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Colposcopic evaluation of cervix in patients with bacterial vaginosis 细菌性阴道病患者宫颈的阴道镜评价
Pub Date : 2022-10-01 DOI: 10.4103/azmj.azmj_146_21
Abdel Aziz El-Deen El-Darwesh, Abdel Halim Mohammed Halim, Mahmoud A. Sayed
Abstract Background and aim Bacterial vaginosis (BV) is a clinical syndrome emerging from changing of the bacteria Lactobacillus species that produce hydrogen peroxide in the vagina with many population of anaerobic bacteria. A lot of researchers have agreed with the relation between BV and cervical intra-epithelial lesions. However, other researchers have not accepted this relation between cervical neoplasia and BV. The study aim was to evaluate the abnormal colposcopic findings associated with BV and to study the relation between BV and cervical lesions. Patients and methods This study is a cross-sectional observational one that included 246 women diagnosed as having BV using Amsle’s criteria. All participants underwent proper history taking, general and abdominal examination, local vaginal examination, and colposcopic examination. Finally, Swede score was applied to abnormal colposcopic findings. Results By naked-eye examination, there were 163 patients with normal findings and 83 patients had abnormal cervical appearance, colposcopic examination of patients revealed 14 patients with unsatisfactory findings, and 196 patients had normal findings and 36 patients had abnormal cervix. The abnormal colposcopic findings were significantly associated with urban (55.6%) than rural women (44.4%) (P=0.039), educated (72.2%) than noneducated women (27.8%) (P=0.033), nonemployed (72.2%) than employed women (27.8%) (P=0.011), and women using oral contraceptive pills (OCP) (38.9%) than other contraceptive methods (P=0.024). Conclusion Most cervical lesions associated with BV in our study were of low grade and although use of colposcopy allowed early detection and management of cervical precancerous lesions associated with BV.
摘要背景和目的细菌性阴道病(BV)是一种临床综合征,由阴道内产生过氧化氢的乳酸杆菌种类变化引起,并伴有大量厌氧菌。许多研究者已经同意BV与宫颈上皮内病变之间的关系。然而,其他研究人员尚未接受宫颈肿瘤与BV之间的这种关系。本研究旨在评估与BV相关的异常阴道镜检查结果,并研究BV与宫颈病变之间的关系。患者和方法本研究是一项横断面观察性研究,包括246名使用Amsle标准诊断为BV的女性。所有参与者都接受了适当的病史记录、全身和腹部检查、局部阴道检查和阴道镜检查。最后,将Swede评分应用于异常阴道镜检查结果。结果裸眼检查163例,宫颈外观正常83例,阴道镜检查14例,宫颈检查196例,宫颈异常36例。异常阴道镜检查结果与城市(55.6%)比农村妇女(44.4%)(P=0.039)、受过教育的妇女(72.2%)比未受过教育的女性(27.8%)(P=0.033)、未就业的妇女(7.22%)比就业的妇女,结论本研究中大多数与BV相关的宫颈病变级别较低,尽管使用阴道镜可以早期发现和处理与BV相关联的宫颈癌前病变。
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引用次数: 0
Monkeypox: typical and atypical clinical presentation 猴痘:典型和非典型临床表现
Pub Date : 2022-10-01 DOI: 10.4103/azmj.azmj_26_22
P. Sookaromdee, B. Joob, V. Wiwanitkit
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引用次数: 0
Short-term outcome of cataract surgery in tertiary hospitals 三级医院白内障手术的近期疗效
Pub Date : 2022-10-01 DOI: 10.4103/azmj.azmj_104_21
N. Mahmoud, Ibrahim Major, M. Mansour, Afaf H. Rashwan
Background and aim In this study we aimed to assess the short-term outcome of phacoemulsification in a tertiary hospital and to analyze which are the factors affecting visual outcomes. Patients and methods This is a prospective cohort study that included 50 eyes (50 patients) with senile cataract, phacoemulsification was done between September 2019 and December 2020. Comprehensive ophthalmic examination: preoperatively, first day, 1 week, and 1 month postoperatively was done. The changes in best-corrected visual acuity, corneal curvature, and intraocular pressure were compared. Double-angle plot of the corneal surgically induced astigmatism (SIA) was calculated, including centroid values (C-SIA) and mean of surgically induced astigmatism (M-SIA). Results The mean age was 64.86±8.48 years, 60% right eyes. No intraoperative complications. Best-corrected visual acuity (log MAR) was 1.079±0.66 with significant improvement postoperatively (P=0.00). Mean intraocular pressure was 16.88±3.193 with significant decrease postoperatively (P=0.04). Corneal astigmatism significantly increased from 0.939±0.57 D preoperatively to 1.146±0.67 D postoperatively (P=0.02). The M-SIA was 0.65±0.32 D (OD), 0.55±0.31 D (OS), the centroid of surgically induced astigmatism C-SIA was 0.28±0.67 D at an axis of 68° (OD), and 0.15±0.72 D at an axis of 76° (OS). Good visual acuity (>20/40) was achieved in 80% and 20/20 in 22%, dense cataract significantly influences the visual outcome (P=0.02). Conclusions This study implicates that in the absence of ocular comorbidity, the visual outcome of phacoemulsification is satisfactory in short-term follow-up, and effort should be exerted during surgery to deal with ocular conditions requiring complex surgery such as dense cataract and to observe every postoperative visual progression for interventions.
