Women's knowledge, practises, and intentions regarding correct pelvic floor exercises.

AIM: Although research has demonstrated the efficacy of pelvic floor exercises (PFXs) for the prevention and treatment of female urinary incontinence (FUI), adherence to PFX regimens is commonly poor. There is some evidence that this finding is in part due to a lack of knowledge about how to perform PFXs correctly and misconceptions about the required frequency and duration of PFX regimens. METHODS: By using a sample of 720 postpartum women, this study investigates women's PFX regimens both before and during pregnancy and postpartum. RESULTS: Findings demonstrated that most women were aware of the required frequency for PFXs (at least every second day): just over half had done them this often during pregnancy and 91% intended to do so postpartum. However, few had done them at this level before pregnancy and less than half knew that PFXs should be carried out indefinitely throughout the lifetime. Moreover, only two thirds were confident that they were doing PFXs correctly. CONCLUSION: The findings suggest that, despite good knowledge of the required frequency of PFXs, few women practise them regularly over their lifetime, many apparently perceiving PFXs as relevant only to the childbirth years. Implications for health professionals in addressing these gaps in women's knowledge and practises are discussed.     

输尿管镜电子动能碎石182例报告

目的：探讨输尿管镜下电子动能碎石术治疗输尿管结石的疗效。方法：对182例(198侧)输尿管结石患者采用输尿管镜下电子动能碎石术治疗。结果：一次性碎石成功率为95.0%(188／198)，并发症发生率为4.0%(8／198)，其中穿孔2侧。结论：输尿管镜下电子动能碎石术是治疗输尿管结石的一种安全、疗效确切的方法。     

经皮肾穿气压弹道碎石联合体外冲击波碎石治疗上尿路结石

目的 探讨提高上尿路结石碎石成功率的微创治疗方法。方法 采用经皮肾穿微造瘘输尿管镜气压弹道碎石，术中放置双J管，术后配合体外冲击波碎石术(ESWL)治疗上尿路结石48例。结果 结石总排净率为89．1％，结石最小排净率79．2％，无严重并发症发生。结论 该方法结石排净率高，创伤较小，手术并发症少，是上尿路结石较为理想的微创治疗方法。     

多层螺旋CT尿路造影在尿路梗阻性疾病中的临床应用

目的探讨多层螺旋CT尿路造影在泌尿系梗阻性疾病诊断中的应用价值。方法对48例泌尿系统梗阻性疾病者,分别进行多层螺旋CT平扫及多时相期CT增强扫描。对增强后各期图像进行相关处理,以不同的三维重建方式获得CTA、CTU影像。所有病例均经临床及手术证实。结果48例中肾脏及输尿管先天畸形者15例;输尿管阴性结石致肾盂输尿管积水者4例;泌尿系炎症者5例;肾及输尿管、膀胱结核6例;外源性压迫导致肾盂及输尿管积水者8例;泌尿系肿瘤者10例。结论多层螺旋CT泌尿系造影对尿路梗阻性疾病的诊断具有很高的应用价值。     

The complex enterprise of modelling prenatal exposure to cigarettes: what is ‘enough’?

While there is a burgeoning body of research linking smoking during pregnancy to problem behaviour in offspring, a major criticism of this work has been the crude measurement of exposure in these studies (e.g. retrospective, self-reported only) that could lead to biased estimates. To address this issue, we used a pregnancy cohort with repeated prospective measures of exposure as well as biological assays to generate estimates of exposure patterns using a range of modelling techniques. In this paper we report on the analytical approaches we have developed, including patterns of exposure over time and best-estimate approaches that combine self-report and cotinine measures, and compare their predictive value in relation to different dimensions of fetal growth as a first step towards examining the utility of greater precision of exposure measurement.
Surprisingly, in this sample the more complex assessments of exposure, including biological measures, generally did not perform better than simple indicators of exposure based on repeated self-report measures, with one exception: a combined self-report cotinine 'best estimate' of third trimester exposure was uniquely associated with lower brain : body ratio. Further study is needed using more sophisticated cotinine assays and testing prediction of a range of outcomes to ascertain whether these findings represent true differences or are specific to the sample, methods and outcomes used. Such research will inform the development of guidelines for adequate exposure characterisation in developmental studies.     

