT)与开放取栓治疗急性下肢动脉血栓形成的效果。方法 回顾性分析32例接受Rotarex PMT(PMT组)及45例接受经股动脉切开取栓(开放组)治疗的急性单侧下肢动脉血栓患者,对比组间球囊使用率及支架植入率,治疗相关并发症发生率、踝肱指数(ABI)变化、疼痛缓解及血管恢复通畅情况,以及截肢率及死亡率。结果 对全部患者均成功完成治疗。PMT组球囊使用率及支架植入率均高于开放组(P均＜0.05)。组间治疗相关并发症发生率差异无统计学意义[3.13%(1/32) vs. 13.33%(6/45),χ²=2.358,P=0.229]。治疗前组间ABI差异无统计学意义(P＞0.05),治疗后3天PMT组ABI低于开放组[(0.77±0.01) vs. (0.84±0.17),P=0.013],治疗后1个月PMT组ABI高于开放组[ (0.80±0.15) vs. (0.72±0.12),P=0.010]。治疗后1个月,PMT组疼痛改善率为90.63%(29/32),高于开放组[77.78%(35/45),P=0.033]。治疗后1、3、6及12个月,组间血管通畅率差异均无统计学意义(P均＞0.05)。治疗后12个月,PMT组截肢率及死亡率[9.38%(3/32)、3.13%(1/32)]与开放组[8.89%(4/45)、4.44%(2/45)]差异均无统计学意义(P均＞0.05)。结论 Rotarex PMT治疗急性下肢动脉血栓与开放取栓效果相当,且更利于缓解症状。