• 제목/요약/키워드: Vein thrombosis

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하지압박요법이 중증 뇌손상 환자의 대퇴 정맥 혈류 속도변화에 미치는 영향 (Effects on Changes in Femoral Vein Blood Flow Velocity with the Use of Lower Extremity Compression for Critical Patients with Brain injury)

  • 김정숙;김혜정;우연희;임지영;이철형
    • 대한간호학회지
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    • 제39권2호
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    • pp.288-297
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    • 2009
  • Purpose: This study was done to evaluate the mean venous velocity (MVV) response with knee and thigh length compression stockings (CS) versus intermittent pneumatic compression (IPC) devices in immobile patients with brain injuries. Methods: We carried out a randomized controlled study. We analyzed both legs of a randomly chosen sample of 43 patients assigned to one of 4 groups (86 legs). The patients were sequentially hospitalized in the intensive care unit (ICU) in "S hospital" from November 2005 to December 2006. The base line and augmented venous velocity was measured at the level of the common femoral vein. We applied leg compression 42 times over 7 days (for 2 hours at a time at 2 hour intervals). Results: There was a statistical difference among the 4 groups. The difference for the "IPC" group was more significant than the "CS" group. Conclusion: These results indicate that the application of IPC can be considered as an effective method to prevent deep vein thrombosis for immobile patients with brain injury.

Unconventional shunt surgery for non-cirrhotic portal hypertension in patients not suitable for proximal splenorenal shunt

  • Harilal, S L;Biju Pottakkat;Senthil Gnanasekaran;Kalayarasan Raja
    • 한국간담췌외과학회지
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    • 제27권3호
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    • pp.264-270
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    • 2023
  • Backgrounds/Aims: Proximal splenorenal shunt (PSRS) is a commonly performed procedure to decompress portal hypertension, in patients with refractory variceal bleed, especially in non-cirrhotic portal hypertension (NCPH). If conventional methods are hindered by any technical or pathological factors, alternative surgical techniques may be required. This study analyzes the effectiveness of various unconventional shunt surgeries performed for NCPH. Methods: A retrospective analysis of NCPH patients who underwent unconventional shunt surgeries during the period July 2011 to June 2022 was conducted. All patients were followed up for a minimum of 12 months with doppler study of the shunt to assess shunt patency, and upper gastrointestinal endoscopy to evaluate the regression of varices. Results: During the study period, 130 patients underwent shunt surgery; among these, 31 underwent unconventional shunts (splenoadrenal shunt [SAS], 12; interposition mesocaval shunt [iMCS], 8; interposition PSRS [iPSRS], 6; jejunal vein-cava shunt [JCS], 3; left gastroepiploic-renal shunt [LGERS], 2). The main indications for unconventional shunts were left renal vein aberration (SAS, 8/12), splenic vein narrowing (iMCS, 5/8), portalhypertensive vascular changes (iPSRS, 6/6), and portomesenteric thrombosis (JCS, 3/3). The median fall in portal pressure was more in SAS (12.1 mm Hg), and operative time more in JCS, 8.4 hours (range, 5-9 hours). During a median follow-up of 36 months (6-54 months), shunt thrombosis had been reported in all cases of LGERS, and less in SAS (3/12). Variceal regression rate was high in SAS, and least in LGERS. Hypersplenism had reversed in all patients, and 6/31 patients had a recurrent bleed. Conclusions: Unconventional shunt surgery is effective in patients unsuited for other shunts, especially PSRS, and it achieves the desired effects in a significant proportion of patients.

완전 거치형 정맥도관의 임상분석 (Clinical Review of Totally Implantable Venous Catheter)

