• 主题
高级搜索  >
历史搜索 清空历史
您现在的位置：首页> 中文期刊>外科学>医药卫生>中华血管外科杂志

中华血管外科杂志

中华血管外科杂志

Chinese Journal of Vascular Surgery
《中华乳腺病杂志(电子版)》系国内唯一公开发行的乳腺病专业学术期刊。本刊由著名肿瘤学专家孙燕院士担任名誉总编辑，姜军教授担任总编辑。本刊自2007年创刊起连续被国家新闻出版广电总局列为“十一五”和“十二五”重点电子出版物出版规划项目，且从2009年起连续多次通过中国科技信息研究所信息分析研究中心的综合评定和专家评议，被遴选为国家科技部“中国科技论文统计源期刊(中国科技核心期刊)”，2015年被收录为中国科学引文数据库(CSCD)来源期刊，并先后被《中文科技期刊数据库(全文版)》、《中国学术期刊网络出版总库》、《中国核心期刊(遴选)数据库》、美国《化学文摘》(CA)、波兰《哥白尼索引》(1C)、《乌利希期刊指南》、 《中文生物医学期刊文献数据库》(CMCC)、 《中国生物医学期刊引文数据库》(CMCl)等国内外重要检索系统收录。本刊自创刊以来多次荣获中华医学会优秀期刊奖和中华医学会电子版系列杂志优秀编校质量奖。本刊以从事乳腺疾病相关专业医务和科研工作者为主要读者对象，报道乳腺疾病领域领先的科研成果、临床诊断治疗技术和经验，介绍国内外乳腺病领域最新的发展趋势。
更多
  • 发文量：298
  • 被引量：73
  • H指数：0
  • 开始收录时间：-
  • CNKI综合因子：-
  • 维普期刊影响因子： -
  • 万方期刊影响因子：0.64
  • 创刊时间：-
  • 国内刊号/CN：10-1411/R
    国际刊号/ISSN：2096-1863
  • 发行周期：季刊
    邮发代号：-
  • 主管单位：中国科学技术协会
    主办单位：中华医学会
中华血管外科杂志-联系信息
  • 主编：-
  • 电话：020-28823189
  • 邮箱：cjvs@cmaph.org
  • 地址：广州市越秀区竹丝岗二马路5号之一龙珠大厦2层
  • 邮编：100710
中华血管外科杂志-获奖情况
  • 暂无获奖信息
  • 收录汇总
  • 刊内文献检索
  • 投稿信息

