经皮肾镜气压弹道碎石术治疗肾结石的术后护理

目的 总结38例经皮肾镜气压弹道碎石术治疗肾结石的护理措施.方法 术后密切观察生命体征的变化,卧床休息,多饮水,加强肾造瘘管、双J管、导尿管的护理,加强并发症的观察和护理,做好健康教育和出院指导.结果 35例一次取石成功,3例10 d后二次手术,均痊愈出院.结论 对经皮肾镜气压弹道碎石术的患者实施有效的术后护理,可以预防和减少并发症的发生,使患者平安顺利度过手术期.     

经皮肾镜钬激光碎石术治疗肾结石42例护理体会

目的:探讨泌尿外科新的微创手术方法,经皮肾镜钬激光碎石术的护理.方法:通过对42例经皮肾镜钬激光碎石术患者的护理,总结对于该类手术前、后护理要点.结果:手术过程顺利,取石成功率高,无并发症发生.结论:经皮肾镜钬激光碎石术是一项新的、有效的治疗肾结石的微创手术方法.护理上各个环节的密切配合是保证手术治疗的必要条件.     

腹腔镜下肾切除的护理

目的:总结腹腔镜下肾切除术后的护理经验.方法:对30例腹腔镜下肾切除术患者的护理经验进行回顾性分析总结.结果:30例腹腔镜下肾切除术患者术后情况均得到改善.结论:科学、合理地护理措施对腹腔镜下肾切除术患者具有重要的意义.     

经皮肾镜气压弹道碎石术治疗结石梗阻性脓肾围手术期护理

目的:探讨经皮肾镜气压弹道碎石术治疗结石梗阻性脓肾围手术期护理措施.方法:本文采用经皮肾镜气压弹道碎石术治疗结石梗阻性脓肾,并对54例患者进行了观察与护理.结果:本组54例患者经过精心治疗与护理后均痊愈出院;术中、术后未出现严重并发症;平均住院(6.3±2.2)d.结论:充分的术前准备、精心细致的术后护理能提高治疗成功率,降低了并发症的发生,保证了手术的顺利进行.     

双J管内引流用于妊娠期输尿管结石致顽固性肾绞痛患者的护理

目的 探讨妊娠期输尿管结石致顽固性肾绞痛患者行双J管内引流术的护理方法与效果.方法 通过膀胱镜将双J管置入10例妊娠期输尿管结石患者的患侧输尿管实施内引流,并进行针对性护理.结果 置入双J管后10例肾绞痛均消失,并顺利渡过围生期,顺产健康新生儿.结论 严密监测患者及胎儿情况并做好术前心理护理、体位护理,术中密切观察血压变化,术后做好并发症护理,对患者的康复和胎儿的安全起重要作用.     

乳糜尿患者经后腹腔镜肾蒂淋巴管离断术的护理

对19例乳糜尿患者经后腹腔镜行肾蒂淋巴管离断术治疗.结果患者术后乳糜尿消失,住院(4.7±0.7) d痊愈出院.提出术前做好病情观察、饮食指导、改善营养状况及心理护理,术中严密监护,术后加强病情监护、引流管护理、并发症的防治及出院指导,是保证患者顺利康复,减少并发症,防止复发的重要护理措施.     

经皮肾镜取石术患者的围手术期护理

目的探讨经皮肾镜取石术患者的围手术期护理。方法回顾总结对68例经皮肾镜取石术的患者进行有针对性的术前心理护理、术后的特殊护理和出院时的康复指导。结果 68例患者经精心治疗与护理后痊愈出院,平均住院时间8 d。结论对经皮肾镜取石术患者实施有效的围手术期护理,可以使患者顺利度过手术期。     

后肾腺瘤的临床特征(附1例报告及文献复习)

目的 探讨后肾腺瘤的临床表现及影像学、病理学特征,提高对后肾腺瘤的认识和术前诊断水平.方法 回顾性分析1例后肾腺瘤患者的相关资料并进行相关文献复习.结果 患者术后病理诊断为后肾腺瘤;术后恢复较好,顺利出院.结论 后肾腺瘤的临床特征有限,多为体检时发现,术前需结合生化及影像学检查综合判断,必要时行穿刺病理及术中冷冻病理明确诊断,为患者选择合适手术方式;一般预后良好,但术后仍需定期复查.     

无痛护理在经皮肾镜碎石取石术的效果观察

目的 探讨无痛护理在经皮肾镜碎石手术围手术期的临床应用价值.方法 2011年1月～2012年12月64例肾结石在全麻下行经皮肾镜碎石取石术,按患者入院顺序号分为2组:奇数者为实验组32例,术后实施无痛护理;偶数者为对照组32例,术后接受常规护理.比较2组患者术后疼痛评分和满意度.结果 64例手术均顺利,实验组术后疼痛视觉模拟评分(4.5±1.2)分,对照组为(6.7±1.9)分,2组有统计学差异(t=5.538,P=0.000).实验组满意度为93.8％(30/32),明显高于对照组对照组40.6％(13/32)(Z=-4.537,P=0.000).结论 无痛护理能够有效减轻经皮肾镜碎石术后患者疼痛,提高患者满意度.     

