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1.
Objective: To investigate if intra-aortic balloon pump(IABP) is contraindicated without anticoagulation therapy. Methods:
Some 153 IABP patients in the King Abdulaziz Cardiac Center(KSA) were randomly assigned into two groups. Anticoagulation group
(Group A) consisted of 71 patients who were given heparin intravenously with target aPTT50–70 seconds. Non-anticoagulation
group (Group B) consisted of 82 patients without intravenous heparin during balloon pumping. Hematological parameters including
platelet count, D-dimer, Plasminogen activator inhibitor-1 (PAI-1) and fibrinogen degradation products (FDP) were checked
respectively at the point of baseline, 24 hours, 48 hours and 24 hours post IABP counterpulsation. Clot deposits on balloon
surface, vascular complications from IABP including bleeding and limb ischemia were recorded. Results: Platelet count and
PAI-1 level decreased at 24 hours and 48 hours in both groups (P<0.05). D-dimer dimer and FDP level increased at 24 hours and 48 hours in both groups(P<0.05), but returned to the baseline level 24 hours post IABP removal (P>0.05). Three patients in Group A and 2 patients in Group B developed minor limb ischemia (P>0.05). No major limb ischemia in either group. Two patients in Group A suffered major bleeding and required blood transfusion
or surgical intervention, whereas no patient had major bleeding in Group B. Eight patients had minor bleeding in Group A,
but only 2 patients in Group B (P<0.05). No clot deposit developed on IABP surface in either group. Conclusion: IABP is safe without routine anticoagulation
therapy. Selecting appropriate artery approach and early detection intervention are key methods for preventing complications. 相似文献
2.
Anticoagulation therapy in intra-aortic balloon counterpulsation: Does IABP really need anti-coagulation? 总被引：1，自引：0，他引：1
INTRODUCTIONTheintra aorticballoonpump(IABP)isthemostwidelyusedofallcirculatoryassistdevicestodayandisroutinelyusedinawiderangeofse riouscardiovascularconditions,rangingfromhe modynamicinstabilityinpatientssufferingfromcomplicationsofacutemyocardialinfarc… 相似文献
3.
白蛋白治疗急性脑出血的疗效分析 总被引：4，自引：0，他引：4
禹爱梅 《河北北方学院学报(医学版)》2006,23(5):26-27
目的：观察白蛋白在急性脑出血中的治疗价值。方法：将64例急性脑出血病人随机分成治疗组和对照组，两组均给予甘露醇降颅压及对症治疗。治疗组同时加用白蛋白10g静脉滴注，1次／d，共7d。结果：治疗组比对照组神经功能缺损评分明显改善（P〈0．01）。结论：在脑出血急性期应用白蛋白治疗可明显改善其病情及预后。 相似文献
4.
目的：探讨藻酸双脂钠（PSS）治疗急性脑梗死患者血液成分变化及疗效。方法：急性脑梗死患者158例，随机分为两组。对照组：78例，常规治疗；治疗组：80例，在常规治疗基础上，应用藻酸双脂钠注射液100mg加入0．9％氯化钠静脉滴注，每日一次，连续观察14d。对比分析二组治疗前后脂蛋白（a）、血脂、纤维蛋白原等血液流变学指标．并动态观察治疗前后临床神经功能缺损评分。结果：藻酸双脂钠可降低全血粘度、血浆粘度、血小板聚集率、纤维蛋白原及血清TC、TG、LDL，与治疗前比较有显著性改变（P〈0．01或P〈0．05）；与对照组比较有显著性差异（P〈0．01或P〈0．05）．但对脂蛋白（a）无影响；近期预后较常规治疗组好（P〈0．05）．结论：藻酸双脂钠可改善血液高粘滞状态，起到降低纤维蛋白原、抗血小板聚集作用，可改善近期临床神经功能缺损程度。 相似文献
5.
