应用输尿管镜放置双J管早期治疗输尿管阴道瘘

Objective To evaluate the clinical effect of placing double J stent using a ureteroscope in early managing ureterovaginal fistula.Methods Twenty-eight patients cases with ureterovaginal fistula from 2002 to 2008 were treated early with placing double J stent using a ureteroscope and the clinical data were reviewed.Results Twenty-two of 28 cases were treated and double J stent was placed in them by a uretero-scope and 75% (21/28)of cases were cured.Four of 21 cases were treated twice by a ureteroscope and were cured finally.7 cases with failure ureterovaginal treatment underwent ureterocystostomy and were cured.The follow-up from 6 months to 33 months (average 10.1±6.4 months)showed that all of the 28 cases had been cured and had no urinary fistula.Conclusion Placing double J stent using a ureteroscope is the first choice of operative procedure for the early treatment of ureterovaginal fistula.     

应用输尿管镜放置双J管早期治疗输尿管阴道瘘

Objective To evaluate the clinical effect of placing double J stent using a ureteroscope in early managing ureterovaginal fistula.Methods Twenty-eight patients cases with ureterovaginal fistula from 2002 to 2008 were treated early with placing double J stent using a ureteroscope and the clinical data were reviewed.Results Twenty-two of 28 cases were treated and double J stent was placed in them by a uretero-scope and 75% (21/28)of cases were cured.Four of 21 cases were treated twice by a ureteroscope and were cured finally.7 cases with failure ureterovaginal treatment underwent ureterocystostomy and were cured.The follow-up from 6 months to 33 months (average 10.1±6.4 months)showed that all of the 28 cases had been cured and had no urinary fistula.Conclusion Placing double J stent using a ureteroscope is the first choice of operative procedure for the early treatment of ureterovaginal fistula.     

应用输尿管镜放置双J管早期治疗输尿管阴道瘘

Objective To evaluate the clinical effect of placing double J stent using a ureteroscope in early managing ureterovaginal fistula.Methods Twenty-eight patients cases with ureterovaginal fistula from 2002 to 2008 were treated early with placing double J stent using a ureteroscope and the clinical data were reviewed.Results Twenty-two of 28 cases were treated and double J stent was placed in them by a uretero-scope and 75% (21/28)of cases were cured.Four of 21 cases were treated twice by a ureteroscope and were cured finally.7 cases with failure ureterovaginal treatment underwent ureterocystostomy and were cured.The follow-up from 6 months to 33 months (average 10.1±6.4 months)showed that all of the 28 cases had been cured and had no urinary fistula.Conclusion Placing double J stent using a ureteroscope is the first choice of operative procedure for the early treatment of ureterovaginal fistula.     

泌尿系结石患者微创术后结石成分分析及饮食干预对结石复发率的影响

目的分析泌尿系结石患者微创术后结石成分及饮食干预对结石复发率的影响。方法将行微创术治疗的60例泌尿系结石患者随机分为两组,各30例。两组术后均采用结石红外光谱自动分析系统分析结石成分,对照组给予常规饮食,观察组根据结石成分给予饮食干预。经1年随访,观察两组结石复发率。结果两组患者结石成分构成基本一致,构成比比较差异均无统计学意义(P>0.05);经1年随访,观察组结石复发率13.33%,低于对照组的36.67%(P<0.05)。结论泌尿系结石微创术后根据结石成分给予患者饮食干预,可明显降低结石复发率。     

1450株支原体耐药性分析

目的了解我院泌尿生殖道感染患者解脲支原体(Uu)和人型支原体(Mh)的感染情况及对9种抗生素的耐药性,为临床治疗支原体感染用药提供参考依据,有效控制支原体感染。方法采用上海奥普生物药业有限公司生产的支原体培养、鉴定药敏一体化的试剂盒进行支原体培养及药敏试验。结果从3 130例患者标本中分离出支原体1 450株,男性患者支原体阳性166例(11.45%),女性患者支原体阳性1 284例(88.55%);其中单纯解脲支原体(Uu)感染1 061例(73.17%);单纯人型支原体(Mh)感染353例(24.34%);Uu/Mh混合感染36例(2.49%)。药敏试验结果显示支原体对多西环素最为敏感。结论支原体对多种抗生素耐药,治疗支原体引起的泌尿系统感染,应以多西环素、交沙霉素、米诺环素作为首选药物。     

443株肺炎克雷伯菌的耐药性分析

目的了解肺炎克雷伯菌对抗生素的耐药情况,为临床合理使用抗生素提供依据。方法对临床各种标本中分离得到的443株肺炎克雷伯氏菌进行药敏试验分析。结果从4 845份送检标本中共分离得到肺炎克雷伯菌443株(9.14%),主要来源于呼吸道标本。肺炎克雷伯菌耐药率最高的抗生素为氨苄西林(94.6%);对氨基糖苷类的阿米卡星耐药率较低,为14.67%;对庆大霉素耐药率为68.79%;对碳青霉烯类抗生素(亚胺培南,美洛培南)全部敏感。在443株肺炎克雷伯菌中,117株为超广谱β-内酰胺酶(ESBLs)阳性,阳性率为26.41%。结论肺炎克雷伯菌是产ESBLs条件致病菌之一,临床应加强对肺炎克雷伯菌耐药性的监测,预防耐药菌株的传播流行。     

