粘性弹力绷带结合“8”字包扎法在腋臭术后护理中的应用

目的:探讨将粘性弹力绷带与传统"8"字包扎法结合在腋臭术后护理中的应用效果。方法:选取135例行小切口大汗腺切除术治疗的腋臭患者,采用粘性弹力绷带结合传统"8"字加压包扎的方法进行术后换药及护理,分析护理效果。结果:134例患者术后恢复良好,无血肿及血清肿形成,1例患者出现局部皮肤坏死。结论:对于腋臭术后的护理,粘性弹力绷带结合"8"字包扎是一种简单有效的方法。     

神经源性膀胱合并上尿路扩张患者尿动力学检查的护理

目的探讨神经源性膀胱合并上尿路扩张患者尿动力学特点及检查过程中的护理配合。方法回顾性分析150例神经源性膀胱合并上尿路扩张患者膀胱功能测定的护理配合要点、检查结果和并发症发生情况。结果上尿路扩张患者多表现为膀胱低顺应性、逼尿肌过度活动、高逼尿肌漏尿点压、相对安全容量显著降低、残余尿量显著增多、膀胱活动低下等,尿动力学检查后患者并发泌尿系感染的风险和严重程度明显增加。结论神经源性膀胱合并上尿路扩张患者行尿动力学检查时需加强相关的护理配合,如严格控制膀胱充盈速度及重复检测次数、及时留置导尿管持续引流尿液或进行清洁间歇导尿、预防性使用抗生素等,以保证检查结果的准确性,并有效预防检查后泌尿系感染的发生。     

输尿管皮肤造口患者尿路感染的危险因素分析及预防对策

摘要 目的 分析输尿管皮肤造口术后尿路感染的病原菌分布及相关危险因素,为临床预防及治疗提供参考。方法 回顾性分析某医院泌尿外科行输尿管皮肤造口术患者的临床资料,对其尿路感染的相关危险因素进行单因素和多因素Logistic回归分析。结果 本研究98例患者中发生尿路感染患者共28例,尿路感染发生率为28.57%,共分离出病原菌42株,其中革兰阴性菌占73.81%,革兰阳性菌占21.43%,真菌占4.76%;多因素Logistic回归分析结果显示,患者年龄≥60岁、输尿管支架管留置时间≥3个月、尿液引流不畅、造口周围并发症和合并糖尿病为患者术后发生尿路感染的独立危险因素。 结论 输尿管皮肤造口患者术后发生尿路感染与患者合并基础疾病、支架管留置时间过长及尿液引流不畅有关。采取定期更换输尿管支架管并保持支架管通畅、减少造口周围并发症的发生、增加每日饮水摄入量、有效控制糖尿病等措施可有效预防输尿管皮肤造口术后尿路感染的发生。     

体质量管理对女性尿失禁疗效的 Meta分析

目的评价控制体质量(BM)在女性尿失禁病人中的有效性。方法检索中国知网(CNKI)、万方数据库(Wanfang Date)和维普数据库(VIP)等中文数据库以及 Cochrane Library、Pubmed和Web of science等英文数据库中有关控制 BM对尿失禁病人的队列研究、病例对照研究和随机对照试验,同时筛检纳入文章的参考文献,检索建库至 2019年 5月期间公开发表的文章。采用 RevMan 5.3软件进行 Meta分析。结果共纳入 13篇文献,涉及1079例病人。Meta分析结果显示,在 6个月和 12个月的随访中,控制 BM显著降低了病人尿失禁的发生率［RR=2.02,95%CI(1.25~3.24)P＜0.01］,降低了病人的 BMI［MD=12.22,95%CI(9.51~14.93),P＜0.01］,提高了病人的生活质量［MD=0.77,95%CI(0.43~1.00P＜0.01］,改善了病人的盆底功能［MD=2.22,),95%CI(13.13~31.11),P＜0.01］,减轻了病人尿失禁症状的严重程度［MD=4.03,9,5%CI(1.77~6.28),P＜0.01］。结论控制 BM能有效降低病人尿失禁的发生率、 BMI,有效改善病人盆底功能以及尿失禁症状的严重程度,有助于提高病人的生活质量。     

电刺激小脑顶核后脑外伤患者脑血流和脑损害变化

目的　探讨小脑顶核电刺激 (FNS)对脑外伤患者脑血流速度 (Vm)和血清髓鞘碱性蛋白 (MBP)的影响。方法　30名健康者为正常对照组 (A)。 6 0例脑外伤患者 ,随机均分为B(外伤对照组 )和C(刺激治疗组 )两组。用FNS对C组实施治疗。应用经颅多普勒超声动态监测A、B和C三组患者ACA、MCA的Vm。分别于外伤后第 1、3、5天检测B、C两组血清MBP。结果　ACA和MCA的Vm正常值分别为 ( 4 5 .4± 6 .1)cm/s和 ( 5 4.3± 5 .7)cm/s ;B组外伤后呈现持续性低Vm ,ACA和MCA的Vm分别为 ( 35 .9± 5 .6 )cm/s和 ( 4 5 .5± 6 .5 )cm/s ;C组FNS后Vm明显升高 ,分别为 ( 4 2 .8± 6 .8)cm/s和 ( 5 1.9± 6 .2 )cm/s。MBP正常值为 ( 1.0 2± 0 .46 ) μg/L。外伤后第 1天 ,B、C两组MBP明显升高 ,B组于第 5天达高峰 ,而C组MBP于第 5天则明显下降。结论　外伤后Vm降低 ,血清MBP升高。FNS可明显提高脑外伤后Vm ,改善脑循环 ,降低MBP ,减轻脑损害     