经皮肾镜与肾孟切开取石术的护理比较

目的 对比开放性肾孟切开取石与经皮肾镜取石两种不同的手术后护理.方法 术后对比观察两组患者的术中出血量,手术时间,引流管留置时间,术后住院时间.结果 两组比较,经皮肾镜组在术中出血量、手术时间、引流管留置时间、术后住院时间明显少于开放性肾切开取石组.结论 经皮肾镜取石术具有创伤小、痛苦少、恢复快、疗效与开放手术相近的优点,值得推广.     

Increased cytokine secretion in patients with failed implants compared with patients with primary implants

All total joint replacements generate wear debris; yet, some implant prostheses fail while others survive despite the presence of ultrahigh molecular weight polyethylene particulate. It was hypothesized that patients with failed hip implants who have osteolysis will secrete higher inflammatory cytokines than patients receiving total joint replacements. Our study evaluated the peripheral blood monocyte response to varying polyethylene particle volume ratios through cytokine quantification in two patient populations: patients having revision surgery for failed total hip replacements (failed implant group) and patients having primary total hip surgery for osteoarthritis of the hip (primary implant group). We observed elevation of all three proinflammatory cytokines tested (interleukin-6, interleukin-1, and tumor necrosis factor-alpha) in response to polyethylene particulate challenge when compared with the controls in both patient groups. The population with failed implants also had a higher absolute cytokine response to polyethylene exposure compared with the control patients having primary implants. These findings suggest that patients with failed implants have a greater inflammatory cytokine response to polyethylene than seen in patients with primary implants.     

Relations with cancer patients

A patient suffering from cancer expects to be cured by surgery, irradiation or chemotherapy. Despite of great progress in treating malignant tumours a great deal of these patients come to death due to their disease. This fact is known to the patients. Therefore, their personal attitude is often characterised by anxiety, hopelessness and impairement of their ability to communicate. Surgeons should know this and pay more attention to the special psychic situation of their tumour patients.     

Assessment of sexual activity in patients with back pain compared with patients with neck pain

Recent research has shown significant adverse effects of chronic low back pain on sexual activity in 46% of patients. To establish whether and how chronic low back pain adversely affects sexual activity, a questionnaire-based study was conducted on a patient group (low back pain) and a comparison group (neck pain). Patients were administered a visual analog scale, a series of conventional questionnaires, and a specifically designed sexual activity questionnaire covering frequency of intercourse before and since onset of pain, discomfort during intercourse, satisfaction with sexual life, and comfortable and uncomfortable basic coital positions. Patients with low back pain reported more interference than did patients with neck pain, and women with low back pain were more affected than men. Compared with the other groups, women with low back pain had greater reduction in frequency of intercourse, more marked discomfort during intercourse, and more interference with their sexual lives. The most pain generating position was prone for both genders, and the most comfortable one was supine. Sexual impairment, more marked in women, seems to be related to the triggering of pain by intercourse and to psychologic factors.     

Renal function in patients with abdominal aortic aneurysm. Comparison with hypertensive patients

AIMS: Renal dysfunction occurs occasionally after the repair of abdominal aortic aneurysm (AAA), and preoperative renal function is considered as one of the potential causes. The present study was designed to evaluate and compare renal function and risk factors of AAA patients with those of hypertensive patients. METHODS: We prospectively examined 95 patients with AAA and 72 patients with essential hypertension (HT) without other cardiovascular diseases (CVD). Renal function, urinary albumin excretion (UAE) and renal scintigraphy were compared. Kidney size was calculated using ultrasonography. RESULTS: Serum creatinine and creatinine clearance in AAA patients was worse than in HT patients. Smoking status was more apparent in AAA patients. Renal artery stenosis occurred in 8 patients with AAA. Renal scintigraphy showed normal function in 19%, hypofunction in 69% and severe dysfunction in 12% of the AAA patients, and normal function in 42% and hypofunction in 58% of the HT patients (p < 0.0001). Multivariate linear regression analysis showed that renal function was related to age, UAE, CVD, smoking status and kidney size for all patients, UAE, CVD, smoking status and kidney size for AAA patients, and age and kidney size for HT patients. CONCLUSION: Renal function of AAA patients was worse than HT patients without other CVD. The risk factors for renal dysfunction were different between AAA and HT patients. These preoperative conditions may relate to the postoperative renal dysfunction seen in AAA patients.     

阿德福韦酯治疗慢性乙型肝炎致低磷性骨软化症8例

目的：进一步探讨阿德福韦酯（ADV）所致低磷性骨软化症的临床特点。方法回顾性分析2010至2012年共收治的8例慢性乙型肝炎患者经ADV治疗所致低磷性骨软化症的临床表现、治疗和转归。结果8例患者均在服用ADV后出现低磷血症及骨质疏松，其主要临床表现为乏力、多发骨痛，进行加重至行走障碍；低血磷、低尿酸和高碱性磷酸酶血症、骨密度检查提示骨质疏松。经停用ADV、对症补钙、补磷治疗后患者的血磷恢复正常，疼痛缓解，骨质疏松改善。结论 ADV可引起低磷性骨软化症；补充磷、维生素D3及钙剂治疗可恢复。