肾盏切开联合经肾实质气压弹道碎石治疗复杂鹿角形结石

目的探讨肾盏切开联合经肾实质气压弹道碎石治疗复杂鹿角形结石的疗效。方法电刀切开积水较重的肾盏,气压弹道碎石杆对准结石碎石后分块取出。盏颈口狭窄但肾盏积水不严重者,将直径1 mm气压弹道碎石杆于肾实质处刺入结石位置,将肾盏内结石击碎后从盏颈口取出。结果19例均未阻断肾蒂,手术时间90-150 min,平均120 min。术中出血量100-250 ml,未输血。17例一次取石成功,术后无结石残余;1例术中残余泥沙状结石,术后经肾造瘘管冲洗引流排出;1例肾盏结石术中取石遗漏,术后经ESWL碎石后排净结石。15例随访10-60个月,平均18个月,结石复发2例,体外震波碎石后排净结石。结论肾盏切开联合经肾实质气压弹道碎石治疗复杂性鹿角形结石出血少,疗效可靠。     

经尿道切除技术在下尿路疾病中的应用（附128例报告）

目的 探讨经尿道切除技术（TUR）治疗下尿路疾病的适应证、操作方法、术中术后处理及并发症预防的要点。方法 应用经尿道汽化电切术（TURVP）和双极等离子汽化电切术（TUPKVP），分别以5％葡萄糖液和生理盐水作冲洗介质，选择性耻骨上膀胱造瘘，持续低压灌洗，术后气囊导尿管留置5～7天拔管，自行排尿。结果 经尿道前列腺双极等离子汽化电切术7例，经尿道前列腺汽化电切术58例，合计前列腺手术65例；腺性膀胱炎汽化电切术43例；膀胱肿瘤汽化电切术15例；后尿道狭窄等离子汽化电切术3例；精阜腺瘤汽化电切术2例。全部病例均一次手术完成，有效率（126／128）98．4％。无膀胱穿孔、电切综合征、大出血、真性尿失禁发生。前列腺术后尿道狭窄、排尿困难再次手术者2例，占3．08％，排尿疼痛、不适感6例，占9．23％，逆行射精4例，占6．15％。结论 TUR技术是一种微创、安全、迅速、有效、恢复快、并发症较少的腔内泌尿外科治疗方法，特别适用于下尿路疾病的手术；术中持续低压灌注对确保切割视野清晰、预防并发症至关重要。     

腹腔镜X线联合经胆囊管胆总管网篮取石的探讨

目的：探讨腹腔镜胆囊切除术时在X线透视下经胆囊管胆总管网篮取石的可行性。方法：2002年6月至2006年10月85例患者术前均经B超诊断为胆囊结石,伴胆总管扩张、胆总管结石。术中于腹腔镜下经胆囊管、胆总管造影,胆道镜取石网篮,在C臂机透视下用胆道镜网篮取石后经胆囊管取出。结果：85例患者经胆总管造影发现胆总管结石26例,经胆囊管胆总管网篮取石成功21例。3例因胆总管损伤中转开腹。2例腹腔镜下胆总管切开取石T管引流。结论：胆囊结石伴胆总管结石在X线透视下,正确掌握手术操作技巧,经胆囊管胆总管网篮取石可一次完成,术后效果满意。     

腹腔镜胆囊切除术中处理胆囊颈管结石的体会

目的 :探讨腹腔镜胆囊切除术 (LC)中处理胆囊颈及胆囊管结石的方法。方法 :回顾分析 2 0 0 0年 4月至 2 0 0 4年 6月 2 9例胆囊颈部结石及胆囊管结石患者行LC时 ,采用胆囊管纵行切开取石 ,圈套器结扎 ,多钛夹阶梯施夹 ,胆囊管残端丝线结扎或缝扎等方法处理胆囊颈、管结石。结果 :2 9例用上述方法治疗均获成功 ,3例置腹腔引流管引流 ,分别于术后第 2、3天拔管 ,均痊愈出院。结论 :在LC术中只要合理处理胆囊颈、胆囊管结石 ,不会出现胆漏、胆管损伤等严重并发症。     

射频消融术后尿潴留患者的护理

分析86例射频消融术后患者出现尿潴留的不同原因，包括不习惯床上排尿、精神因素、疼痛等。护理对策包括：减少卧床时间，心理护理，变换体位，物理诱导，术后多饮水等，结果81例患者排尿成功，只有5例(5．8％)男性前列腺肥大患者需要导尿。