刊期浏览

相关中文期刊

相关中文会议

相关外文期刊

相关外文会议

最新期刊

热门期刊

中华血管外科杂志 >2021年第3期

学科

年度

全选（0）
排序：
共4384条结果
  • 摘要：血透通路是血液透析患者的生命线,如何更好的维护血透通路一直困扰医护人员.既往针对血透通路失功,主要采取取栓、溶栓及重建等手术方法,随着介入技术的发展,部分患者可通过经皮球囊扩张成形术 (percutaneous transluminal angioplasty, PTA) 或 经 皮 血 管 支 架 植 入 术 (percutaneous transluminal stenting, PTS )等介入方法获益.我院自2014年12月至2017年4月, 通过介入技术治疗21例血透通路失功患者,现总结如下.
  • 摘要：Objective To investigate the possible correlation between carotid artery calcification score (CS) and cognitive impairment of carotid artery stenosis (CAS) patients. Methods Carotid artery plaque volume was measured in 123 carotid arteries using multi-detector computer tomography angiography and magnetic resonance imaging, we measured the CS of each sample and divided them by recognition examination and degree of luminal stenosis. Together with other risk factors for cognitive impairment including age, education level, hypertension, diabetes mellitus, smoking, hyperlipidemia and body mass index, the CSs had been analyzed by Kruskal-wallis test for their association with cognitive function. Correlation analysis was launched between MRI parameters、cognitive scores and CS. Follow-up review analysis was operated on 38 postoperative patients. Results In the Kruskal-Wallis analysis of CSs between groups divided by degree of cognitive impairment and luminal stenosis, the results both showed significantly difference (P<0.001). Significant correlation was discovered with CS and cognitive scores in patients with carotid artery stenosis ( P<0.001), while the correlation did not exist within postoperative patients(P=0.348). It was shown the correlation between CS and MRI parameters in pre-operative patients. Conclusion Carotid artery calcification scores show significant correlation with cognitive impairment and the degree of stenosis, which can be used as an independent risk factor for early screening. The possible mechanism may be related to the calcification-impact on the stability of the plaques.%目的 探讨颈动脉狭窄(CAS)患者的钙化积分(CS)与其认知障碍关联性及其可能机制.方法 通过对123例CAS患者行多层螺旋CT扫描,计算患者颈动脉斑块内CS,同时通过磁共振扫描采集患者脑灌注参数[相对脑血流量(rCBF)、相对脑血容量(rCBV)、相对平均通过时间(rMTT)、血流达峰时间TTP)及血流到达时间(TO)].将所有患者按认知障碍程度和CAS程度分组,将所测得CS数据与认知潜在的常规危险因子(年龄、性别、高血压、糖尿病、高血脂、吸烟史及体重指数)一并进行分组对比差异性分析,同时对同一患者的认知评分、磁共振灌注参数与CS进行关联性分析,并对术后38例患者进行随访分析.结果 与年龄、 高血压及糖尿病相似,CS值在不同认知功能的患者中具有显著差异性分布(P<0.001);与年龄、 性别、 高血压及糖尿病相似,CS值在不同CAS程度患者中具有显著差异性分布(P<0.001).患者的CS值与其认知评分存在显著相关性(P<0.001),术后随访患者CS值与认知评分无明确相关性(P=0.348);CS值与患者磁共振灌注参数中的rMTT、TTP及TO参数均存在显著相关性(P<0.001).结论 颈动脉CS与CAS患者的认知障碍及狭窄程度均存在显著相关性,可作为其独立危险因子,其机制可能与钙化对斑块稳定性的影响有关.
  • 摘要：目的 总结近端脑保护装置(MoMa系统)下颈动脉支架成形术(CAS)的经验,并探讨其应用过程中的技术要点及围术期处理方法.方法 回顾性分析2014年8月至2016年8月本中心收治,在近端脑保护装置下完成CAS的27例颈动脉狭窄患者的临床资料,详细记录术前评估、 术中操作过程、 围手术期病情变化及术后随访资料.结果 患者均在近端脑保护装置下完成CAS,技术成功率100%.颈动脉中度狭窄4例(13.8%),重度狭窄16例(59.3%),闭塞前病变7例(25.9%).前9例患者采用局麻,后18例患者采用全麻;26例患者采用股动脉入路,1例患者经右侧肱动脉入路;平均手术时间(53.3±10.5)min,平均阻断时间(5.07±1.06)min;围手术期无严重不良事件,19例患者术中出现颈动脉窦反射,6例患者予以阿托品干预,7例患者可见黄色粥样斑块滤出;术后3例患者呈现不同程度血流动力学不稳定,2例患者出现短暂脑缺血表现,均顺利恢复;术后随访时间6~24个月,症状不同程度改善,未出现短暂性脑缺血发作、脑梗死、肢体活动异常等颈动脉相关神经症状,未见显著的支架内再狭窄.结论 近端脑保护装置下CAS安全有效,充分理解CEA的手术原理及操作流程,有效调控血流阻断与诱导性升压的关系,有助于熟练学习并运用MoMa系统.