Mohetaboer MOMIN 《Journal of Zhejiang University. Science. B》2012,13(8):638-644
Objective:To investigate the relationship between renal function and clinical outcomes among patients with acute ST-segment elevation myocardial infarction (ASTEMI), who were treated with emergency percutaneous coronary intervention (PCI). Methods: 420 patients hospitalized in Peking University First Hospital, diagnosed with ASTEMI treated with emergency (PCI) from January 2001 to June 2011 were enrolled in this study. Estimated glomerular filtration rate (eGFR) was used as a measure of renal function. We compared the clinical parameters and outcomes between ASTEMI patients combined renal insufficiency and the patients with normal renal function. Results:There was a significant increase in the concentrations of fibrinogen and D-Dimer (P<0.05) and a much higher morbidity of diabetes mellitus in the group of patients with chronic kidney disease (CKD; eGFR<60 ml/(min·1.73 m2)) (P<0.01). CKD (eGFR<60 ml/(min·1.73 m2)) was an independent predictor of in-hospital mortality for patients hospitalized with ASTEMI receiving PCI therapy rapidly (P=0.032, odds ratio (OR) 4.159, 95% confidence interval (CI) 1.127-15.346). Conclusions:Renal insufficiency is an independent predictor of in-hospital mortality for patients hospitalized with ASTEMI treated with primary PCI. 相似文献
6.
Xiao-jie Xie Ju-bo Jiang Jun Jiang Jian-an Wang 《Journal of Zhejiang University. Science. B》2014,15(9):838-844
Based on different mechanisms of blood coagulation, coexistence of venous thromboembolism and arterial thrombosis in a single individual is extremely rare in clinical practice. Both antiplatelet and anticoagulation therapy should be adopted for patients with arteriovenous embolism. Balancing the risk of ischemia and hemorrhage is especially challenging in these patients in order to achieve an optimal clinical benefit. We report on a 55-year-old female with acute pulmonary embolism (PE), subsequently diagnosed as having acute myocardial infarction (AMI) and a cerebral infarction. Examinations had been carried out, excluding potential arteriovenous shunts, cancer, antiphospholipid syndrome and other common hypercoagulable states. A combination of an anticoagulant drug (rivaroxaban, an Xa inhibitor) and an antiplatelet agent (clopidogrel, an ADP receptor inhibitor) was prescribed with a β-blocker and atorvastatin. The embolus was gradually shrunk during the next 10 months, and then it turned back into expanding. During the 16 months’ follow-up, an aneurysm of left ventricular apex was found through an echocardiogram and an angiotensin-converting enzyme inhibitor was administered. We conclude that combined anticoagulation and antiplatelet therapy significantly relieved the symptoms and improved the prognosis in patients suffering from arteriovenous embolism without any major clinical bleeding events. 相似文献
7.
就资金利用策略问题建立了一个决策优化模型。该模型考虑了资金存入银行和购买国库券的两种情形。在保证n年末仍能拥有原基金额M万元和每年奖金数大致相同（情形3中第三年的奖金为其它年份的1．2倍）的前提下，使得每年的奖金达到最大值。在求解过程中，我们根据现行银行取款规定，采用单利计算年利息并认为每年仅购买一次国库券，一旦有可利用资金就进行一次资金的分配。我们应用LINDO软件求出最优解，即发放奖金数额的最大值，并给出了具体的利用方案，还进行了验证。本模型的重要的结论是：仅存款，最高奖金为109．8170万元；即存款又购买国库券，最高奖金为131．8278万元；第三年将奖金提高20％，最高资金为128．8480万元。 相似文献
8.
Comparison of an SMS text messaging and phone reminder to improve attendance at a health promotion center： A randomized controlled trial 总被引：2，自引：0，他引：2
Objective To compare the efficacy of a short messaging service (SMS) text messaging and phone reminder to improve attendance rates at a health promotion center. Methods A total of 1 859 participants who had scheduled appointments in the health promotion center of our hospital from April 2007 to May 2007 were enrolled in the study and randomly assigned into 3 groups control (no reminder) group, SMS text messaging reminder group and telephone reminder group. Attendance rates and costs of interventions were collected. Results A total of 1848 participants were eligible for analysis. Attendance rates of control,SMS and telephone groups were 80.5%, 87.5% and 88.3%, respectively. The attendance rates were significantly higher in SMS and telephone groups than that in the control group, with odds ratio 1.698, 95% confidence interval 1.224 to 2.316, P=0.001 in the SMS group, and odds ratio 1.829, 95% confidence interval 1.333 to 2.509, P＜0.001 in the telephone group. However, there was no difference between the SMS group and the telephone group (P=0.670). The cost effectiveness analysis showed that the cost per attendance for the SMS group (0.31 Yuan) was significantly lower than that for the telephone group (0.48 Yuan). ConclusionSMS and telephone are effective reminders for improving attendance rate at a health promotion center. SMS reminder may be more cost-effective compared with the telephone reminder. 相似文献
9.
