静脉血栓形成

Firstly, the establishment of model requires sophisticated neurointerventional techniques and costly interventional materials(sacculus, minikin circlip ring, endovascular electrocoagulation), it not only consumed time but also increased the resesrch expense ; Secondly, although the Massoud model is the first successful model that contain the nidus, but it is far from mimicking the high-flow fistulae frequently observed in a brain AVM; Thirdly, the rapid spontaneous thrombosis result in fistula occlusion in a short time;Fouthly, the model's natural course and the long–term patency of fistula are unclear;Currently the model is only used for the short-term research.

但Massoud模型目前存在以下主要缺点：第一，模型的建立需要复杂的神经介入技术和昂贵的介入材料(球囊、微弹簧圈、血管内电凝等)，操作费时，又大大增加了研究费用；第二，Massoud模型虽然首次具备了畸形血管团，但它远不是我们临床上常见的含有高流量动静脉瘘的脑AVM；第三，颈动静脉吻合口自发性血栓形成进而导致引流静脉闭塞的机率很高；第四，Massoud模型的长期自然过程和动静脉吻合口的长期通畅性尚不清楚，目前仅仅作为急性期模型。

METHODS Vein thrombus was formed in rat by ligating postcava. Thrombus formation in vitro was observed by Chandlers method. Clotting indexes were measure by ACL200 congulation system.

结扎大鼠下腔静脉观察对静脉血栓的形成，Chandler方法观察体外血栓形成，全自动凝血仪测定凝血指标和纤维蛋白原及ATⅢ、Ⅱ、Ⅱa活性。

Research results indicate that varicosity can be treated by means of endovenous thrombus formation, blood vessel wall damnification and vessel enclosure induced by light absorption of haemoglobin irradiated by semiconductor laser.

研究结果表明：半导体激光进行腔内静脉照射，由于血红蛋白对光的吸收，可以引起静脉腔内血栓形成、血管壁损伤、血管闭合，实现对静脉曲张的治疗；激光照射导致静脉腔内血栓形成，与血栓性静脉炎的形成机制不同，并没有影响全身凝血功能。

Portal braches of 4-5 orders were found in all 19 cases of Child Grade I, with esophageal varices and paragastric varices and no fistula of hepatic artety-portal vein or portal vein embolus; Portal braches of 3-4 orders were displayed in all 16 cases of Child Grade II, besides esophageal varices and paragastric varices, cirsomphalos, retroperitoneal varices, paraesophageal varices, dilated azygos vein were also noted, some patients had fistula and portal vein embolus; in Child Grade III, portal branches of 3~4 orders were displayed with more collateral circulations, dilated left renal vein and paragallbladder varices were appeared, with fistula and portal vein embolus or not.

Child I级19例，肝内门静脉显影4~5级，侧枝循环以食管及胃周静脉曲张为主，没有肝动脉－门静脉瘘或门静脉血栓形成；Child Ⅱ级16例，肝内门静脉显影3~4级，侧枝循环除食管及胃周静脉外，脐周静脉、腹膜后静脉、食管周围静脉、奇静脉也有所开放，部分有肝动脉－门静脉瘘或门静脉血栓形成；Child Ⅲ级6例，肝内门静脉显影3~4级，侧枝循环开放较Ⅱ级增多，可出现左肾静脉扩张或胆囊周围静脉曲张，伴或不伴有肝动脉－门静脉瘘或门静脉血栓形成。16排螺旋CT门静脉造影对上述病例分级为一级17例，二级18例，三级6例，与Child分级结果高度相关。

To pay attention to carry out effective cardiopulmonary resuscitation, hemostasis by compression and deep vein intubation rapidly in the initial stage of emergency. The carotid shunt tube plays an important role in severe carotid injury and re-establishment process. We use external jugular vein to transplant and re-establish,which are rung with artificial blood vessels for the long distance carotid injury and achieved the best result. We expose as fully as possible for the hepatic venae and the posthepatic post caval injury,and adopt effective methods to stop bleeding and repair. The application of blood shunt pump could raise the success rate for those severe patients. The self-double vastransplantation with both ends being all trousers-style one opening solve some problems such as there are no suitable caliber self-transplantation blood vessels and the artificial blood vessels are easy to occur obliteration for long-term and so on for the great or middle blood vessels.We use improved Fogarty duct and anterograde intubation to eliminate thrombus could eliminate thrombus effectively and avoid accessory injury for the deep vein injury and extensive thrombosis.

