目的 探讨计算机断层扫描血管成像(CTA)下的计算机断层扫描(CT)值与颈动脉斑块患者脑血管症状的相关性.方法 收集2020年1月至2023年1月内蒙古自治区人民医院收治的64例颈动脉斑块患者的临床资料,根据CTA检查显示的CT值评估颈动脉斑块性质,分析CT值与脑血管症状的相关性及具体关系,评估CTA对颈动脉斑块性质的诊断效能.结果 不同颈动脉斑块性质的CT值比较,差异有统计学意义(P﹤0.05).CTA检查显示的CT值与视物模糊、黑蒙、肢体无力、行走不利、间歇性言语不清这些颈动脉斑块患者的脑血管症状均呈负相关(P﹤0.05).CT值较高是颈动脉斑块患者出现脑血管症状的保护因素(P﹤0.05).受试者工作特征(ROC)曲线分析结果显示,CT值≥145.11 Hu的颈动脉斑块患者不易出现脑血管症状,CTA显示的CT值对颈动脉斑块患者出现脑血管症状具有中等评估价值(AUC=0.772,95%CI:0.514～1.000,P=0.013),灵敏度和特异度分别为75.00%、94.64%.结论 CTA下的CT值与颈动脉斑块患者主要脑血管症状的发生具有明确相关性,硬质斑块是脑血管主要症状发生的保护因素,而存在软性斑块与混合斑块的患者更易发生脑血管症状.

目的:探讨超声下腔内激光消融联合点式剥脱治疗大隐静脉曲张的效果和安全性观察.方法:选取我院血管外科在2019年1月到2021年12月收治的140例大隐静脉曲张患者作为研究对象.将所有患者依照住院号单双号进行分组,分为联合组与对照组,每组70例.对照组采用常规高位结扎联合抽剥术进行治疗,联合组采用超声下腔内激光消融联合点式剥脱进行治疗.对比两组手术指标、临床疗效、术前术后下肢深静脉瓣膜功能变化以及术后并发症的发生率.结果:联合组的手术耗时较对照组高,术中出血量、切口个数及住院时间均较对照组低(P＜0.05);两组临床疗效分布对比有明显差异,且联合组显效率高于对照组(P＜0.05);术后3个月两组VCT均有缩短,Vmax均有提升,且联合组术后3个月VCT较对照组短,Vmax较对照组高(P＜0.05);联合组术后并发症较对照组低(P＜0.05).结论:对大隐静脉曲张患者采用超声下腔内激光消融联合点式剥脱方法治疗,与常规手术相比疗效更佳,且能够明显改善患者下肢静脉瓣膜功能,安全性高.

目的 观察紫杉醇药物涂层球囊(DCB)治疗股腘动脉闭塞性动脉硬化的疗效及安全性.方法 收集2018年1月至2020年2月内蒙古自治区人民医院收治的86例股腘动脉闭塞性动脉硬化患者.按照治疗方法的不同将其分为研究组(n=43,予以紫杉醇DCB治疗)和对照组(n=43,予以普通球囊治疗).术前、术后6个月,比较两组患者Rutherford分级、踝肱指数(ABI)、靶病变最小管腔直径(MLD)、晚期管腔丢失(LLL)、不良事件发生率.结果 术后6个月,研究组患者ABI高于对照组患者,MLD宽于对照组患者,LLL少于对照组患者,Rutherford分级优于对照组患者;研究组患者不良事件总发生率为13.95％(6/43),低于对照组患者的34.88％(15/43),差异均有统计学意义(P<0.05).结论 股腘动脉闭塞性动脉硬化患者行紫杉醇DCB疗法可以获得良好的疗效,术后不良事件发生率较低,值得临床推广使用.

目的:探究脱细胞真皮基质治疗对糖尿病足综合征合并下肢动脉硬化闭塞患者神经病变的缓解作用和对足部功能的影响.方法:选择本院2017.5-2020.5收治的80例糖尿病足综合征合并下肢动脉硬化闭塞患者平均分为观察组和对照组2组,其中对照组患者给与常规干预结合下肢动脉腔内治疗,观察组则在对照组的基础上实施脱细胞真皮基质治疗.分析两组患者治疗前后TCSS评分、神经传导速度、足部功能、治疗效果、创面感染发生率、治疗费用以及并发症发生率的差异.结果:治疗后观察组患者TCSS评分和足部功能评分均较对照组低,神经传导速度较对照组快,差异有统计学意义(P＜0.05);观察组患者治疗总有效率、患者创面感染发生率和并发症发生率分别为100.00％、2.50％和2.50％,对照组患者则分别为80.00％、17.50％和55.00％,且对照组住院费用较观察组高,差异有统计学意义(P＜0.05).结论:脱细胞真皮基质治疗对糖尿病足综合征合并下肢动脉硬化闭塞患者神经病变具有确切的缓解作用,尤其对足部功能效果显著,值得临床广泛推广使用.

