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1.
目的 探讨经皮肾镜和输尿管镜联合弹道超声碎石、清石系统治疗肾、上段输尿管结石的方法和疗效.方法 肾、上段输尿管结石,采用B 超引导下穿刺,扩张建立经皮肾通道,在肾镜、输尿管镜下采用第4代EMS 超声气压弹道碎石、清石系统治疗肾、上段输尿管结石.结果 本组患者99例行Ⅰ期穿刺取石成功,5例双肾复杂性肾结石采用分期穿刺取石,单通道取石94例,双通道取石5例;一次取石91例,2次取石8例;2例残留0.5 cm小结石,结石清除率98%.平均手术时间90 min.1例穿刺扩张失败,中转手术.结论 经皮肾镜和输尿管镜联合弹道超声碎石、清石术是治疗肾、上段输尿管结石较好的方法.  相似文献   

2.
B超定位下经皮肾镜弹道超声碎石术治疗肾结石   总被引:5,自引:0,他引:5  
目的 探讨B超定位下经皮肾镜气压弹道超声波碎石术治疗肾结石的临床疗效.方法 89例肾结石患者采用B超定位下经皮肾镜超声气压弹道碎石术,进行一期或二期碎石.结果 双肾结石32例;单侧肾结石57例,其中合并患侧输尿管结石15例;一期穿刺碎石成功89例次,需二期碎石5例次.结论 单用B超定位经皮肾穿刺,临床简便可行;经皮肾镜弹道超声碎石治疗肾结石疗效确切,除具有创伤性小、碎石快的优点外,还具有在彻底清除结石、防止结石残留方面独特的优越性.  相似文献   

3.
罗林 《吉林医学》2011,32(12):414-415
目的:观察B超引导经皮肾镜碎石取石术治疗上尿路结石的临床疗效和安全性。方法:219例患者中,输尿管上段结石77例,肾结石103例,肾输尿管上段结石39例,均在B超引导下穿刺建立皮肾通道,采用气压弹道碎石治疗。结果:全部病例均穿刺成功,Ⅰ期取石219例,需Ⅱ期取石7例。手术时间(输尿管逆行插管至放置肾造瘘管)35~150 min。术后4~6 d复查腹部平片(KUB),197例Ⅰ期取石干净,Ⅰ期结石取净率为89.95%。无术后肾造瘘管脱出,无胸、腹腔脏器损伤。结论:B超引导经皮肾镜碎石取石术治疗上尿路结石具有微创、高效、安全和并发症少等优势,值得临床推广应用。  相似文献   

4.
目的探讨在B超引导下经皮肾镜气压弹道联合超声碎石术治疗肾和输尿管上段结石的手术效果。方法对126例上尿路结石患者进行在B超引导下经皮肾镜碎石术,分析其在B超引导下对手术的影响。结果126例患者均为一期穿刺碎石取石,123例取净,3例术后复查KUB显示残留小结石。Ⅰ期手术结石取净率98%。结论B超在行经皮肾镜气压弹道联合超声碎石术治疗上尿路结石穿刺时,有方便、清楚等优点  相似文献   

5.
目的 探讨经皮肾镜联合经尿道输尿管镜气压弹道碎石术治疗一侧肾结石及对侧输尿管结石的方法及疗效.方法 采用经皮肾镜联合经尿道输尿管镜气压弹道碎石术治疗一侧肾结石及对侧输尿管结石36例.B 超引导下穿刺,扩张建立F22 经皮肾通道,在F20.8 肾镜下采用第3代EMS 超声气压弹道碎石清石系统争取Ⅰ期粉碎结石并主动吸出;输尿管镜处理对侧输尿管结石.结果 术前诊断36例均为一侧肾结石合并对侧输尿管结石,31例Ⅰ期手术取尽结石术,5例Ⅰ期手术后行ESWL排尽结石,无1例术中转开放手术.碎石清石时间72~177 min,平均117 min.肾造瘘术后6~14 d拔出肾造瘘管,3~4周拔出双J管.术后住院7~21 d,平均10.8 d.全组病例随防2~14个月,平均7.3个月,定期影像学检查和肾功能检测无并发症.合并肾功能衰竭者术后1~2周肾功能恢复,无1例透析.结论 随着经皮肾镜、输尿管镜以及高效碎石清石系统在临床上的普遍推广,极大提高了复杂性上尿路结石的取石效率,Ⅰ期同时处理肾结石合并对侧输尿管结石,具有微创、快速改善急性肾功能衰竭、住院时间短、费用低以及并发症少等优点,值得进一步探讨和推广.  相似文献   

6.
郑军  邓晓洪  欧平  王元中  葛冰  舒志松 《重庆医学》2008,37(13):1411-1412
目的探讨输尿管镜Ⅰ期联合经皮肾镜下超声气压弹道碎石清石术治疗复杂性上尿路结石的方法和疗效。方法输尿管镜处理输尿管结石;B超引导下穿刺,扩张建立F22经皮肾通道,在F20.8肾镜下采用第3代EMS超声气压弹道碎石清石系统争取Ⅰ期粉碎结石并主动吸出。结果术前诊断17例输尿管合并肾结石,清除时间78~156min,平均102min,结石粉碎率100%,取净率82.3%(14/17)。术后随访2~10个月,平均6.5个月,均无严重并发症,如大出血、穿孔、粘连狭窄,亦无复发。结论随着输尿管镜、经皮肾镜以及高效碎石清石系统在临床上的普遍推广,极大提高了复杂性上尿路结石的取石效率,Ⅰ期同时处理输尿管合并肾结石成为现实,具有安全、微创、并发症少的特点,有较好的临床推广价值。  相似文献   