%Objective To summarize the clinical effects, experience and complications of carotid artery stenting (CAS) using proximal cerebral protection device, and to investigate its technical points and perioperative management. Methods Twenty-seven patients with carotid artery stenosis between August 2008 and August 2016 were analyzed retrospectively. The patients ' preoperative assessment, operational process, condition changes and follow-up were recorded in detail. Results All of the patients received CAS under proximal cerebral protection device. The technical success rate was 100%. Among the patients, moderate stenosis was recorded in 4 cases (13.8%), severe stenosis in 9 cases (59.3%), and pre-occlusion stenosis in 7 cases (25.9%). Procedures were performed under local anesthesia in 9 cases, and under general anesthesia in 18 cases. Access through femoral artery and right brachial artery were gained in 26 cases and 1 case, respectively. The average operation time was (53.3 ±10.5)min and average cross-clamp time of carotid artery was (5.07 ±1.06) min. There were no adverse events during perioperative?period. Carotid sinus reflex was motivated in 19 cases during surgery, among which 6 were treated with atropine. Yellow atherosclerotic plaques were captured by filter in 7 cases. Hemodynamic instability and transient cerebral ischemia were found in 3 and 2 cases, respectively, and all of these 5 patients recovered well. After 6-24 months of follow-up, patients' symptoms were improved at different level. All patients were free from neurological symptoms such as TIA, cerebral infarction, abnormal physical activity, and in-stent restenosis. Conclusion Carotid artery stenting with proximal cerebral protection device is relatively safe and effective. Adequate understanding of CAS and effective regulation of blood blocking and elevated blood pressure are crucial to mastery of Mo. Ma device.
  • 摘要：目的 探讨超声造影(CEUS)技术在经外周静脉穿刺中心静脉置管(PICC)相关性血栓诊断中的应用价值.方法 2015年8月至2016年8月,在天津医科大学总医院普通外科超声介入室对23例临床怀疑PICC相关性血栓但常规超声不能确诊的患者行CEUS检查,比较常规超声和CEUS两种检查方法的血栓检出情况,总结分析CEUS的诊断价值.结果 CEUS在腋静脉和肱静脉处的血栓检出例数多于常规超声检查,差异有统计学意义(P<0.05);CEUS检查可对存在彩色外溢、低流速下无明显血流信号、临床症状严重等PICC相关性血栓可疑者做出进一步诊断,明确血栓形成情况.结论 对于临床怀疑PICC相关性血栓但常规超声难以确诊者,可进一步实施CEUS检查,其过程安全,结果可靠,值得推广应用.
  • 摘要：目的 评估应用台上体外改造覆膜支架行开窗胸主动脉修复术治疗伴有不良锚定区的急性Stanford B型夹层的早期结果.方法 回顾性分析2015年11月至2016年12月按纳入和排除标准收集的天津医科大学总医院血管外科20例伴有不良锚定区的急性Stanford B型夹层患者的临床资料.分析台上体外开窗技术的应用及围手术期并发症情况,并观察早期治疗结果.结果 本组20例患者中,男性16例(80%),中位年龄53(18~83)岁.入组患者均为伴有不良锚定区的复杂性急性Stanford B型夹层患者,包括短锚定区4例、逆撕夹层累及左侧锁骨下动脉(LSA)13例、逆撕血肿累及LSA 3例.4例采用美敦力Valiant支架、10例采用波士顿医疗Relay支架、6例采用先健Ankura支架.支架改造中位时间45(30~60)分钟.LSA单开窗19例、一窗(LSA))一槽(左侧颈总动脉)1例.平均发病至手术间隔时间为(5±3)天.初始技术成功率90%.1例出现Ⅲ型内漏,二次介入采用封堵器封堵漏口;1例开窗定位不准,采用烟囱技术补救.平均手术时间(101±48)分钟,平均透视时间(24±16)分钟.无围手术期死亡及神经系统并发症.1例术后出现左肱动脉假性动脉瘤,行手术切除.1例术后肾功能不全加重,非手术治疗好转.平均住院时间为(9±6)天.平均随访时间为6(1~13)个月,未发现并发症、所有开窗分支血管通畅、无开窗相关Ⅰ和Ⅲ型内漏.结论 从早期观察结果来看,应用台上体外改造覆膜支架行开窗胸主动脉修复术是一种安全、有效的治疗伴有不良锚定区的急性Stanford B型夹层的方法.
  • 摘要：颈动脉内膜切除术(CEA)已是治疗颈动脉狭窄、预防脑卒中公认的'金标准',但其对于改善症状性颈动脉狭窄患者在视觉、听觉以及认知功能等方面临床症状的相关研究,目前疗效尚存争议,其机制也尚未明确.本文针对CEA在症状性颈动脉狭窄患者对视觉、听觉及认知功能等方面的影响,从临床疗效、作用机制等方面作一综述.
  • 摘要：本刊从2008年开始增加继续医学教育项目。主要内容为皮肤病及其相关疾病的诊断和治疗，某些治疗方法在皮肤科的应用进展等。我们在每期出测试题，最后1期附答题卡，您只要将正确答案填在答题卡上，并在规定时间内将答题卡寄回编辑部，即可获得中国中西医结合学会继续教育学分6学分。
  • 摘要：目的 探讨CT增强血管造影对孤立性内脏动脉夹层的临床诊断及治疗价值.方法 回顾性分析2012年至2015年中山大学附属第一医院放射科增强CT诊断的孤立性内脏动脉夹层患者的临床及影像资料,对肠系膜上动脉夹层的CT血管造影征象与临床症状及治疗选择的相关性进行研究.结果 51例患者的56例内脏动脉夹层,包括49例肠系膜上动脉夹层,4例髂动脉夹层,2例肾动脉夹层,1例腹腔干夹层.内脏动脉夹层长度(53.3±32.1)mm,真腔直径(3.4±1.7)mm,真腔残留率(40.9±11.3)%.51例患者中,1例外科治疗,8例血管内介入治疗,42例保守治疗.结论 增强CT血管造影可作为发现孤立性内脏动脉夹层、评价治疗效果及追踪复查的有效方法.