目的:为提高治疗效率,本研究对髂静脉压迫综合征合并下肢深静脉血栓患者的导管接触溶栓同期球囊扩张+支架治疗方案和分期治疗方案进行比较.方法:以65例髂静脉压迫综合征合并下肢深静脉血栓患者为研究对象,根据治疗方法分为研究组和对照组,研究组32例,进行导管接触溶栓同期球囊扩张+支架治疗,对照组33例,进行导管接触溶栓分期球囊扩张+支架治疗.以治疗前后患者大腿围、小腿围、血管通畅评分,手术指标(住院时间、住院次数、溶栓时间及穿刺次数),并发症(血栓复发、出血以及肺栓塞)及深静脉血栓后遗症为指标,考察两组疗效.结果:两组患者大腿围、小腿围和静脉畅通评分在治疗前均无显著差异(P＞0.05),经过治疗,两组大腿围、小腿围和静脉畅通评分均显著改善(P＜0.05),但两组间各项指标无显著差异(P＞0.05).研究组患者住院时间、住院次数、溶栓时间及穿刺次数均显著低于对照组(P＜0.05).研究组血栓复发0例,对照组血栓复发4例,有显著差异(P＜0.05);研究组出血1例,肺栓塞0例,对照组出血2例,肺栓塞0例,两组出血和肺栓塞情况比较,无显著差异(P＞0.05).研究组PTS发生率为6.25％,显著低于对照组的18.18 ％(P＜0.05).结论:导管接触溶栓同期球囊扩张+支架治疗方案对髂静脉压迫综合征合并下肢深静脉血栓有良好的疗效.

Objective To explore the effect of high ligation combined with endovenous laser in the treatment of great saphenous varicose veins. Methods 90 patients with great saphenous varicose veins admitted in our hospital during August 2012 and August 2014 were randomized into observation group(n=45) and control group(n=45) in which high ligation combined with endovenous laser and single endovenous laser were performed in them respectively. The therapeutic effects of the two groups were compared. Results After treatment, the unilateral operation time, incision number, intraoperative blood loss and hospitalization time of the two groups were(44±9)min,(3±1),(20±9)mL;(4±2)d vs(79±9)min,(5±2),(59±19)mL,(11±3)d, therefore in terms of clinical in-dicators above, the observation group was superior to the control group with statistically significant difference(P<0.05). What's more, there was statistically significant difference in complication rate between the two groups, 35.48%vs 59.68%(P<0.01). Conclusion High ligation combined with endovenous laser is worthy of clinical promotion in the treatment of great saphenous varicose veins due to its remarkable effect and low complication rate.

Objective To study the great saphenous vein high ligation joint lumen laser for the treatment of closed lower extremity varicose veins clinical effect.Methods Between January 2013 and May 2013 in our hospital between treatment of 68 patients with lower extremity varicose veins, were divided into treatment group and control group, 34 cases, adopt different treatment the curative effect comparison.Results Treatment group in 17 cases cured, 3 had no effect, the effective rate was 91.2%; the control group in 9 cases cured, 12 cases ineffective, effective rate was 64.7%. Two sets of results compared with signiifcant difference (P<0.01).Conclusion The great saphenous vein high ligation joint lumen laser closed surgery is an effective in the treatment of varicose veins of lower limb, which were liable to occur during laser closed operation complications, worthy of clinical research.

目的：对31例右下肢深静脉血栓患者的诊断治疗方式及效果进行分析评价。方法选取我院的31例右下肢深静脉血栓患者的诊疗资料为研究对象，按照治疗方式不同分为西医常规治疗组和西医综合治疗组，观察两组右下肢深静脉血栓患者的临床治疗效果。结果西医常规治疗组治疗后对患者疼痛总有效率为100%，西医综合治疗组为100%，两组相比，总有效率相同；西医常规治疗组治疗后对患者肿胀总有效率为85.71%，西医综合治疗组为94.12%，两组相比，总有效率不同；西医常规治疗组治疗后总有效率为85.71%，西医综合治疗组为94.12%，两组相比，总有效率不同。结论对右下肢深静脉血栓的治疗西医综合治疗的治疗效果更好。

Objective To study the clinical effect of interventional therapy for elderly patients with arteriosclerosis obliterans in lower extremity. Methods 60 patients with arteriosclerosis obliterans in lower extremity admitted in our hospital during April 2012 and April 2013 were randomly divided into control group in which the 30 patients were treated with artificial vessels bypass, and the observation group in which the other 30 patients underwent interventional therapy. The total effective rates and recurrence rates were compared between them. Results The total effective rate was higher in the observation group (96.7%) than in the control group (80.0%) with statistically significant difference(P<0.05); 1 year follow-up showed that the recurrence rate was lower in the observation group(3.3%) than in the control group(13.3%) with statistically significant difference(P<0.05). Conclusion Interventional therapy is worthy of clinical application and promotion in the treatment of elderly patients with arteriosclerosis obliterans in lower extremity due to its remarkable effect.

<正>胆石症是急性胰腺炎的重要病因之一。老年人胆源性急性胰腺炎具有合并症多和病死率高等特点。病情复杂,治疗难度大。现将我科2005年1月～2008年12月收治的老年人胆源性急性胰腺炎26例治疗情况报道如下。1资料与方法1.1一般资料本组病人26例,男17例,女9例;年龄65～81