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The paper reports the treatment of a maintenance hemodialysis patient with pseudoaneurysm (PSA) caused by accidental injury of brachial artery during the puncture of internal fistula. The main treatment methods of PSA include surgical incision and repair, local pressure therapy, ultrasound-guided intraluminal thrombin injection, implantation of covered stent, coil embolization and so on, but they all have some defects. The patient was admitted to hospital due to poor fistula function, and the formation of brachial artery PSA was confirmed by color ultrasound. PSA was successfully treated with ultrasound-guided and balloon-assisted injection of human fibrin sealant. The fistula had good function 3 months after the operation.
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Objective To investigate the clinical significance of detecting the level of D-dimer and fibrino-gen degradation products(FDP)in the prognosis of acute pulmonary embolism(APE).Methods The plasma D-dimer and FDP levels in patients with APE were determined by the method of turbidimetric inhibition im-muno assay in 126 patients with respiratory medicine of Renmin Hospital of Wuhan University.According to the severity of APE patients,they were classified into high-risk group,middle risk group and Low-risk Group. According to the 6-month clinical outcome after treatment,the patients were divided into survival group and death group,and evaluate the predictive value of D-dimer and FDP levels in assessing the prognosis of patients with APE.Results With the increase in the severity of APE,the levels of D-dimer and FDP were significantly increased(P<0.05).The levels of D-dimer and FDP were significantly higher in the death group than those in the survivor group(P<0.05).The D-dimer and FDP level were positively correlated(r=0.437,P=0.000). ROC curve analysis showed that D-dimer>0.98 mg/L and FDP>10.02 mg/L had a higher prognostic value for APE Patients.Conclusion D-dimer and FDP levels are associated with the risk stratification and long-term prognosis of APE patients.Meanwhile,the combination of D-dimer and FDP can improve the accuracy of the disease severity and prognosis of APE patients,which deserves extensive attention in the new situation of clin-ical personalized medical care.