%Objective To study the value of enhanced computed tomography (CT) angiography in the diagnosis and treatment decision of isolated dissection of the visceral arteries. Methods Retrospectively evaluated the clinical report and CT imaging of isolated dissection of the visceral arteries from 2012 to 2015. Studied the relationship of CT features with clinical symptom, treatment strategy in superior mesenteric artery. Results Fifty-six isolated dissections of the visceral artery were found in 51 patients, including 49 superior mesenteric artery dissections,4 iliac artery dissections,2 renal artery dissections and 1 celiac artery dissection. The length of visceral artery dissection was(53.3±32.1)mm,true lumen diameter was(3.4±1.7)mm,true lumen residual diameter was (40.9±11.3)%. In 51 patients, one achieved surgery, 8 achieved endovascular treatment and 42 were treated conservatively. Conclusion Enhanced CT angiography is an effective method in detecting isolated dissection of the visceral arteries, and plays an important role in therapy evaluation and follow-up.
  • 摘要：全球范围内, 脑卒中已经成为第2位的致死原因(1)而据《中国脑卒中防治报告(2015)》,近5年来,我国脑卒中发病率增长13.19%,高危人群发病率为14.01%, 脑卒中已经成为我国国民第1位的死亡原因. 约20%~30%的脑卒中与动脉粥样硬化性颈动脉狭窄有关(2)研究表明,颈动脉狭窄>60%的无症状患者第 1 年发生脑卒中的风险为2.4%[3], 颈动脉狭窄70%~79%的有症状的患者第1 年发生脑卒中的风险为19%, 而颈动脉狭窄≥90%者第1年发生脑卒中的风险则高达33%(4)因此,科学规范的颈动脉狭窄治疗对于预防脑卒中的发生十分重要,其包括药物治疗、外科治疗(开放手术和血管腔内治疗).
  • 摘要：目的 总结近端脑保护装置(MoMa系统)下颈动脉支架成形术(CAS)的经验,并探讨其应用过程中的技术要点及围术期处理方法.方法 回顾性分析2014年8月至2016年8月本中心收治,在近端脑保护装置下完成CAS的27例颈动脉狭窄患者的临床资料,详细记录术前评估、 术中操作过程、 围手术期病情变化及术后随访资料.结果 患者均在近端脑保护装置下完成CAS,技术成功率100%.颈动脉中度狭窄4例(13.8%),重度狭窄16例(59.3%),闭塞前病变7例(25.9%).前9例患者采用局麻,后18例患者采用全麻;26例患者采用股动脉入路,1例患者经右侧肱动脉入路;平均手术时间(53.3±10.5)min,平均阻断时间(5.07±1.06)min;围手术期无严重不良事件,19例患者术中出现颈动脉窦反射,6例患者予以阿托品干预,7例患者可见黄色粥样斑块滤出;术后3例患者呈现不同程度血流动力学不稳定,2例患者出现短暂脑缺血表现,均顺利恢复;术后随访时间6~24个月,症状不同程度改善,未出现短暂性脑缺血发作、脑梗死、肢体活动异常等颈动脉相关神经症状,未见显著的支架内再狭窄.结论 近端脑保护装置下CAS安全有效,充分理解CEA的手术原理及操作流程,有效调控血流阻断与诱导性升压的关系,有助于熟练学习并运用MoMa系统.
  • 摘要：目的 探讨单纯抗凝治疗对比置管溶栓(CDT)联合抗凝治疗急性髂股静脉血栓形成(IFVT)的中远期疗效.方法 回顾性分析2012年2月至2016年7月我科收治的急性IFVT患者临床资料,分为单纯抗凝组(A组,34例)、CDT+抗凝组(B组,41例).对比两组治疗后血管通畅情况、Villalta评分和CIVIQ-2评分.结果 共纳入病例90例,75例获得随访,A组平均随访(24.74±18.97)个月,B组平均随访(18.66±12.46)个月.随访12、24个月时,A、B两组静脉通畅率比较差异均有统计学意义[(0.58±0.25)%比(0.93±0.13)%及(0.62±0.25)%比(0.94±0.13)%,P值均<0.05];两组Villalta评分比较差异无统计学意义[(2.47±1.19)分比(2.00±1.28)分;(2.15±1.26)分比(1.78±1.33)分,P值均>0.05];两组血栓形成后综合征(PTS)的发生率分别为8.8%、4.9%;两组CIVIQ-2评分分别为[(21.82±1.96)分比(20.95±1.20)分,P<0.05]及[(21.35±1.92)分比(20.73±1.10)分,P>0.05].两组住院期间并发症发生率比较差异无统计学意义.结论 对于保护静脉瓣膜结构、提高深静脉通畅度,降低PTS发生,改善后期生活质量,CDT联合抗凝治疗优于单纯抗凝.
  • 摘要：Objective To analyze the validity of Caprini risk assessment scale in evaluation of deep vein thrombolysis (DVT) risk among patients after stroke, and to explore the effect based on Caprini risk score to prevent DVT. Methods A retrospective case-control study design was used to collect 212 cases of DVT patients after stroke admitted to the the third affiliated hospital of Qingdao university from January 2015 to December 2015 as DVT group, 212 patients admitted during the same period of non DVT patients were randomly selected as control group. The risks score were retrospectively assessed with the Caprini risk assessment model, and the relationship between the DVT risk classification and the DVT was analyzed. Results Caprini score of patients in DVT group was significantly higher than that in the control group [(7.7 ±2.5) vs. (4.8 ±2.4), P<0.001]. In DVT patients, the largest proportion of high-risk patients (120 cases, 57.1%), followed by high risk (47 cases, 22.2%), high-risk and above accounted for 79.3% of total;in the no thrombus group, low risk accounted for the largest proportion (61 cases, 28.8%), followed by high risk (60 cases, 28.3%), the lowest was very high (42 cases, 19.8%), the difference was statistically significant between the two groups (P<0.001). Caprini