  • 김정태;오태윤
    • Journal of Chest Surgery
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    • 제40권10호
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    • pp.691-695
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    • 2007
  • 배경: 중심정맥 도관은 1979년 처음 사용된 이래로 암환자의 치료에 있어 많은 편의를 제공하였다. 이에 본원 흉부외과에서는 완전 거치형 정맥도관의 임상 양상 및 사용에 따른 합병증 등을 분석하여 향후 치료에 도움이 되고자 본 연구를 하였다. 대상 및 방법: 2004년 11월부터 2006년 2월까지 완전 거치형 정맥도관 시술을 받은 100명의 환자를 대상으로 후향적 연구를 하여 다음과 같은 결과를 얻었다. 결과: 완전 거치형 정맥 도관 시술의 삽입정맥으로는 우측 쇄골하정맥 삽입이 74예(74%)였으며 좌측쇄골하 정맥(21예, 21%), 우측 경정맥(3예, 3%), 좌측 경정맥(1예, 1%)을 사용하였으며 1예에서는 우측 대퇴정맥을 사용하였다. 초기 합병증으로는 위치 이상이 5예(5%)와 동맥천자한 경우 5예 있었다. 만기 합병증으로는 쇄골하 정맥 혈전 형성이 한 예 있어 현재 항응고제 복용중이며 pinch off 증후군이 2예 있었다. 그 외의 초기 또는 만기 합병증은 없었다. 결론: 완전 거치형 도관의 사용은 합병증의 발생률은 낮고 비교적 안전한 방법이지만 감염, 혈전 형성, 도관의 절단 등은 장기간 사용시 나타날 수 있는 합병증으로 초기에 진단 및 치료가 된다면 더 큰 합병증을 예방할 수 있다.

초음파에서 단순 심경부 감염증으로 오인하여 흡인치료를 시도한 내경정맥 혈전정맥염 (레미에르 증후군) 1례 (A Case of Lemierre's Syndrome, Misdiagnosed as a Simple Deep Neck Infection on Initial Ultrasonography Followed by an Abscess Aspiration Trial)

  • 이동연;김상빈;반명진
    • 대한두경부종양학회지
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    • 제35권2호
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    • pp.31-34
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    • 2019
  • Lemierre's syndrome is rare disease characterized by anaerobic sepsis, internal jugular vein thrombosis, septic emboli that resulted from head and neck infection. Lemierre's syndrome has significant morbidity, so immediate, accurate diagnosis and treatment is needed. It is necessary to perform contrast-enhanced computed tomography (CT) for diagnosis. Systemic antibiotics is recommended, and surgical interventions, anticoagulation may beis considered for treatment. We report misdiagnosed case as a simple deep neck infection on initial ultrasonography with simultaneous abscess aspiration but finally diagnosed and treated internal jugular vein thrombophlebitis (Lemierre's syndrome) on CT scan. We report a case of a 45-year-old patient, who was diagnosed with a simple deep neck infection and treated with simultaneous abscess aspiration, but finally diagnosed and treated internal jugular vein thrombophlebitis (Lemierre's syndrome) on CT scan.

혈액투석 카테터에 의한 쇄골하정맥 혈전성 폐쇄증의 수술치험 1례 (Subclavian Vein Thrombotic Occlusion Secondary to Hemodialysis Catheterization)

  • 김관민;지현근;안혁
    • Journal of Chest Surgery
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    • 제28권1호
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    • pp.73-77
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    • 1995
  • We are reporting one case of right subclavian vein thrombotic occlusion as a result of previous hemodialysis catheter placement in a patient with a functioning right brachio-cephalic arteriovenous fistula. Its complication was painful right arm swelling, limitation of motion and cellulitis. Diagnosis was confirmed by right subclavian venography and the complication was successfully managed by right subclavian vein-superior vena cava bypass with a GoreTex vascular graft. The arteriovenous fistula had remained to protect patency of the bypass at first, but two months later after the operation, the arteriovenous fistula had to be occluded because of the heart failure resulting from shunt over flow. After ligation of arteriovenous fistula, heart failure improved, and uncomfortable arm swelling did not develop again.

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손목의 동맥 문합술 후 반복적 혈전형성 (Recurrent Thrombosis After Arterial Repair at the Wrist)

  • 조용현;노시균;이내호;양경무
    • Archives of Plastic Surgery
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    • 제36권5호
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    • pp.667-669
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    • 2009
  • Purpose: Radial and ulnar arteries are two major arteries responsible for the blood supply of the hand. We experienced early recurrent thrombosis of ulnar artery after arteriorrhaphy in a patient with rupture of ulnar and radial arteries due to glass injury. Thus, we thought this would require reviews. Method: 41 - year - old female patient was presented for the laceration of right wrist due to glass injury. Operative findings revealed the rupture of radial artery, ulnar artery, ulnar nerve and most of the flexor tendons. We performed three consecutive operations because of the recurrent arterial thrombosis in ulnar artery. Arteriorrhaphy was performed in each operation and the interpositional vein graft was performed in the final operation. Result: Consequently, doppler ultrasonography was performed on twentieth postoperative day and fair flow in the ulnar artery was visualized. Pathologic examination of the artery revealed no histopathologic abnormalities. Conclusion: It is not a matter of ease to follow up the patients with rupture of radial or ulnar arteries. Obstruction of the repaired artery is also not easy to detect because it usually presents no definite symptoms. We could detect the obstruction of the artery following arteriorrhaphy with the doppler ultrasonography in less than a week postoperatively, and repeated operations were followed. We reviewed the causes and factors affecting the thrombosis and hereby report with literature review.