背景和目的在本研究中,我们旨在评估三级医院超声乳化术的短期效果,并分析影响视觉效果的因素。患者和方法这是一项前瞻性队列研究,包括50眼(50名患者)老年性白内障,超声乳化术于2019年9月至2020年12月进行。眼科综合检查:术前、术后第1天、1周、1个月进行检查。比较最佳矫正视力、角膜曲率和眼压的变化。计算角膜手术诱导散光(SIA)的双角图,包括质心值(C-SIA)和手术诱导散光平均值(M-SIA)。结果平均年龄64.86±8.48岁,60%为右眼。无术中并发症。最佳矫正视力(log MAR)为1.079±0.66,术后有显著改善(P=0.00)。平均眼压为16.88±3.193,术后显著下降(P=0.04)。角膜散光从术前的0.939±0.57D显著增加到术后的1.146±0.67D(P=0.02),手术诱导散光C-SIA的质心在68°(OD)轴处为0.28±0.67 D,在76°(OS)轴处则为0.15±0.72 D。80%和22%的患者获得了良好的视力(>20/40),致密性白内障对视觉效果有显著影响(P=0.02),在手术过程中应努力处理需要复杂手术的眼部疾病,如密集性白内障,并观察每一次术后视觉进展以进行干预。
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引用次数: 0
Role of antisecretory drug in treatment of children with acute watery diarrhea: A Randomized Controlled Trial 抗分泌药物在儿童急性水样腹泻治疗中的作用:一项随机对照试验
Pub Date : 2022-10-01 DOI: 10.4103/azmj.azmj_126_21
Reham Sayed, H. El-Masry, Ismail El-Razek Kasem
Background and aim Previous studies have shown that Racecadotril is safer and more effective in treating children with acute diarrhea. This study aimed to evaluate the effect of Racecadotril as a booster to oral rehydration solution in the management of acute watery diarrhea among children aged 5 years or less. Patients and methods This random clinical trial included 50 children with acute watery diarrhea for less than or equal to 5 days with a frequency of more than or equal to three diarrheic stools in the past 24 h before admission to the hospital, with no mild-to-moderate dehydration. Our study is registered to clinicaltrials.gov (NCT05216822). Results The main findings of this study were that Racecadotril reduced the duration of the diarrheal episodes and the duration of hospitalization significantly. This study revealed that Racecadotril showed an improvement in the consistency of stool, which protects the patient from fluid loss and dehydration. Conclusion Racecadotril is an effective booster-rehydration drug that carries out its antidiarrheal effect by inhibiting intestinal enkephalinase. It is efficient in reducing the volume and frequency of stool output.
背景与目的以往的研究表明,消旋卡多曲治疗儿童急性腹泻更安全有效。本研究旨在评价消旋卡多曲作为口服补液的增强剂在治疗5岁以下儿童急性水样腹泻中的作用。患者和方法本随机临床试验纳入50例入院前24 h内出现≥3次腹泻便的急性水样腹泻,持续时间小于等于5天的儿童,无轻至中度脱水。我们的研究已在clinicaltrials.gov注册(NCT05216822)。结果本研究的主要发现是消旋卡多曲能显著缩短腹泻发作时间和住院时间。这项研究表明,消旋卡多曲显示改善大便的稠度,从而保护患者免受水分流失和脱水。结论消旋卡多曲是一种有效的补液药,其止泻作用是通过抑制肠脑啡肽酶来实现的。它能有效减少排便量和次数。
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引用次数: 0
Changing epidemiology of monkeypox and risk for wide-scale outbreak 猴痘流行病学的变化和大规模暴发的风险
Pub Date : 2022-10-01 DOI: 10.4103/azmj.azmj_33_22
S. Yasri, V. Wiwanitkit
Monkeypox has spread over Europe, posing a major threat to public health. Monkeypox is a rare pox infection that has returned, with zoonosis suspected as the cause. Human-to-human transmission is now under observation. The medical community has been alerted by an increasing number of reported cases in several countries. SARS-CoV-2 pandemic taught us that in the event of an outbreak, we must act promptly to respond, examine thoroughly, and take appropriate action. Although monkeypox is an old disease, a new genetic mutation may have resulted in a more severe illness and a widespread outbreak.