risk assessment scale of risk factors as independent variables were analyzed by logistic regression analysis. The results showed that obesity (body mass index greater than or equal to 25 kg/m2), lower extremity edema (<1 months), age (over 60 years), bedrest time longer than 72h, DVT/PTE disease history and family history of thrombosis were the major risk factors of the occurrence of DVT among patients after stroke. The relationship between Caprini risk classification and DVT risk in patients with stroke showed that the very high risk and high risk of stroke patients were at high risk of DVT population, the risk of DVT were 12.756 times and 2.136 times respectively. Conclusion Caprini risk assessment model can effectively assess the risk of DVT among patients after stroke, and can be clinically applicable.%目的 分析Caprini血栓风险评估模型在脑卒中患者深静脉血栓形成(DVT)筛选中的有效性,探讨依据Caprini风险评分预防DVT发生的效果.方法 采用回顾性病例对照研究设计,选择青岛大学第三附属医院青岛市市立医院脑科中心2015年1月至2015年12月收治的5268例脑卒中患者中确诊的212例DVT患者作为DVT组,采用随机数字表法选择同时期入院的212例未发生DVT的脑卒中患者作为无栓组.采用Caprini血栓风险评估模型对两组患者进行回顾性风险评分、DVT危险度分级,并分析评分及危险度分级与实际发生DVT的相关关系.结果 DVT组患者Caprini评分明显高于无栓组[(7.7±2.5)比(4.8±2.4),P<0.001].DVT患者中,极高危患者所占比例最多(120例,57.1%)、其次为高危(47例,22.2%),高危及以上者合计占79.3%;无栓组中,低危所占比例最多(61例,28.8%)、其次为高危(60例,28.3%)、最低为极高危(42例,19.8%),两组构成之间差异具有统计学意义(P<0.001).基于Caprini量表危险因素的Logistic回归分析,结果显示:肥胖(体质指数≥25kg/m2)、下肢水肿(<1个月)、年龄(≥60岁)、需长期卧床(>72h)、DVT/肺血栓栓塞症疾病史、血栓家族史等6个危险因素是脑卒中患者并发DVT的主要危险因素.脑卒中患者Caprini危险度分级与DVT发病风险关系分析显示:极高危和高危的脑卒中患者是DVT发病的高危人群,DVT的发病风险分别为低危患者的12.756倍和2.136倍.结论 基于Caprini血栓风险评估模型可以很好的预测脑卒中患者DVT的发病风险,值得在临床中推广应用.
  • 摘要：目的 评估应用台上体外改造覆膜支架行开窗胸主动脉修复术治疗伴有不良锚定区的急性Stanford B型夹层的早期结果.方法 回顾性分析2015年11月至2016年12月按纳入和排除标准收集的天津医科大学总医院血管外科20例伴有不良锚定区的急性Stanford B型夹层患者的临床资料.分析台上体外开窗技术的应用及围手术期并发症情况,并观察早期治疗结果.结果 本组20例患者中,男性16例(80%),中位年龄53(18~83)岁.入组患者均为伴有不良锚定区的复杂性急性Stanford B型夹层患者,包括短锚定区4例、逆撕夹层累及左侧锁骨下动脉(LSA)13例、逆撕血肿累及LSA 3例.4例采用美敦力Valiant支架、10例采用波士顿医疗Relay支架、6例采用先健Ankura支架.支架改造中位时间45(30~60)分钟.LSA单开窗19例、一窗(LSA))一槽(左侧颈总动脉)1例.平均发病至手术间隔时间为(5±3)天.初始技术成功率90%.1例出现Ⅲ型内漏,二次介入采用封堵器封堵漏口;1例开窗定位不准,采用烟囱技术补救.平均手术时间(101±48)分钟,平均透视时间(24±16)分钟.无围手术期死亡及神经系统并发症.1例术后出现左肱动脉假性动脉瘤,行手术切除.1例术后肾功能不全加重,非手术治疗好转.平均住院时间为(9±6)天.平均随访时间为6(1~13)个月,未发现并发症、所有开窗分支血管通畅、无开窗相关Ⅰ和Ⅲ型内漏.结论 从早期观察结果来看,应用台上体外改造覆膜支架行开窗胸主动脉修复术是一种安全、有效的治疗伴有不良锚定区的急性Stanford B型夹层的方法.%Objective To evaluate the early results of fenestrated thoracic endovascular aortic repair (fTEVAR) using physician-modified stent grafts (PMSGs) to revascularize left subclavian artery (LSA) for acute type B aortic dissection (ABAD) with unfavorable proximal landing zone. Methods Twenty consecutive patients who underwent fTEVAR using PMSGs between Nov 2015 and Dec 2016 were retrospectively reviewed. The modality of the fTEVAR technique was assessed, peri-operative clinical data were recorded and the early results were evaluated. Results The median patient age was 53 years old (range, 18-83years), and 16 of the 20 (80%) patients were male. Indications were complex ABAD with unfavorable proximal landing zones, including inadequate proximal landing zone (n=4), retrograde dissection extending to the LSA (n=13), and retrograde hematoma involving the LSA (n=3). Twenty PMSGs (Medtronic Valiant stent grafts, n=4; Relay thoracic stent grafts, n=10; Ankura thoracic stent grafts, n=6) were deployed. One LSA fenestration was created in 19 patients, and one LSA fenestration combined with a left common carotid artery (LCCA) scallop were created in 1 patient. Initial technical success rate was 90% (18 of 20). Partial coverage of the LCCA in one patient