Cavernous sinus thrombosis following dental extraction: a rare case report and forgotten entity

  • Aggarwal, Karun;Rastogi, Sanjay;Joshi, Atul;Kumar, Ashish;Chaurasia, Archana;Prakash, Rajat
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제43권5호
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    • pp.351-355
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    • 2017
  • Prior to the advent of efficacious antimicrobial agents, the mortality rate from cavernous sinus thrombosis (CST) was effectively 100%. There have been very few reports of CST associated with tooth extraction. A 40-year-old female presented to the emergency room with swelling over the right side of the face and history of extraction in the upper right region by an unregistered dental practitioner. The patient presented with diplopia, periorbital ecchymosis, and chemosis of the right eye. A computed tomography scan revealed venous dilatation of the right superior ophthalmic vein. The patient was immediately treated with incision and drainage, intravenous antibiotics, and heparin (low molecular weight). Unfortunately, the patient died two days after surgery due to complications from the disease. CST is a rare disease with a high mortality rate. Therefore, dental health education in rural areas, legal action against unregistered dental practitioners, early diagnosis, and aggressive antibiotic treatment can prevent future mortality resulting from CST.

방사성동위원소정맥촬영술(放射性同位元素靜脈撮影術)의 진단적(診斷的) 의의(意義) - X-선정맥조영술(線靜脈造影術)과의 비교(比較) 연구(硏究) - (Diagnostic Significance of Radionuclide Venography - A Comparison with X-ray Contrast Venography -)

  • 배상훈;박재형;한만청;조보연;고창순
    • 대한핵의학회지
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    • 제15권2호
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    • pp.19-25
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    • 1981
  • Radionuclide venographies were performed in 138 limbs of 58 patients and X-ray contrast venographies were performed in 23 paitents of them. Positive radionuclide venography findings were area of decreased sponding to the region of thrombosis, abnormal collateral flows below the lesion. The success rate of radionulide venography was 89% and the overall concordance between radionuclide venography and X-ray contrast venography was 91%. Radionuclide venography is simple and easy to perform and less invasive than X-ray contrast venography. These results indicate that radionuclide venography is the most ideal screening test for the detection of venous thrombosis in patient with signs & symptoms of deep vein thrombosis.

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혈액투석을 위한 동정맥루의 장기관찰 성적 (Long-Term Results of Arteriovenous Fistula for Hemodialysis in Chronic Renal Failure)

  • 김인광
    • Journal of Chest Surgery
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    • 제27권9호
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    • pp.764-769
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    • 1994
  • From november, 1985 to May, 1993, 222 arteriovenous fistulae were made in 201 patients with chronic renal failure. Among them, a total of 183 arteriovenous fistulae in 173 patients were reviewed to evaluate the factors influencing patency rate of the vascular access. The results were revealed as follows: There were 102 men and 71 women,aged 10 to 76 years [mean = 45.7 years]. Sixteen patients of them had previous shunts. The procedures included establishment of 214 radiocephalic or brachioocephalic fistulae, 203 side to end, 9 side to side, 2 end to end, 2 autologous saphenous vein grafts, 6 Gore-Tex grafts. There were 28 early shunt failures[12%] due to use of 23 inadequate veins and 5 thrombosis.There were 32 late complications[14%]; 19 thrombosis, 4 aneurysm, 4 venous hypertension, 3 steal syndrome, 2 infections. There were 32 diabetic patients [17 %]. No significant differences in graft patency were noted between diabetic and nondiabetic individuals. There were no significant difference in graft patency between male and female. Overall shunt patency in 183 cases with chronic renal failure was 96% at I month, 95% at 3 months, 93% at I year, 91% at 2 years, 84% at 3 years, 56% at 5years.This Study showed that early postoperative thrombosis and diabetic vasculopathy were most causes of the vascular access failure and suggested that prevention of thrombi and well control of diabetes mellitus were most important to enhance patency rates of the vascular access.

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