猴痘已在欧洲蔓延,对公共卫生构成重大威胁。猴痘是一种复发的罕见痘感染,怀疑是人畜共患病。目前正在观察人际传播。一些国家报告的病例数量不断增加,引起了医学界的警惕。SARS-CoV-2大流行告诉我们,一旦爆发疫情,我们必须迅速采取行动应对,彻底检查并采取适当行动。虽然猴痘是一种古老的疾病,但一种新的基因突变可能导致更严重的疾病和广泛的暴发。
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引用次数: 0
Doxycycline Plus Trimethoprim-Sulfamethoxazole versus Doxycycline plus Rifampicin in Treatment of Brucellosis: A Randomized Controlled Trial 多西环素加甲氧苄啶-磺胺甲恶唑与多西环肽加利福平治疗布鲁氏菌病的随机对照试验
Pub Date : 2022-10-01 DOI: 10.4103/azmj.azmj_61_22
W. Hassan, M. Abdel-Gawad, A. Abdelmohsen
Background and aim Brucellosis is one of the most common endemic zoonotic diseases that have large animal and human burden. Many regimens of drug combinations are used for a variable period (at least 6 weeks). Rifampicin with doxycycline is one of the most used combinations. In this respect, we aimed to compare between the efficacy of two different combinations: trimethoprim-sulfamethoxazole combined with doxycycline (TMX-Doxy) versus rifampicin combined with doxycycline (Rif-Doxy). Patient and methods Between June 2020 and January 2022, 100 patients with brucellosis were included. Half of them (50 patients) received TMX-Doxy, whereas the other half (50 patients) received Rif-Doxy for 6 weeks. Follow-up was done during the treatment course and 6 months after the end of treatment to detect successfully treated cases, failed-to-treat cases, and relapsed cases. Results The success rates of both used drug regimens were comparable, with the rate of success of TMX-Doxy combination being 90%, whereas it was 94% in the RIF-Doxy group (P=0.23). The failure rate was 4% in the TMX-Doxy group and 2% in the RIF-Doxy group (P=0.31). Relapse of brucellosis was recorded in 6% of patients in the TMX-Doxy group, whereas it was 4% of patients in the RIF-Doxy group (P=0.32). The adverse effects of both drug combinations were mild and self-limited, and none of the enrolled patients needed to stop treatment. Conclusion Combination of TMX-Doxy is effective, safe, and not inferior to the more used RIF-Doxy combination.
背景与目的布鲁氏菌病是最常见的地方性人畜共患疾病之一,对动物和人类造成巨大负担。许多药物组合方案的使用时间不等(至少6周)。利福平与强力霉素是最常用的组合之一。在这方面,我们旨在比较两种不同组合的疗效:甲氧苄啶-磺胺甲恶唑联合强力霉素(TMX-Doxy)与利福平联合强力霉素(Rif-Doxy)。患者和方法2020年6月至2022年1月,纳入100例布鲁氏菌病患者。其中一半(50例)接受TMX-Doxy治疗,另一半(50例)接受Rif-Doxy治疗,疗程6周。在治疗期间和治疗结束后6个月进行随访,以发现治疗成功病例、治疗失败病例和复发病例。结果两种用药方案的成功率具有可比性,TMX-Doxy联合用药的成功率为90%,而RIF-Doxy联合用药的成功率为94% (P=0.23)。TMX-Doxy组失败率为4%,RIF-Doxy组为2% (P=0.31)。在TMX-Doxy组中,6%的患者复发布鲁氏菌病,而在RIF-Doxy组中,这一比例为4% (P=0.32)。两种药物组合的不良反应都是轻微且自限性的,并且没有入组的患者需要停止治疗。结论TMX-Doxy联合用药有效、安全,不逊于常用的RIF-Doxy联合用药。
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引用次数: 0
Cognitive impairment after first-ever ischemic stroke 缺血性中风后的认知障碍
Pub Date : 2022-10-01 DOI: 10.4103/azmj.azmj_72_21
Mosaab Omran, N. Ibrahim, M. Zaki
Background and aim Ischemic stroke has a good outcome because these patients usually have a good motor recovery. The aim of this work was to assess the prognostic value of the neurocognitive status to detect early cognitive dysfunction in stroke phases, evaluate outcome after first-ever ischemic stroke, and to choose proper preventive management of stroke cognitive dysfunction. Patients and methods Patients with ischemic stroke were prospectively evaluated using Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE) individually and in combination with National Institutes of Health Stroke Scale (NIHSS), either at the subacute stroke phase or within 