was resolved through a chimney uncovered stent implantation in the LCCA. TypeⅢendoleak occurred in this patient one week after fTEVAR and was resolved by re-intervention with deployment of an Amplatzer occluder device across the site of the leak. A chimney stent was deployed to solve the misalignment of the LSA in another patient. Mean operative time was 101 ±48 minutes, and mean fluoroscopy time was 24 ±16 minutes. Mean duration of hospital stay was 9 ±6 days (range, 5-26 days). One patient presented with a left brachial artery (LBA) pseudoaneurysm at the puncture site that required open repair. One patient presented with renal deterioration post-operatively and recovered uneventfully after the conservative therapy. There were no in-hospital death and no peri-operative neurologic complications. All the patients survived at a mean follow-up of 6 months (range, 1~13 months). During follow up, no postoperative complications occurred, all target vessels remained patent and no fenes-tration-related type Ⅰ or Ⅲ endoleaks were observed. Conclusions fTEVAR using PMSGs may be a vi-able alternative for patients with complicated ABAD with unfavorable proximal landing zones, when pa-tients are unable to wait for a custom-made fenestrated device.
  • 摘要：颈动脉闭塞往往见于颈动脉狭窄基础上的血栓形成或粥样斑块进展性增厚致使管腔闭塞、突发血管夹层病变、斑块或栓子脱落栓塞所致,或者炎性血管病变持续进展而成,因其病因和发病时间的缓急情况不同,而又分为急性颈动脉闭塞与慢性颈动脉闭塞.慢性颈动脉闭塞与同侧的缺血性脑卒中发生风险直接相关:在抗凝和抗血小板治疗的症状性颈动脉闭塞患者中,每年中风总的发生风险概率为5%~7%, 并且闭塞颈动脉同侧大脑半球每年发生中风风险概率为2%~6%;因此,选择合适的手术时机、 恰当的干预措施治疗慢性颈动脉闭塞病变,对降低因颈动脉闭塞导致的脑卒中事件有着重要的意义.本文旨在对慢性颈动脉闭塞的治疗方式进行探讨,为临床规范化诊治颈动脉闭塞提供依据.
  • 摘要：目的 比较不同手术方案对双侧颈动脉重度狭窄的治疗效果.方法 回顾性分析38例双侧颈动脉重度狭窄患者的临床资料,依据手术方式分成双侧颈动脉内膜剥脱术(双CEA组,10例)、双侧颈动脉支架成形术(双CAS组,13例)及CEA/CAS组(15例).结果 三组患者在临床症状改善上无明显差异(P=0.657).双CAS组术后3例(23.1%)患者出现低血压,明显高于其他两组(P=0.044).术后5例患者出现心动过缓,三组间比较差异无统计学意义(双CEA:双CAS:CEA/CAS=1:3:1,P=0.415).3例患者术后发生缺血性脑卒中,双CEA组1例(10%),双CAS组2例(15.4%),三组之间差异无统计学意义(P=0.309).术后高灌注综合征6例,三组之间比较差异无统计学意义(双CEA:双CAS:CEA/CAS=2:3:1,P=0.451).双CEA组和双CAS组术后各有1例患者出现心肌梗死,经统计学分析后未见明显差异(P=0.487).不良事件总和上,三组之间有显著差异(P=0.008).结论 双侧CAS手术在安全性上要劣于其他两种手术方案.
  • 摘要：Objective To evaluate the treatment outcomes in patients with bilateral severe carotid artery who underwent three different surgical methods. Methods The clinical data of 38 patients with se-vere bilateral carotid stenosis were retrospectively analyzed. Thirty eight patients were divided into bilateral carotid endarterectomy (double CEA, 10 cases), bilateral carotid artery stenting (double CAS , 13 cases), and CEA combined with CAS (CEA/CAS, 15 cases). Results There was no significant difference in the clinical benefit of the three groups (P = 0.657). There were 3 patients (23.1%) with low blood pressure in the bilat-eral CAS group, which was significantly more than other two groups (P = 0.044). 5 cases with Bradycardia were observed postoperatively(double CEA:double CAS:CEA/CAS=1:3:1), and there was no statistically dif-ference between 3 groups (P = 0.415). 3 patients had ischemic stroke after operation, 1 case (10%) in dou-ble CEA group, 2 cases (15.4%) in double CAS group, and there was no significant difference among 3 groups(P=0.309). 6 patients with hyperperfusion syndrome among 3 groups was no significant (double CEA:double CAS:CEA/CAS=2:3:1,P=0.451).1 case with myocardial infarction in the double CEA and double CAS groups respectively, there was no difference among 3groups (P=0.487). The total adverse events in 3 groups was significant different (P=0.008). Conclusion The safety of Bilateral CAS operation was inferior to the other two kinds of surgical project.