目的：探讨无创呼吸机联合纳洛酮治疗慢性阻塞性肺疾病急性加重期（AECOPD）合并Ⅱ型呼吸衰竭的临床应用价值。方法：选取2011年3月-2013年9月收治的78例AECOPD合并Ⅱ型呼吸衰竭患者,随机分为对照组和观察组,两组患者均给予常规治疗措施及无创呼吸机辅助呼吸,观察组在此基础上再给予静滴纳洛酮治疗,对两组患者治疗效果、血气指标改善情况进行综合比较。结果：观察组治疗总有效率为90.00%,高于对照组72.05%（P〈0.05）;观察组患者p H、Pa O2、Pa CO2三项血气指标改善情况均优于对照组（P〈0.05）。结论：在呼吸机辅助通气基础上联合应用盐酸纳洛酮治疗AECOPD合并Ⅱ型呼吸衰竭效果显著,可显著改善患者血气结果。 相似文献
10.
参芪扶正注射液对慢性肺心病患者血液流变学的影响 总被引：1，自引：0，他引：1
目的:观察参芪扶正注射液对慢性肺原性心脏病(以下简称肺心病)患者血液流变学的影响.方法:将74例慢性肺心病急性加重期患者随机分为A、B两组.A组(36例)在常规治疗的基础上加用参芪扶正注射液,B组(38例)仅给予常规治疗.两组均连续用药2周.治疗前后对血液流变学相关指标进行检测与对比观察.结果:患者经参芪注射液治疗后血液流变学示低切与高切变率下全血黏度、血浆比黏度、红细胞聚集指教、红细胞电泳时间、红细胞比积、血小板聚集率、纤维蛋白原均有显著性下降(P＜0.01或P＜0.05),与B组比较亦有显著下降(P＜0.05).临床总有效率及显效率A组分别为94.5%及50.0%;B组为73.6%及26.4%.A组疗效明显优于B组(P＜0.05),治疗期间未见参芪扶正注射液严重不良反应.结论:参芪扶正注射液能显著改善慢性肺心病急性加重期患者的血液流变性,是辅助治疗肺心病的一种有效、安全的药物. 相似文献
11.
王建军 《黄冈职业技术学院学报》2012,(4):88-90
目的观察沙丁胺醇和丙酸氟替卡松雾化吸入治疗慢性阻塞性肺病急性加重的疗效。方法将29例慢性阻塞性肺疾病急性加重的患者随机分成两组,对照组28例,常规给予抗生素及相应对照治疗;实验组29例,在对照组的基础上沙丁胺醇与丙酸氟替卡松雾化吸入治疗。用药后观察实验组及对照组临床效应、不良反应及住院时间。结果实验组及对照组每组治疗前后1周临床症状评分差异有显著性,实验组FEV1/预计值,PEF/预计值及住院时间较对照组治疗差异有显著性,并且未发现不良反应。结论在常规抗炎、祛痰等治疗基础上加用沙丁胺醇和丙酸氟替卡松联合雾化治疗一周后,患者临床症状评分及肺功能均明显改善,明显缩短了治疗疗程和住院时间,且无严重不良反应。 相似文献
12.
Objective: to report the application of GPIIb/IIIa antagonist (Integrilin) in peri-percutaneous transluminal catheter angioplasty and stent implantation in Chinese. Method: Twenty-one patients who underwent percutaneous transluminal catheter angioplasty(PTCA) and stent implantation were included. After arterial puncture, integrilin was injected at dose of 180ug/kg, and then maintained at 2μg/kgmin for 18 hours. Asprine, plavix(clopidogrel) and heparin were used at the same time. ACT, PT, KPTT and blood routine were routinely monitored. Results: All sheaths were drawn out 2 to 4 hours after the procedure.. There was no severe complication such as hematoma, acute and subacute thrombosis in coronary artery, or thrombocytopenia. ACT returned to less than 150 seconds in 2 hours in 15 patients; in 4 hours in 6 patients. There was no significant difference between the pre- and post-procedure value of PT and platelet count. KPTT was significantly higher than pre-procedure value at 2 hours after the procedure .No recurrence of angina pectoris was observed in the first nine patients within one year follow-up, and no restenosis occurred in stents in the five patients who had coronary angiography one year later. Conclusion: Application of GPIIb/IIIa receptor antagonist (Integrilin) in peri-percutaneous transluminal catheter angioplasty and stent implantation in combination with aspirin and plavix could significantly reduce the dosage and duration of heparin with benefit of shortening the indwelling time of sheaths, but did not increase risk of bleeding or lead to thrombosis in stent. 相似文献
13.
