Objective:To compare the efficacy and quality of life of patients with lower extremity varicose veins treated by high ligation and stripping (HLS) without preservation of the great saphenous vein and endovascular radiofrequency ablation (RFA) with preservation of the below-knee great saphenous vein.Methods:The clinical data of 177 patients (217 affected limbs) with lower extremity varicose veins admitted to the Second Hospital of Shanxi Medical University and Taiyuan Central Hospital from May 2018 to April 2020 were retrospectively collected and analyzed. Among them, 90 patients (112 affected limbs) received HLS and 87 patients (105 affected limbs) received RFA. The recurrence rate within 2 years after surgery, postoperative complications, venous clinical severity score (VCSS) and Chronic Venous Insufficiency Questionnaire (CIVIQ-14) were compared between two groups using t and χ2 tests. Results:The length of hospital stay, operation time and intraoperative blood loss in RFA group were significantly less than those in HLS group [(4.67±1.11) d vs (9.34±2.24) d, t=17.523, P<0.001; (57.74±8.36) min vs (121.46±40.55) min, t=14.361, P<0.001; (11.90±3.07) ml vs (85.06±21.21) ml, t=32.378, P<0.001]. In terms of postoperative complications, limb pain and numbness were less common in the RFA group than that in the HLS group, and the differences were startistically significant (8 vs 18, χ2=4.121, P=0.042; 6 vs 16, χ2=4.812, P=0.028). However, there was no significant difference in the incidence of deep vein thrombosis, thrombophlebitis, subcutaneous hematoma, infection, skin induration, and other complications between the two groups. A total of 177 patients completed the 2-year follow-up, of which 2 patients had recurrence in HLS group and no recurrence in the RFA group. The scores of VCSS (HLS group: 5.30±1.07, 1.97±1.29, 1.87±1.31, 9.20±0.96; RFA group: 1.44±0.50, 1.11±0.69, 1.09±0.68, 9.11±0.87) and CIVIQ-14 scores (HLS group: 57.32±5.79, 61.50±5.17, 62.78±4.61, 49.43±5.42;RFA group: 65.15±2.69, 65.43±2.51, 65.72±2.33, 48.82±4.87) in the two groups at 3 months, 1 year and 2 years after operation were significantly improved compared with those before operation [(1) VCSS: HLS group: t=49.313, 48.239, 47.867, all P<0.001; RFA group: t=77.739, 72.145, 71.596, all P<0.001; (2) CIVIQ-14: HLS group: t=-12.700, -17.599, -18.922, all P<0.001; RFA group: t=-26.412, -26.814, -27.974, all P<0.001]. Compared with HLS group, the VCSS score was lower ( t=31.073, 5.469, 4.924, all P<0.001) and CIVIQ-14 score was higher ( t=11.594, -6.464, -5.394, all P<0.001) in RFA group at 3 months, 1 year and 2 years after operation, and the differences were startistically significant. Conclusion:RFA with the preservation of the below-knee great saphenous vein and HLS without the preservation of the below-knee great saphenous vein show good therapeutic effect. Compared with HLS, RFA has shorter operation time, faster postoperative recovery, fewer complications, and improved quality of life during the follow-up period, with higher patient satisfaction.

Objective:To evaluate the mid-term results of surgery-assisted in-situ needle fenestration technique in complicated aortic arch lesion.Methods:The clinical data of 13 patients(11 males and 2 females) with complicated aortic dissection (AD) treated with surgery-assisted in-situ needle fenestration technique from October 2017 to September 2019 were retrospectively analyzed. There were type A AD in 5 cases and type B in 8 cases.Results:In-situ fenestration with c-TAG aortic covered stent was performed on all the 13 patients, among which three supra-arch branches were reconstructed in 8 cases and two supra-arch branches were reconstructed in 5 cases. The technical success rate was 100% (13/13). One patient died of a sudden cerebral hemorrhage 4 months after surgery while the remaining 12 patients were followed up for (23.3±0.7) months. The incidence rate of recurrent postoperative AD was 15.4% (2/13). One patient received ascending aortic replacement due to retrograde AD at 6-month postoperatively. Another patient suffering from cervical artery dissection at the first postoperative month did not receive special treatment because of no discomfort.Conclusion:For complicated aortic arch lesion requiring reconstruction of multiple branches, surgery-assisted in-situ needle fenestration technique showed promising mid-term results.

维持性血液透析目前是肾功能衰竭终末期患者的主要治疗方法.在血液透析过程中,肝素药物是主要的抗凝药物,而在使用过程中肝素诱导血小板减少症(heparin-induced thrombocytopenia,HIT)是其严重的不良反应之一,对患者的预后造成严重的影响,严重者甚至导致死亡.目前研究显示10％血液透析患者血浆中存在HIT抗体,而HIT发生率为0.5％～5.0％[1-2].本研究探讨1例维持性血液透析过程中出现HIT患者治疗过程,现报道如下.

探讨血栓弹力图基本原理.其血液凝固过程中形成的血凝块的黏弹性随着时间发生变化,将这种变化过程与发生变化相对应的时间的函数关系,利用力学原理绘制成图像就是血栓弹力图(TEG),TEG反映了全血的凝血与纤溶能力.通常不超过30min TEG就可较准确地检测出血小板功能以及凝血和纤维蛋白溶解状态,被广泛应用于临床.

目的：通过对临床发生的输血不良反应资料回顾分析探讨有效降低输血不良反应的措施。方法：按《临床输血技术规范》要求，对新乡市中心医院2012—2013年各类输血不良反应回报单进行统计分析。结果：在7980人次输血中，发生输血不良反应24人次，输血不良反应发生率为0.30%，主要表现为过敏及发热反应，其中过敏反应11日次，占45.83%，以输注血浆引起为主；负荷过重1人次占4.16%；其他反应3人次，占12.50%。结论：提高科学合理用血水平及输血新技术、新方法的应用有助于降低输血不良反应发生。