%目的 比较不同手术方案对双侧颈动脉重度狭窄的治疗效果.方法 回顾性分析38例双侧颈动脉重度狭窄患者的临床资料,依据手术方式分成双侧颈动脉内膜剥脱术(双CEA组,10例)、双侧颈动脉支架成形术(双CAS组,13例)及CEA/CAS组(15例).结果 三组患者在临床症状改善上无明显差异(P=0.657).双CAS组术后3例(23.1%)患者出现低血压,明显高于其他两组(P=0.044).术后5例患者出现心动过缓,三组间比较差异无统计学意义(双CEA:双CAS:CEA/CAS=1:3:1,P=0.415).3例患者术后发生缺血性脑卒中,双CEA组1例(10%),双CAS组2例(15.4%),三组之间差异无统计学意义(P=0.309).术后高灌注综合征6例,三组之间比较差异无统计学意义(双CEA:双CAS:CEA/CAS=2:3:1,P=0.451).双CEA组和双CAS组术后各有1例患者出现心肌梗死,经统计学分析后未见明显差异(P=0.487).不良事件总和上,三组之间有显著差异(P=0.008).结论 双侧CAS手术在安全性上要劣于其他两种手术方案.
  • 摘要：Objective To investigate the application effect of contrast-enhanced ultrasound in the diagnosis of peripherally inserted central catheter (PICC) associated thrombosis. Methods Twenty three cases of PICC with highly suspected thrombosis underwent conventional Doppler ultrasound and contrast-enhanced ultrasound (CEUS), the two methods of inspection were then compared for detection in different parts of the upper limb veins. Results The number of thrombosis in axillary vein and brachial vein detected by CEUS was greater than that detected by conventional Doppler ultrasound(P<0.05). CEUS can make further diagnosis of PICC associated thrombosis in the presence of color spillover, low blood flow rate and severe clinical symptoms. Conclusion The application of contrast-enhanced ultrasound in the accurate diagnosis of PICC related thrombosis is safe and reliable, it is worthy of clinical application.%目的 探讨超声造影(CEUS)技术在经外周静脉穿刺中心静脉置管(PICC)相关性血栓诊断中的应用价值.方法 2015年8月至2016年8月,在天津医科大学总医院普通外科超声介入室对23例临床怀疑PICC相关性血栓但常规超声不能确诊的患者行CEUS检查,比较常规超声和CEUS两种检查方法的血栓检出情况,总结分析CEUS的诊断价值.结果 CEUS在腋静脉和肱静脉处的血栓检出例数多于常规超声检查,差异有统计学意义(P<0.05);CEUS检查可对存在彩色外溢、低流速下无明显血流信号、临床症状严重等PICC相关性血栓可疑者做出进一步诊断,明确血栓形成情况.结论 对于临床怀疑PICC相关性血栓但常规超声难以确诊者,可进一步实施CEUS检查,其过程安全,结果可靠,值得推广应用.
  • 摘要：颈动脉内膜切除术(CEA)已是治疗颈动脉狭窄、预防脑卒中公认的"金标准",但其对于改善症状性颈动脉狭窄患者在视觉、听觉以及认知功能等方面临床症状的相关研究,目前疗效尚存争议,其机制也尚未明确.本文针对CEA在症状性颈动脉狭窄患者对视觉、听觉及认知功能等方面的影响,从临床疗效、作用机制等方面作一综述.
  • 摘要：一、概述 (一)指南制定的方法和背景 本指南是由中华医学会外科学分会血管外科学组组织, 在近年临床研究证据及2008年学组编写的颅外段颈动脉狭窄治疗指南基础上,参考2014年美国心脏协会和美国卒中协会 (American Heart Association/American Stroke Association,AHA/ASA)发 布 的 相 关 指 南 ,2016 年 CREST (Carotid Revascularization Endarterectomy versus Stenting Trial)和ACT(Asymptomatic Carotid Trial)临床试验结果,结合中国颈动脉狭窄的临床诊治特点修改而制定,本指南中涉及的颈动脉狭窄除特殊说明外均指动脉粥样硬化导致的颅外段颈动脉狭窄.
  • 摘要：目的 探讨颈动脉狭窄(CAS)患者的钙化积分(CS)与其认知障碍关联性及其可能机制.方法 通过对123例CAS患者行多层螺旋CT扫描,计算患者颈动脉斑块内CS,同时通过磁共振扫描采集患者脑灌注参数[相对脑血流量(rCBF)、相对脑血容量(rCBV)、相对平均通过时间(rMTT)、血流达峰时间TTP)及血流到达时间(TO)].将所有患者按认知障碍程度和CAS程度分组,将所测得CS数据与认知潜在的常规危险因子(年龄、性别、高血压、糖尿病、高血脂、吸烟史及体重指数)一并进行分组对比差异性分析,同时对同一患者的认知评分、磁共振灌注参数与CS进行关联性分析,并对术后38例患者进行随访分析.结果 与年龄、 高血压及糖尿病相似,CS值在不同认知功能的患者中具有显著差异性分布(P<0.001);与年龄、 性别、 高血压及糖尿病相似,CS值在不同CAS程度患者中具有显著差异性分布(P<0.001).患者的CS值与其认知评分存在显著相关性(P<0.001),术后随访患者CS值与认知评分无明确相关性(P=0.348);CS值与患者磁共振灌注参数中的rMTT、TTP及TO参数均存在显著相关性(P<0.001).结论 颈动脉CS与CAS患者的认知障碍及狭窄程度均存在显著相关性,可作为其独立危险因子,其机制可能与钙化对斑块稳定性的影响有关.
  • 摘要：目的 分析Caprini血栓风险评估模型在脑卒中患者深静脉血栓形成(DVT)筛选中的有效性,探讨依据Caprini风险评分预防DVT发生的效果.方法 采用回顾性病例对照研究设计,选择青岛大学第三附属医院青岛市市立医院脑科中心2015年1月至2015年12月收治的5268例脑卒中患者中确诊的212例DVT患者作为DVT组,采用随机数字表法选择同时期入院的212例未发生DVT的脑卒中患者作为无栓组.采用Caprini血栓风险评估模型对两组患者进行回顾性风险评分、DVT危险度分级,并分析评分及危险度分级与实际发生DVT的相关关系.结果 DVT组患者Caprini评分明显高于无栓组[(7.7±2.5)比(4.8±2.4),P<0.001].DVT患者中,极高危患者所占比例最多(120例,57.1%)、其次为高危(47例,22.2%),高危及以上者合计占79.3%;无栓组中,低危所占比例最多(61例,28.8%)、其次为高危(60例,28.3%)、最低为极高危(42例,19.8%),两组构成之间差异具有统计学意义(P<0.001).基于Caprini量表危险因素的Logistic回归分析,结果显示:肥胖(体质指数≥25kg/m2)、下肢水肿(<1个月)、年龄(≥60岁)、需长期卧床(>72h)、DVT/肺血栓栓塞症疾病史、血栓家族史等6个危险因素是脑卒中患者并发DVT的主要危险因素.脑卒中患者Caprini危险度分级与DVT发病风险关系分析显示:极高危和高危的脑卒中患者是DVT发病的高危人群,DVT的发病风险分别为低危患者的12.756倍和2.136倍.结论 基于Caprini血栓风险评估模型可以很好的预测脑卒中患者DVT的发病风险,值得在临床中推广应用.