2 weeks (baseline), and modified Rankin scale (mRS) scores, for functional outcome 3 and 6 months later. Results Cognitive impairment was diagnosed at baseline in 37.5% of patients with median NIHSS=4 and median mRS=2 (P<0.001). Baseline NIHSS, MMSE, and MoCA can individually predict mRS scores at 3 and 6 months, and NIHSS is the strongest predictor. However, patients with more disability at baseline (NIHSS>2), baseline MoCA, and MMSE had a moderately large significant predictive value to the baseline NIHSS for mRS scores at 3 and 6 months. Conclusion Screening of cognitive state at the subacute stroke phase can predict functional outcome independently and improve the predictive value of stroke severity scores. And it is important to evaluate what cognition is, and the brief cognitive test may facilitate assessment in the early phases.
背景与目的缺血性脑卒中患者通常具有良好的运动功能恢复,预后良好。本研究的目的是评估脑卒中早期认知功能障碍的神经认知状态的预后价值,评估首次缺血性脑卒中后的预后,并选择适当的脑卒中认知功能障碍预防管理。对缺血性脑卒中患者进行前瞻性评估,分别使用蒙特利尔认知评估(MoCA)和迷你精神状态检查(MMSE),并结合美国国立卫生研究院卒中量表(NIHSS),在亚急性卒中期或2周内(基线),以及修改的Rankin量表(mRS)评分,评估3个月和6个月后的功能结局。结果37.5%的患者在基线时被诊断为认知障碍,中位NIHSS=4,中位mRS=2 (P2),基线MoCA和MMSE对基线NIHSS在3个月和6个月时的mRS评分具有中等较大的显著预测价值。结论亚急性期认知状态筛查可独立预测脑卒中功能结局,提高脑卒中严重程度评分的预测价值。评估什么是认知是很重要的,简短的认知测试可能有助于在早期阶段进行评估。
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引用次数: 2
COenzyme Q10 ameliorates bisphinol A induced reproductive male toxicity: A transmission electron microscopic and immunohistochemistry study 辅酶Q10改善双酚A诱导的雄性生殖毒性:透射电镜和免疫组织化学研究
Pub Date : 2022-10-01 DOI: 10.4103/azmj.azmj_24_22
Samia S. Barghash, I. Farrag, Fatma El-Zahraa Abd El-Hakam, S. Ali, E. Aly
Background and aim The endocrine disruptor compound bisphenol A (BPA) affects spermatogenesis and exacerbates benign prostate hyperplasia induced by testosterone. Nonetheless, the direct effect of BPA on prostate and testicular cells is not fully investigated. The objective of this study was to evaluate the pathogenic effects of BPA on the structure of the prostate and the ultrastructure of the testis of adult male albino rats via immunohistochemical and transmission electron microscopic study and the potential protective effect of CoQ10 supplementation. Methods A total of 30 male albino Wistar rats were categorized into five equal cohorts: group I, no treatment; group II was administered corn oil; group III received coenzyme Q10 (CoQ10); group IV was administrated BPA; and group V received BPA+CoQ10. Results BPA administration significantly decreased the mean values of the plasma fertility hormones and serum antioxidant enzymes and increased malondialdehyde. BPA administration markedly affected seminal parameters. Coadministered CoQ10 significantly reversed these biochemical changes. BPA induced histopathological alterations in the epithelium and connective tissue of prostate. Immunohistochemistry of the prostate revealed decreased E-cadherin and increased vimentin expressions in BPA-treated group. Ultrastructural analysis of the testis showed impairment of the basal lamina of seminiferous tubules and tight junctions between Sertoli cells after BPA exposure. Conclusion The biochemical and histopathological results of this study revealed direct evidence for BPA-induced male reproductive toxicity in the testes and prostate, causing male infertility. CoQ10 coadministration with BPA partially protects against its damaging effect mediated via its antioxidant capabilities.