7.
目的 探讨经皮肾镜超声联合气压弹道碎石术一期治疗上尿路结石合并脓肾的安全性及疗效.方法 上尿路结石合并脓肾26例(30侧),B超引导下行经皮肾镜超声联合气压弹道碎石术,在低压或无压力状态下碎石清石并吸除脓液和脓栓.结果 26例患者中结石取净22例(26侧),结石清除率86.66%(26/30),其中2例建立双通道取石,2例二期取石,1例三期取石.术中术后均未出现菌血症、脓毒血症、感染性休克、肾周脓肿、严重出血等并发症,无切肾.结论 经皮肾镜超声联合气压弹道碎石清石术一期治疗上尿路结石合并脓肾,安全有效.  相似文献   

8.
目的 探讨超声定位引导经皮肾镜气压弹道联合超声碎石清石术治疗复杂上尿路结石的安全性及其疗效.方法 2005年6月-2009年10月,采用在新型微创经皮肾镜(F20.8)下超声联合气压弹道碎石清石术治疗1 088例复杂上尿路结石患者,其中肾多发结石583例,部分或完全鹿角状结石387例,感染性结石35例,孤立肾结石13例,合并肾功能不全(氮质血症)43例,肾盏憩室结石27例,均在B超引导下穿刺并扩张建立F24皮肾通道,在肾镜下应用瑞士EMS三代气压弹道联合超声碎石清石系统进行碎石并吸出体外,术中B超检查示有残留结石的患者,则在B超引导下进入结石位置肾盏进行碎石.结果 866例患者一期经皮肾镜碎石(PCNL)取净所有结石,一期净石率为79.6%.一期手术的时间为20~180 min,平均手术时间为(45.2±4.7)min;术中失血量为10~450 mL,平均失血量为(40.3±3.5)mL.术后泌尿系X线平片检查显示115例(10.6%)有残留的直径5 mm的结石,行二期PCNL取石;76例(7.0%)患者接受三期PCNL取石.29例(2.7%)术后行辅助体外冲击波碎石治疗.9例术后出现严重出血,8例行超选择性肾动脉栓塞止血后好转,1例因术后严重迟发性出血止血效果不理想行肾切除;1例术后出现肾周巨大血肿,行保守治疗后好转.结论 采用经皮肾镜下超声联合气压弹道碎石清石术治疗复杂上尿路结石安全、高效,术中应用B超检查残留结石简便、易行,并能帮助引导肾镜清除残留结石,可显著提高复杂上尿路结石的治疗效果.  相似文献   

9.
目的探讨经皮肾镜下气压弹道联合超声碎石清石术治疗孤立肾复杂上尿路结石的疗效及安全性。方法B超引导下建立皮肤肾脏取石通道,采用瑞士EMS气压弹道联合超声碎石清石术治疗18例孤立肾上尿路结石,其中复杂肾结石16例、输尿管上段结石2例。结果18例均成功建立取石通道,一期单通道取石11例,双通道取石1例;二期单通道取石5例,双通道取石1例。一期取净10例,二期取净5例,结石取净率83.3%。术后输血1例,无气胸、内脏损伤、大出血及尿源性败血症等严重并发症。结论经皮肾镜下气压弹道联合超声碎石清石术治疗孤立肾复杂上尿路结石创伤小、疗效好、安全可靠,值得推广。  相似文献   

10.
目的探讨经皮肾镜输尿管镜联合EMS三代超声/气压弹道碎石清石技术的治疗效果和应用体会。方法总结分析对收治的86例泌尿系结石患者采用经皮肾镜输尿管镜联合EMS第三代超声/气压弹道碎石清石技术的应用情况。结果本组86例泌尿系结石患者中38例肾结石采用经皮肾镜或输尿管镜联合EMS第三代超声/气压弹道碎石清石技术,手术成功率达92.11%(35/38),输尿管结石41例成功率85.37%。结论经皮肾镜输尿管镜联合EMS第三代超声/气压弹道碎石清石技术已经成为目前最完美的泌尿系统结石的治疗手段,其适应证范围广泛,可应用于泌尿系统各个部位的结石。手术微创、高效、安全可靠、广泛实用,极具临床推广价值。  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.
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   

20.
ANTI-PROLIFERATION EFFECT OF ORIDONIN ON HL-60 CELLS AND ITS MECHANISM   总被引:4,自引:0,他引:4  
Objcetive To investigate the anti-proliferation effect of oridonin on leukemic HL-60 cells and its mechanism. Methods HL-60 cells in vitro in culture medium were given different concentrations of oridonin. The inhibitory rate of cells were measured by microculture tetrazolium (MTT) assay, cell apoptotic rate was detected by flow cytometry (FCM), morphology of cell apoptosis was observed by hoechst 33258 fluorescence staining, and the activity of telomerase was detected using telomere repeat amplification protocol (TRAP) PCR-ELISA before and after apoptosis occurred. Results Oridonin could decrease telomerase activity, inhibit growth of HL-60 cells, and cause apoptosis significantly. The suppression was both in time- and dose-dependent manner. Marked morphological changes of cell apoptosis including condensation of chromatin and nuclear fragmentation were observed clearly by hoechst 33258 fluorescence staining especially after cells were treated 48-60 hours by oridonin. Conclusions Oridonin has apparent anti-proliferation and apoptotic effects on HL-60 cells in vitro, decreasing telomerase activity of HL-60 cells may be one of its most important mechanisms. These results will provide strong laboratory evidence of oridonin for clinical treatment of acute leukemia.  相似文献   

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