抢救初期要注意进行有效的心肺复苏、压迫止血和快速进行深静脉插管；颈动脉转流管在严重颈动脉损伤重建过程中有重要作用；对长距离颈动脉损伤用颈外静脉移植外环包人造血管重建，可取得最佳效果；对肝静脉及肝后下腔静脉损伤，要充分暴露，采用有效方法止血和修复，对病情极危重的凶险性出血者，血液转流泵的应用可提高成功率；对大、中血管损伤，两端均为裤式单开口自体双血管移植，解决了无适宜口径自体移植血管和应用人造血管远期易闭塞等问题；对深静脉损伤并广泛血栓形成者，应用改进的Fogarty导管和顺行插管取栓法，可有效取栓并避免了副损伤。

To pay attention to carry out effective cardiopulmonary resus-citation,hemostasis by compression and deep vein intubation rapidly in the initial stage of emergency.The carotid shunt tube plays an important role in severe carotid injury and re-establishment process.We use external jugular vein to transplant and re-establish,which are rungwith artificial blood vessels for the long distance carotid injury and achieved the best result.We expose as fully as possible for the hepatic venae and the posthepatic post caval injury,and adopt effective methods to stop bleeding and repair.The application of blood shunt pump could raise the success rate for those severe patients.The self-double vastransplantation with both ends being all trousers-style one opening solve some problems such as there are no suitable caliber self-transplantation blood vessels and the artificial blood vessels are easy to occur obliteration for long-term and so on for the great or middle blood vessels.We use improved Fogarty duct and anterograde intubation to eliminate thrombus could eliminate thrombus effectively and avoid accessory injury for the deep vein injury and extensive thrombosis.

抢救初期要注意进行有效的心肺复苏、压迫止血和快速进行深静脉插管；颈动脉转流管在严重颈动脉损伤重建过程中有重要作用；对长距离颈动脉损伤用颈外静脉移植外环包人造血管重建，可取得最佳效果；对肝静脉及肝后下腔静脉损伤，要充分暴露，采用有效方法止血和修复，对病情极危重的凶险性出血者，血液转流泵的应用可提高成功率；对大、中血管损伤，两端均为裤式单开口自体双血管移植，解决了无适宜口径自体移植血管和应用人造血管远期易闭塞等问题；对深静脉损伤并广泛血栓形成者，应用改进的Fogarty导管和顺行插管取栓法，可有效取栓并避免了副损伤。

Shikimic acid is a single compound extracted from anise Chinese medicine, anti-inflammatory, analgesic effect, is the anti-cancer drug intermediates, there are clear anti-thrombosis, can inhibit the arteries and veins Thrombosis and cerebral thrombosis.

莽草酸是从中药八角茴香中提取的一种单体化合物，有抗炎、镇痛作用，是抗癌药物中间体，有明显抗血栓形成作用，可抑制动、静脉血栓及脑血栓形成。

Results:There were luminal dilations of the femoral vein(12.9±2.7mm vs 9.2±2.1mm,P＜0.001)and the popliteal vein(8.8±1,2mm vs 5.9±1.5mm,P＜0.001)in the acute stage of all cases compared to the healthy extremity.There were low echoes in the thrombosed segments by 2D and no blood flow signals by CDFI.

结果：19例急性血栓形成患者入院初诊患肢深静脉内径较健肢明显增宽，股静脉(12.9±2.7)mm vs (9.2±2.1)mm，P＜0.001；静脉(8.8±1.2)mm vs (5.9±1.5)mm，P＜0.001 ，管腔内呈低回声，CDFI未显示血流信号或有血流充盈缺损。

The particular arrangement of veins in the telencephalon permits them to flow in both directions via medullary veins, as seen with certain disorders, such as deep arteriovenous malformations, Sturge-Weber disease, and the developmental venous anomalies[60], possibly explaining the small diameter and unimportance of parenchymal lesions when such a vein is thrombosed.

这种特殊的解剖分布使得端脑内的静脉可以通过脑穿通髓静脉产生双向血流，这一点在脑深部动静脉畸形、Sturge-Weber病/斯特季-韦伯二氏病/脑眼颜面血管瘤病、脑静脉发育异常等疾病中都可观察到，同时也可以解释当这些静脉受累形成血栓时常产生较小的、甚至不容易被发现的病灶。

Dr Virchow noticed an association between venous thrombosis in the legs and pulmonary embolism.

博士菲尔绍注意到之间存在某种联系静脉血栓形成的腿部和肺栓塞。

Do you know, i need you to come back

你知道吗，我需要你回来

Yang yinshu、Wang xiangsheng、Li decang,The first discovery of haemaphysalis conicinna.

1〕 杨银书，王祥生，李德昌。安徽省首次发现嗜群血蜱。