顾彬 《泰州职业技术学院学报》2005,5(6):45-46
目的探讨老年慢性肺心病伴发急性心肌梗死(AMI)的临床特点.方法对66例老年慢性肺心病伴发AMI的病人(A组)进行分析,并与老年单纯冠心病AMI152例(B组)作比较.结果A组疼痛发生率(45.4%)显著低于B组(83.9%)(p＜0.01),A组急性左心衰、心源性休克发生率显著高于B组,分别为53.1%与25.0%,48.4%与21.7%(p＜0.05),A组病死率(42.4%)显著高于B组(15.7%),肺心病对其伴发AMI的发生部位无影响.结论对老年肺心病患者突然发生的急性左心衰和/或心源性休克应高度警惕伴发AMI的可能. 相似文献
14.
采用市场价值法、旅游费用法、意愿调查法等方法对雷州半岛红树林湿地的生态价值进行了评估.结果表明,按雷州半岛红树林湿地面积20 279hm2（其中红树林面积7 800hm2）核算,2009年其生态价值总和为28 0932.37万元,其中直接使用价值为141 717.59万元,占50.4%（占总价值比例,下同）,包括近海渔业价值93 899.55万元（占33.4%）、旅游与文化价值47 818.04万元（占17.0%）;间接使用价值为61 054.3万元,占21.8%,包括海洋动物栖息价值38 025.00万元（占13.6%）、海岸保护价值13 110.00万元（占4.7%）、环境质量维护价值9 919.30万元（占3.5%）;非使用价值为78 160.48万元,占27.8%,包括选择价值70 450.38万元（占25.1%）、存在价值7 710.10万元（占2.7%）.在当地红树林海岸居民心目中红树林资源的直接使用价值要小于其间接使用价值,其中保护价值在当地居民心中占有极为重要的地位. 相似文献
15.
肝素治疗胎儿生长受限临床应用探讨 总被引：1，自引：0，他引：1
目的:探讨肝素用于治疗胎儿生长受限(FGR)的临床疗效及安全性。方法:将74例胎儿生长受限患者随机分为3组,分别使用低分子右旋糖酐加复方丹参(对照组)、普通肝素(UFH)、低分子肝素(LMWH)治疗。治疗前、治疗后1周及终止妊娠前,行彩色超声检查,监测胎儿生长情况和脐血流变化,同时监测各项凝血指标,记录新生儿情况并进行随访。结果:(1)UFH组、LMWH组治疗后宫高、胎儿股骨长、头围、腹围增长值均高于对照组,差异有显著性(P<0.05),LMWH组胎儿双顶径增长显著高于对照组(P=0.031)。(2)两肝素组治疗后脐动脉收缩期最大血流速度(S)与舒张末期血流速度(D)的比值(S/D比值)、搏动指数(PI)、阻力指数(RI)与对照组比较均明显降低,差异有统计学意义(P<0.05),而两肝素组间比较无统计学差异(P>0.05)。(3)UFH组、LMWH组治疗后新生儿胎龄、出生体重、身长、胎盘重量均较对照组明显增加(P<0.05),而两肝素组间无显著差异(P>0.05);新生儿窒息、胎死宫内、新生儿死亡发生率、早产发生率和新生儿畸形发生情况各组间无统计学差异(P>0.05);对照组足月小样儿发生率明显高于两肝素组(P=0.005),而肝素组之间则无显著差异(P>0.05)。对照组与LMWH相比,新生儿转重症监护病房(NICU)几率明显升高(P=0.003)。(4)各组孕妇治疗前后各项凝血功能检测值比较,差异均无显著性(P>0.05),产后出血量及产后出血发生率相比差异亦无统计学意义。结论:肝素可改善胎盘血流,使胎儿体重增加,减少足月小样儿的发生率,且不增加产后出血发生机会,对母亲及胎儿都较安全。LWMH治疗FGR,新生儿转NICU几率明显低于对照组,效果优于普通肝素,且使用方便,产妇易于接受,更适于推广。 相似文献
16.
