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1.
目的 探讨腹腔镜下中上段输尿管切开取石术的技术、疗效和临床意义.方法 2006年3月-2007年5月收治输尿管中上段结石20例,采用经腹膜后途径腹腔镜下施行输尿管中上段切开取石手术,取石后直接于镜下置入双J管,缝合输尿管切口,置输尿管旁引流管.结果 20例手术均获成功,无一例中转开放性手术,手术时间30-80min,平均50min,失血30-60ml,术后次日下床活动,第2-4天拔除输尿管旁引流管,4-5天拔除导尿管,术后住院时间5-7天,3-4周膀胱镜下拔除双J管,随访3-6个月恢复良好.结论 后腹腔镜下中上段输尿管切开取石术疗效好、创伤小、痛苦少、恢复快.  相似文献   

2.
目的 探讨腹腔镜下中上段输尿管切开取石术的技术、疗效和临床意义.方法 2006年3月-2007年5月收治输尿管中上段结石20例,采用经腹膜后途径腹腔镜下施行输尿管中上段切开取石手术,取石后直接于镜下置入双J管,缝合输尿管切口,置输尿管旁引流管.结果 20例手术均获成功,无一例中转开放性手术,手术时间30-80min,平均50min,失血30-60ml,术后次日下床活动,第2-4天拔除输尿管旁引流管,4-5天拔除导尿管,术后住院时间5-7天,3-4周膀胱镜下拔除双J管,随访3-6个月恢复良好.结论 后腹腔镜下中上段输尿管切开取石术疗效好、创伤小、痛苦少、恢复快.  相似文献   

3.
目的总结腹腔镜输尿管切开取石术中手助双J管置入法置放双J管的经验。方法对行腹腔镜下输尿管切开取石术35例患者,术中应用自行设计的手助双J管置入法置放双J管。结果 35例均成功置入双J管,手术时间41~86 min,平均58 min;术后次日即下床活动,1~3 d拔除腹腔引流管,3~4 d拔除导尿管,术后住院时间4~6d,平均4.6d,无一例出现尿漏。4周后于膀胱镜下拔除双J管,无双J管滞留。均获得随访,随访时间6~18个月,22例肾积水消失,部分患者肾功能改善。结论应用手助双J管置入法置入双J管简便省时。  相似文献   

4.
目的探讨输尿管导管在非复杂性输尿管结石行输尿管镜下碎石术后的临床应用价值.方法选取行输尿管镜钬激光碎石术的非复杂性输尿管结石患者98例,其中术后放置输尿管导管49例(导管组),放置双J管49例(双J管组).比较两组患者碎石术时间,以及术后留管期间(取管前)尿路刺激症、血尿、尿路感染、腰痛或侧腹痛等并发症的发生情况.结果导管组手术时间显著短于双J管组(P<0.01).两组患者仅术后第4天尿路刺激症发生率的差异有统计学意义(P<0.05),其他并发症发生率的差异均无统计学意义(均P>0.05).术后1个月检查结果显示两组患者无石率均为100%,术后3个月检查结果显示均无输尿管狭窄发生.结论输尿管导管是输尿管镜治疗非复杂性输尿管结石术后引流的一种好方法.  相似文献   

5.
目的 探讨单J管配合输尿管镜治疗输尿管结石的临床疗效.方法 2009年3月-2011年9月在兰州石化总医院行输尿管镜治疗的输尿管结石患者100例,根据术后放置单、双J管分为单J管组(53例)及双J管组(47例).比较两组的临床效果.结果 术后第1、2周,双J管组尿路刺激症的发生率均显著高于单J管组(P值均<0.05);两组间肉眼血尿、尿路感染、腰痛或侧腹痛发生率的差异均无统计学意义(P值均>0.05).术后单、双J管组分别有23、27例患者获随访,拔除单或双J管后第1、2周两组并发症发生率的差异均无统计学意义(P值均>0.05).结论 输尿管镜治疗输尿管结石术后放置单J管引流支架的临床效果与双J管相近,且取出导管简单,相关并发症的发生率低,可作为临床一种新的输尿管镜术后的引流支架方法.  相似文献   

6.
目的 观察银花泌炎灵片与左氧氟沙星结合使用对于急性尿路感染患者的疗效观测.方法 将我院2010年10月~2011年10月收治的70例患者,随机分为治疗组和对照组,均35人.予治疗组用银花泌炎灵片(4片/次、3次/日)、左氧氟沙星胶囊(1片/次、2次/日);予对照组服用左氧氟沙星胶囊(1片/次、2次/日).并于两周以后观察两组临床疗效,并对其进行对比.结果 治疗组、对照组总有效率分别为89.4%、68.6%.结论 银花泌炎灵片与左氧氟沙星胶囊合用治疗急性尿路感染疗效确切、治愈率高,临床上值得推广应用.  相似文献   

7.
目的:探讨C臂X线机在预防双J管滞留孝感应用中的价值。方法:对92例术中置管有疑问的16例病人,在C臂X线机下以IVP及输尿管开口,肾门的解剖骨性标志为导向置管,置管后双J管自然卷曲,同时膀胱内美蓝盐水输尿管返流。结果:16例术中置双J管可疑病人,术后无双J管滞留,移位及脱出,膀胱镜双J管拔出顺利。结论:C臂X线机在置管可疑病人时辅助置管,及时、直观、可靠,避免了双J管滞留并发症,同时为上尿路取石提供了方便。  相似文献   