背景和目的内分泌干扰物双酚A(BPA)影响精子发生,并加剧睾酮诱导的良性前列腺增生。尽管如此,BPA对前列腺和睾丸细胞的直接影响尚未得到充分研究。本研究的目的是通过免疫组织化学和透射电镜研究,评估BPA对成年雄性白化大鼠前列腺结构和睾丸超微结构的致病作用,以及补充辅酶Q10的潜在保护作用。方法将30只雄性白化Wistar大鼠分为5组:第一组,不治疗;第二组给予玉米油;第三组给予辅酶Q10(CoQ10);IV组给予BPA;V组接受BPA+辅酶Q10。结果BPA能显著降低血浆生育激素和血清抗氧化酶的平均值,增加丙二醛含量。BPA给药显著影响精液参数。联合服用辅酶Q10可显著逆转这些生化变化。BPA引起前列腺上皮和结缔组织的组织病理学改变。前列腺免疫组织化学显示BPA治疗组E-钙粘蛋白表达减少,波形蛋白表达增加。睾丸的超微结构分析显示,BPA暴露后,曲精管基底层受损,支持细胞之间紧密连接。结论本研究的生化和组织病理学结果揭示了BPA在睾丸和前列腺中诱导男性生殖毒性,导致男性不育的直接证据。辅酶Q10与BPA的联合用药部分保护了其通过抗氧化能力介导的破坏作用。
{"title":"COenzyme Q10 ameliorates bisphinol A induced reproductive male toxicity: A transmission electron microscopic and immunohistochemistry study","authors":"Samia S. Barghash, I. Farrag, Fatma El-Zahraa Abd El-Hakam, S. Ali, E. Aly","doi":"10.4103/azmj.azmj_24_22","DOIUrl":"https://doi.org/10.4103/azmj.azmj_24_22","url":null,"abstract":"Background and aim The endocrine disruptor compound bisphenol A (BPA) affects spermatogenesis and exacerbates benign prostate hyperplasia induced by testosterone. Nonetheless, the direct effect of BPA on prostate and testicular cells is not fully investigated. The objective of this study was to evaluate the pathogenic effects of BPA on the structure of the prostate and the ultrastructure of the testis of adult male albino rats via immunohistochemical and transmission electron microscopic study and the potential protective effect of CoQ10 supplementation. Methods A total of 30 male albino Wistar rats were categorized into five equal cohorts: group I, no treatment; group II was administered corn oil; group III received coenzyme Q10 (CoQ10); group IV was administrated BPA; and group V received BPA+CoQ10. Results BPA administration significantly decreased the mean values of the plasma fertility hormones and serum antioxidant enzymes and increased malondialdehyde. BPA administration markedly affected seminal parameters. Coadministered CoQ10 significantly reversed these biochemical changes. BPA induced histopathological alterations in the epithelium and connective tissue of prostate. Immunohistochemistry of the prostate revealed decreased E-cadherin and increased vimentin expressions in BPA-treated group. Ultrastructural analysis of the testis showed impairment of the basal lamina of seminiferous tubules and tight junctions between Sertoli cells after BPA exposure. Conclusion The biochemical and histopathological results of this study revealed direct evidence for BPA-induced male reproductive toxicity in the testes and prostate, causing male infertility. CoQ10 coadministration with BPA partially protects against its damaging effect mediated via its antioxidant capabilities.","PeriodicalId":7711,"journal":{"name":"Al-Azhar Assiut Medical Journal","volume":"20 1","pages":"319 - 332"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46563571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Effect of new oral anticoagulants on microcirculation in ischemic diabetic foot ulcer 新型口服抗凝剂对缺血性糖尿病足溃疡微循环的影响
Pub Date : 2022-10-01 DOI: 10.4103/azmj.azmj_60_21
K. Attia, M. Moawad, Walied Khereba
Background and aim Diabetic patients with foot ulcer and peripheral ischemia were shown to be associated with hypercoagulation and dysfunction in the fibrinolytic system that in turn would affect the healing of the ulcer. The authors aimed to investigate the role of rivaroxaban in improving the microcirculation of the skin and peripheral tissues and how it can improve ischemic diabetic foot ulcers. Patient and methods The authors conducted an observational retrospective case–control study at Al-Azhar University Hospital, New Damietta, from January 2015 till December 2020. Diabetic patients with foot ulcer and peripheral limb ischemia who received rivaroxaban till ulcer healing were considered as the case group, whereas patients who did not receive rivaroxaban were considered as the control group. Clinical assessment and pulse oximeter were used for the assessment of transcutaneous microcirculation. Results Throughout the 5 years of the study, 172 patients were included; the case group included 87 patients and the control group included 85 patients. There was a significant difference between the two groups regarding the improvement of limb ischemia, tissue plasminogen activator antigen, and transcutaneous microcirculation (P<0.05). Before the treatment, there was a significant correlation between both permeability coefficient and plasma fibrinogen and transcutaneous microcirculation. Conclusion The oxygenation of the ulcer and the microcirculation were found to be improved in the case group and accelerate wound healing in the ischemic diabetic foot.