膀胱黏膜毒蕈碱型胆碱能受体密度与前列腺术后膀胱痉挛的相关性研究

目的  探讨膀胱黏膜毒蕈碱型胆碱能受体（M受体）M2、M3亚型的密度与前列腺电切术后膀胱痉挛的相关性。方法  选取2012年5月-2015年5月医院收治的良性前列腺增生（BPH）患者作为研究对象,将其分为合并膀胱过度活动症（OAB）观察组和不合并OAB对照组,再将观察组分为发生膀胱痉挛组及不发生膀胱痉挛组,比较各组M2、M3受体的密度及其相关性。结果  观察组术后膀胱痉挛的发生率高于对照组;观察组M2、M3受体密度均低于对照组;观察组中发生膀胱痉挛患者的M3受体密度低于不发生膀胱痉挛患者的M3受体密度。结论  膀胱黏膜M3受体密度与前列腺术后发生膀胱痉挛存在相关性,提示M3受体可能参与膀胱痉挛的发病机制。

     

热毒宁注射液联合西药对耐碳青霉烯类铜绿假单胞菌体外抑菌作用实验研究

目的 研究热毒宁注射液与头孢他啶、头孢哌酮/舒巴坦联用对耐碳青霉烯类铜绿假单胞菌(carbapenem-resistantpseudomonasaeruginosa,CRPA)的体外抑菌作用。方法 于临床标本中分离、收集40株CRPA,采用梯度稀释法测定热毒宁注射液最低抑菌浓度(minimuminhibitoryconcentration,MIC),采用倍比稀释法分别测定头孢他啶、头孢哌酮/舒巴坦MIC;采用微量棋盘稀释法检测联合用药MIC,并计算热毒宁注射液联合头孢他啶、热毒宁注射液联合头孢哌酮/舒巴坦的部分抑菌浓度 (fractioninhibitoryconcentration,FIC)指数。     

三维适形加量放疗联合化疗治疗非小细胞肺癌的临床观察

目的：观察常规分割放疗基础上行三维适形加量放疗并联合化疗治疗非小细胞肺癌的可行性及疗效。方法：将68例Ⅱ～Ⅲ期非小细胞肺癌患者先予NP方案化疗（盖诺40mg，静脉注入，d1、d8；DDP40mg，静脉滴入，d1～d3）。鳞癌化疗1个周期，其他类型肺癌化疗2个周期。放射治疗的前半程为常规分割2Gy／次，剂量40Gy／20次后改用三维适形加量放疗5Gy／次，每次间隔1～2d，剂量30Oy／6次。锁骨上有淋巴结转移者采用6MVX线加电子线常规分割放疗至总量Dτ 60Gy。放射治疗结束后根据患者情况再追加化疗2～4个周期。结果：68例患者全部完成治疗计划，其中肺原发灶完全缓解（CR）12例，部分缓解（PR）49例，稳定无进展（NR）7例，总有效率为84．7％。Ⅰ～Ⅱs级急性放射性食管炎64％，Ⅲ级急性放射性食管炎5％，急性放射性气管炎、肺炎35％，急性胃肠道反应64％，治疗期间白细胞下降的发生率100％，升白治疗有效。后期毒副反应主要是放射性肺纤维化38％。1、2年生存率分别为71．2％和52％，1、2年局控率为85％和71％。结论：在常规分割放疗基础上行三维适形加量放疗并联合化疗治疗非小细胞肺癌有较好的近期疗效，毒副反应可耐受，值得进一步观察和推广。     

超微补阳还五汤对气虚血瘀模型大鼠血栓前状态的影响

目的:探讨超微补阳还五汤对气虚血瘀证模型大鼠血栓前状态的影响。方法:采用力竭游泳加皮下注射肾上腺素的方法复制气虚血瘀证动物模型,在药物治疗后采血检测血栓前状态指标。结果:动物造模后血流变学参数、内皮素-1、血栓素B2、血小板α-颗粒膜蛋白-140均较空白组升高(与空白组比,P<0.05),补阳还五汤传统剂型及超微剂型均能降低升高的血栓前状态各参数(与模型组比,P<0.05),其中超微低剂量组(相当于传统汤剂组剂量1/3)即与传统汤剂组作用效果相当,而超微等剂量组(与传统汤剂组剂量相同)效果较传统汤剂与低剂量组略好而无统计学意义(P>0.05)。结论:补阳还五汤超微剂型与传统剂型一样具有干预气虚血瘀证模型大鼠血栓前状态作用,而且超微剂型具有节省药材的特点。