  • 摘要：Objective To find out the characters of artery remolding following the creation of autogenous arteriovenous fistula. Methods A total of 31 patients receiving creation of native arteriovenous fistula on the wrist were reviewed. Doppler ultrasound was used to monitor the diameter, peak flow velocity, flow rate and resistant index of brachial artery, radial artery and ulnar artery at the time before the surgery, one day, one week, two weeks and four weeks after the surgery, respectively. The tendency of the diameter change was analyzed. Results Twenty eight patients completed the whole monitor session. The average age of those patients was 53.68 ±2.61 years old. Twenty one patients' fistula located on the left arm. Twelve of them were diabetic nephropathy. The diameter, peak flow velocity, flow rate of all the artery were increased after surgery (P<0.01). The resistant index of all the three artery decreased during the session (P<0.01). The diameter of radial artery and ulnar artery increased more than brachial artery (P<0.01) while the peak flow velocity, flow rate and resistant index of radial artery changed much obviously than the other two arteries ( P<0.01). Conclusions The diameter, peak flow velocity, flow rate and resistant index of brachial artery, radial artery and ulnar artery were all significantly changed after the surgery. The parameter were changed more obviously in radial artery than the other two.%目的 探讨前臂腕部自体动静脉内瘘建立后动脉系统血管重构的特点.方法 研究对象来自河北医科大学第三医院肾内科接受初次行前臂腕部自体动静脉内瘘成形术的患者31例,应用彩色多普勒超声测量术前及术后1日、1周、2周、4周时的肱动脉、桡动脉及尺动脉内径,峰值血流速,血流量及阻力指数,观察其变化趋势.结果 28例患者完成连续性观测.平均年龄(53.68±2.61)岁.内瘘位置左前臂21例;原发病为糖尿病者12例.肱动脉、桡动脉还是尺动脉,在前臂自体动静脉内瘘建立后,均发生了血管内径增大,峰值血流速度增快,血流量增加,阻力指数下降的变化.其中桡、尺动脉的内径变化幅度大于肱动脉(P<0.001);桡动脉峰值血流速、血流量及阻力指数的变化幅度均大于肱动脉及尺动脉(P<0.001).结论 自体动静脉内瘘建立后,动脉系统会发生动脉内径增大,峰值血流速增快,血流量增加,阻力指数下降的变化,其中桡动脉的变化最为剧烈.
  • 摘要：一、概述 主髂动脉闭塞是因各种原因导致的肾下腹主动脉或/和髂动脉闭塞性疾病, 临床最常见的病因是动脉硬化,少见病因有大动脉炎、继发血栓形成等.发病多为慢性病程,以下肢间歇性跛行、臀肌间歇性跛行为典型临床表现,伴有双下肢动脉硬化闭塞或慢性基础上急性加重,或伴有足趾破溃、感染时,可合并有静息痛.目前,血管腔内治疗已经成为治疗主髂动脉闭塞的主要方法,但是支架治疗仍有一定并发症,且远期通畅率仍不尽如人意. 尽管各种支架产品不断推陈出新,仍然解决不了疾病本身的主要问题.
  • 摘要：随着人群生活水平提高和人口老龄化进程加快,外周动脉硬化闭塞症的发病率逐年增高.介入治疗已逐渐取代传统外科手术,成为外周动脉硬化闭塞症的主要治疗方式.抗凝是外周动脉介入治疗中不可避免的重要环节,肝素以其抗凝起效快、价格低廉等优点成为当今外周动脉介入治疗中主要的抗凝剂,但也存在必须依赖于抗凝血酶Ⅲ、易出血、抗凝效应不可预测、可引起肝素诱导的血小板减少症等缺点.比伐卢定是一种人工合成的新型直接凝血酶抑制剂,其抗凝效果同样可靠,且出血风险低,起效不依赖于抗凝血酶,抗凝效应可预测,受到越来越多血管外科医生的关注.本文就国内外比伐卢定在外周动脉介入治疗中的应用做一综述.
  • 摘要：目的 探讨颈动脉体瘤(CBT)诊断及外科手术治疗经验.方法 回顾性分析第二军医大学附属长海医院血管外科2008年1月至2016年12月收治的116例CBT患者资料.CBT位于左侧58例,右侧41例,双侧17例;共131个CBT,其中ShamblinⅠ型29个,ShamblinⅡ型51个、ShamblinⅢ型51个.结果 手术成功切除131个CBT,围术期无患者死亡.血管损伤19例,其中4例患者行颈动脉修补术,15例行颈动脉重建术,颅神经损伤23例,主要表现为声音嘶哑、饮水呛咳、伸舌偏斜及眼睑下垂等.98例(84.4%)患者得到随访,随访时间1~8年,其中2例患者神经功能未恢复,3例患者术后复发.结论 CBT患者应根据瘤体大小、质地及Shamblin分型等选择合适的手术方式.
  • 摘要：目的 探讨经患侧股静脉插管治疗股、腘静脉血栓的临床价值.方法 对徐州市中医院介入科2013年2月至2016年1月33例下肢深静脉血栓形成患者采用经患侧股静脉穿刺插管,保留溶栓导管于股、腘静脉血栓内,定时定量导管内推注溶栓药物,同时给予全身抗凝治疗,治疗后进行造影复查判定血管通畅情况.结果 33例患者均成功置管,溶栓后血管分级为3级28例,2级4例,1级1例;2级及1级的5例患者血栓大部消融,仅腘静脉局部少量血栓残留;最长溶栓时间14天,最短溶栓时间2天,平均7.6天.结论 经患侧股静脉下行穿刺置管操作方便,技术成功率高,溶栓效果满意,具有较高的临床应用与推广价值.

    中华血管外科杂志的期刊信息

    • 创刊时间：-
    • 地区：-
    • 语言：中文
    • 热门主题：-
    • 学科分类：

    中华血管外科杂志的获奖情况

    中华血管外科杂志的收录情况

    中华血管外科杂志的投稿信息

    • 期刊官方网站：点击前往
    • 通讯地址：广州市越秀区竹丝岗二马路5号之一龙珠大厦2层
    • 邮编：100710
    • 联系电话：020-28823189
    • 邮箱：cjvs@cmaph.org
    免费订阅本刊

    客服邮箱：kefu@zhangqiaokeyan.com

    京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有 出版物经营许可证

    • 客服微信

    • 服务号