背景和目的糖尿病足溃疡和外周缺血患者与高凝状态和纤溶系统功能障碍有关,这反过来又会影响溃疡的愈合。作者旨在研究利伐沙班在改善皮肤和外周组织微循环方面的作用,以及它如何改善缺血性糖尿病足溃疡。患者和方法作者于2015年1月至2020年12月在新达米埃塔爱资哈尔大学医院进行了一项观察性回顾性病例对照研究。将接受利伐沙班治疗至溃疡愈合的足部溃疡和外周肢体缺血的糖尿病患者视为病例组,而未接受利伐沙班治疗的患者视为对照组。临床评估和脉搏血氧计用于评估经皮微循环。结果在整个5年的研究中,172名患者被纳入;病例组87例,对照组85例。两组在改善肢体缺血、组织纤溶酶原激活物抗原和经皮微循环方面有显著差异(P<0.05),治疗前渗透系数与血浆纤维蛋白原和经皮微循环均呈显著相关。结论病例组可改善糖尿病足缺血性溃疡的氧合及微循环,促进创面愈合。
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引用次数: 0
Systemic thrombolytic therapy in treatment of acute limb ischemia: a single-center retrospective observational study 全身溶栓治疗急性肢体缺血:一项单中心回顾性观察研究
Pub Date : 2022-10-01 DOI: 10.4103/azmj.azmj_61_21
K. Attia, M. Moawad, Walied Khereba
Background and aim Owing to the increased risk of morbidity and mortality, the treatment of acute limb ischemia (ALI) is challenging. The authors aimed to investigate the outcomes of thrombolysis in the treatment of ALI and limb salvage. Patients and methods A retrospective observational study was conducted to revise the data of 49 patients who underwent catheter-direct thrombolysis for ALI. A total of 33 cases were at lower limb and 16 cases were at upper limb. The assessed outcomes were primary and secondary patency, survival, amputation-free survival, and conversion to surgery. Results The patients were classified according to the Rutherford classification into class I (52%), class IIa (38%), class IIb (8%), and class III (2%). The primary patency was present in 34% of the patients after the first year and 22% after the second year. On the contrary, 28% of the patients were subjected to conversion to open surgery, 8% were subjected to reintervention, and 6% were subjected to amputation within the first month. The mortality rate within 1 month was 6%. The worst primary and secondary patency rates were seen in the prosthetic grafts in addition to vein bypasses, whereas the native artery was the most successful one regarding the primary patency, secondary patency, and amputation-free survival (P<0.05 for each). Conclusion The thrombolysis of vein bypass and prosthetic grafts did not show technical success as that seen with native artery. Additional treatment at the time of thrombolysis was shown to be associated with better outcomes.
背景和目的由于发病率和死亡率的增加,急性肢体缺血(ALI)的治疗具有挑战性。作者旨在探讨溶栓治疗急性肺损伤和肢体挽救的效果。患者和方法采用回顾性观察研究方法,对49例ALI患者进行导管直接溶栓治疗。下肢33例,上肢16例。评估的结果包括一期和二期通畅率、生存率、无截肢生存率和转为手术。结果根据Rutherford分类法将患者分为I类(52%)、IIa类(38%)、IIb类(8%)和III类(2%)。第一年后34%的患者出现初次通畅,第二年后22%出现初次通畅。相反,28%的患者在第一个月内接受了开放手术,8%接受了再干预,6%接受了截肢手术。1个月内死亡率为6%。除静脉旁路外,人工移植物的一次和二次通畅率最差,而天然动脉在一次通畅、二次通畅和无截肢生存率方面最成功(各P<0.05)。结论静脉转流和人工移植物的溶栓治疗在技术上不如天然动脉溶栓治疗成功。溶栓时的额外治疗被证明与更好的结果相关。
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引用次数: 0
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Al-Azhar Assiut Medical Journal
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