目的：观察急性肾功能衰竭（ARF）家兔心肌匀浆自由基、一氧化氮的变化，探讨心肌损伤的体液机制。方法：60只家兔均分为四组（n=15）。ARF模型1组：皮下注射1％HgCl2（1．3ml／kg．bw）；ARF模型2组：肌肉注射50％甘油（10ml／kg．bw）；以等量生理盐水代替HgCl2和甘油作为对照1、2组。24h后，所有动物颈总动脉放血备检，并选择固定位置。制备10％心肌匀浆。经Aeroset型全自动生化分析仪测定血清反映肾功能的生化指标。检测心肌匀浆丙二醛（MDA）、超氧化物歧化酶（SOD）、一氧化氮（NO）及其合酶（NOS）的变化。结果：与相应对照组比较，ARF模型1、2组心匀浆SOD活性下降、MDA含量升高（P〈0．05），ARF模型1、2组心匀浆NO含量增强、NOS及iNOS活性增强（P〈0．05～0．01）。结论：ARF家兔心肌损伤的机制与自由基损伤及NO升高有关。 相似文献
17.
《阜阳师范学院学报(社会科学版)》2012,(3)
"耗费"义"花动"与"花名"意义相去甚远。从历时看,做"耗费"义的"花"早在宋元时期已经出现,明代已较为普遍,清代则和现代汉语之用法无异。基于语料考察,本文提出"源‘花’说",认为:"耗费"义"花动"是"花名"在去范畴化的动态过程中,结合"花名"原有及新出现的性质、特征,在认知体系及语言系统中创新发展的结果。 相似文献
18.
A simulated moving bed （SMB）, equipped with eight silica-gel columns, was used to separate phosphatidylcholine （PC） from soybean phospholipids. The effects of flow rate in Sections 2 （Q2） and 3 （Q3）, switching time, feed flow rate and feed concentration on the operating performance parameters： purity, recovery, productivity and desorbent consumption were studied. Operating conditions leading to more than 90% purity in both outlet streams have been identified, together with those achieving optimal performance. Regions leading to complete separation are observed and explained theoretically. As the mass-transfer effect was not considered, the triangle theory only gives initial guesses for the optimal operating conditions. 相似文献
19.
蒋寅 《南阳师范学院学报》2012,11(5):57-61
叶燮《原诗》作为古典诗学的重要文本,迄今虽已有两种评注本,但在还原其诗学语境,揭示其话语背景——大背景是明末到康熙前期的两次宋诗潮带来的唐宋之争,小背景则是昊中地区叶燮与汪琬两家讲学宗旨不同带来的诗学之争——方面。还有不少工作可做。文章就笔者笺注所及诸问题,对《原诗》整理的要点和体例作了说明。同时对学界关于《原诗》写作过程及理论渊源的新说,提出了自己的看法。 相似文献
20.
To evaluate the clinic outcome of off-pump coronary bypass grafting (OPCABG) of patients with coronary heart disease and chronic obstructive pulmonary disease, we collected and analyzed 1998-2002 data on 28 patients with these two diseases who had received off-pump coronary bypass operation in our hospital, and compared with data on those who also had the same two diseases but received on-pump coronary artery bypass at same time. There were no operation-related death;one died of respiratory failure 14 days after operation while staying in hospital; there were more respiratory complications in the conventional coronary artery bypass grafting group (CCABG) than in the OPCABG group; and the PaO2/FiO2 in the CCABG group was higher than that in the OPCABG group during operation because of CPB, but lower than that in the OPCABG group 6-12 hours after operation. OPCABG seemed more suitable than CCABG for coronary artery disease patients with chronic obstructive pulmonary disease due to less damage to their oxygen-exchange capability and the fewer respiratory complications. 相似文献