8.
目的:探讨输尿管镜钬激光碎石后双J管留置时间与并发症的关系.方法:根据人院时间将170例患者随机分成2组(留置4周及2周),观察其拔除双J管前后并发症发生.结果:拔除双J管前,2组患者中出现尿路刺激征为8l例(93%)和51例(61%)P<0.01,肉眼血尿均为100%,尿路感染71例(82%)和39例(47%)P<0.01,腰部及侧腹痛为26例(30%)和10例(12%)P<0.05,拔管前双J管钙盐沉积为23例(26%)和9例(11%),P<0.01.拔除双J管后2周尿路刺激征为3例(3.4%)和2例(2.4%),镜下血尿9例(10%)和6例(7%),尿路感染7例(8%)和3例(4%),腰部及侧腹痛均为0例,拔管后以上资料无统计学意义.结论:输尿管镜下钬激光后缩短双J管的留置时间可以减少术后尿路刺激征、尿路感染、腰痛等并发症的发生,拔除双J管后不会增加相关并发症.  相似文献   

9.
目的 通过对较长时间(1~3个月)留置的输尿管内双J管拔管时管壁沉积结石成分的分析,为临床预防拔管困难,预防结石形成的治疗提供依据.方法 对2000年1月~2008年6月该院腔镜中心膀胱镜室或手术室拔除的128例输尿管双J管管壁沉积结石进行化学成分分析,与原有结石标本化学分析报告,尿常规pH值及白细胞数,置管前、拔管前进行比较.结果 双J管沉积结石中尿酸结石、尿酸铵结石明显高于原尿石标本中相应成分(P<0.01).尿常规pH值无显著改变(P0.05),白细胞计数有显著改变(P<0.01).结论 双J管管壁沉积结石与膀胱内环境、原有结石病史、导管材质、留置时间有关.  相似文献   

10.
双J管长期留置的治疗分析   总被引:1,自引:0,他引:1  
廖林楚 《华夏医学》2007,20(1):61-62
目的:探讨双J管长期留置的治疗方法。方法:回顾性分析12例双J管长期留置的临床资料。结果:男8例,女4例,左侧6例,右侧4例,双侧2例,留置时间0.5~5年,其中直接膀胱镜拔除2例,ESWL后膀胱镜拔除4例,输尿管镜检+气压弹道碎石术拔除5例,ESWL+输尿管镜气压弹道碎石术1例。结论:均能顺利拔除双J管,无严重并发症。  相似文献   

11.
Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P< 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P< 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.  相似文献   

12.
Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P < 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (>0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P <0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P < 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.  相似文献   

13.
Objective: To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods: SD rats served as both donors and recipients. 4℃ sodium lactate Ringer's was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava (IVC) inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results: Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion: This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.  相似文献   

14.
Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.  相似文献   

15.
Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.  相似文献   

16.
A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care(~'4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.  相似文献   

17.
Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.  相似文献   

18.
Journal of Nanjing Medical University (English Edition) JNMU, sponsored by Nanjing Medical University, was established in 1987. It is a bimonthly comprehensive English medical journal published locally and abroad.Since 2007, Journal of Nanjing Medical University (English Edition )was granted Elsevier the full publishing and distribution rights worldwide for the Electronic Edition, excluding the People's Republic of China.  相似文献   

19.
目的:评价使用安心颗粒对急诊经皮冠状动脉介入术(PPCI)术后生活质量的影响.方法:将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组(术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次)和对照组(仅接受基础药物治疗).所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表(MIDAS)、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果:入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异(P>0.05);出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低(P<0.05);组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低(P<0.05).两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血(P>0.05).两组发生轻度血小板减少症的患者数比较无差异(P>0.05).结论:PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.  相似文献   

20.
Objective To measure Derpl and Blot5 allergen levels in asthmatics' homes in Hongkong.Methods Seventy houses were enrolled for a mite indoor environment study. Dust samples were obtained from two sites of each patients' house: bed and floor. Derpl and Blot5 levels were quantified by a two-site monoclonal antibody-based ELISA technique.Results The levels of Derpl allergens found in bed (geometric mean (GM) 3.43 μg/g of dust; 95%CI, 1.89-4.96 μg/g)and on the floor (GM 1.12 μg/g of dust; 95%CI, 0.71-1.53 μg/g) indicated significant differences (P=0.005). However, the levels of Blot5 allergens found in bed (GM 19.00 μg/g of dust; 95%CI, 0.89-38.90 μg/g) and on the floor (GM 6.14 μg/g of dust; 95%CI, 0.40-11.90 μg/g) showed no statistically significant difference. In addition, in regards to the exposure index for Derpl and Blot5 allergens found in bed and on the floor, 17.6% in bed and 8.6% on the floor had levels of Blot5 ≥ 10 μg/g of dust, higher than those obtained for Derp1 (7.2% and 0% in bed and on the floor respectively, P< 0.05); higher percentages in bed and on the floor (25.0% and 35.7%) were observed for levels of Blot5 =0 μg/g of dust as compared with Derpl in bed and on the floor (4.3% and 14.5% respectively, P< 0.05).Conclusions Derpl and Blot5 are the major allergens found in this regional study, Blot5 is a more potent allergen in Hongkong, probably reflecting the high level of exposure to Blomia tropicalis (Bt). Bt and Dermatophagoides pteronyssinus (Dp) allergens should be included for precise diagnosis and effective immuno-therapeutic treatment of mite allergy in Hongkong.  相似文献   

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