老年患者尿动力检查前后影响因素评估的临床研究

目的研究672例老年患者尿动力检查前后影响因素,探讨影响检查结果的相关因素,并提出处理对策。方法研究郑州大学第一附属医院2010年6月-2012年6月对672例60岁以上老年患者尿动力学检查的临床资料,根据老年患者自身生理特点、合并症、文化程度、理解力制定并实施相关的检查事项。结果在672例老年患者中检查成功670例,平均检查时间35.4min,其中2例因患者过于紧张而坚决放弃检查。检查成功率99.7%。结论应从多方面对老年患者尿动力检查前后的影响因素进行评估,可增加患者检查的依从性,又能确保尿动力学检查结果的准确性。     

电刺激联合盆底肌训练治疗女性压力性尿失禁合并特发性逼尿肌过度活动的疗效观察

Objective To investigate the short-term efficacy of pelvic floor electrical stimulation (PFES) and pelvic floor training (PFT) for female with idiopathic detrusor overactivity (IDO) and stress urinary incontinence (SUI). Methods PFES and PFT were performed on 70 women (average age 40±7 years old) with IDO and SUI for twelve weeks. Urinary diary, International Continence In-quiring Committee's Questionnaire (ICI-Q-SF) scores were recorded and urodynamic study was per-formed before and after the treatment. Results Fifty women (71%) finally completed treatment for twelve weeks. Urinary incontinence disappeared in 8 (16%), detrusor overactivity disappeared in 10 (20 %). The leakage was not found in 6 (12 %) in leakage point pressure measurement. Moreover, the frequency of voiding (28±5 times/72 h), frequency of leakage (10±5 times/72 h), total scores of ICI-Q-SF(10±3), max detrusor uninhibited contraction pressure (18±8 cmH20) and detrusor unin-hibited contraction duration (8±3 s) were significantly lower than those before treatment (43±8 times/72 h, 20±6 times/72 h, 17±3, 27±9 cm H2O and 13±6s,P<0.01). Maximal voided vol-ume(225±48 ml), normal desired cystometric capacity (210±48 ml), maximal cystometric capacity (247±48 ml), Valsalva leak point pressure (94±11 cm H2O) and maximal urethral closure pressure (59±8 cm H2O) were significantly higher than those before treatment (159±37 ml, 141±39ml, 178±36ml, 81±15 cm H2O and 55±8 cm H2O, P<0.01). The effective rate during three months follow up was 60%, similar to time after treatment (P>0.05). Conclusions Pelvic floor electrical stimulation and pelvic floor training could be a useful therapy to treat women with IDO and SUI. It is both convenient and economical.     

电刺激联合盆底肌训练治疗女性压力性尿失禁合并特发性逼尿肌过度活动的疗效观察

Objective To investigate the short-term efficacy of pelvic floor electrical stimulation (PFES) and pelvic floor training (PFT) for female with idiopathic detrusor overactivity (IDO) and stress urinary incontinence (SUI). Methods PFES and PFT were performed on 70 women (average age 40±7 years old) with IDO and SUI for twelve weeks. Urinary diary, International Continence In-quiring Committee's Questionnaire (ICI-Q-SF) scores were recorded and urodynamic study was per-formed before and after the treatment. Results Fifty women (71%) finally completed treatment for twelve weeks. Urinary incontinence disappeared in 8 (16%), detrusor overactivity disappeared in 10 (20 %). The leakage was not found in 6 (12 %) in leakage point pressure measurement. Moreover, the frequency of voiding (28±5 times/72 h), frequency of leakage (10±5 times/72 h), total scores of ICI-Q-SF(10±3), max detrusor uninhibited contraction pressure (18±8 cmH20) and detrusor unin-hibited contraction duration (8±3 s) were significantly lower than those before treatment (43±8 times/72 h, 20±6 times/72 h, 17±3, 27±9 cm H2O and 13±6s,P<0.01). Maximal voided vol-ume(225±48 ml), normal desired cystometric capacity (210±48 ml), maximal cystometric capacity (247±48 ml), Valsalva leak point pressure (94±11 cm H2O) and maximal urethral closure pressure (59±8 cm H2O) were significantly higher than those before treatment (159±37 ml, 141±39ml, 178±36ml, 81±15 cm H2O and 55±8 cm H2O, P<0.01). The effective rate during three months follow up was 60%, similar to time after treatment (P>0.05). Conclusions Pelvic floor electrical stimulation and pelvic floor training could be a useful therapy to treat women with IDO and SUI. It is both convenient and economical.     

电刺激联合盆底肌训练治疗女性压力性尿失禁合并特发性逼尿肌过度活动的疗效观察

Objective To investigate the short-term efficacy of pelvic floor electrical stimulation (PFES) and pelvic floor training (PFT) for female with idiopathic detrusor overactivity (IDO) and stress urinary incontinence (SUI). Methods PFES and PFT were performed on 70 women (average age 40±7 years old) with IDO and SUI for twelve weeks. Urinary diary, International Continence In-quiring Committee's Questionnaire (ICI-Q-SF) scores were recorded and urodynamic study was per-formed before and after the treatment. Results Fifty women (71%) finally completed treatment for twelve weeks. Urinary incontinence disappeared in 8 (16%), detrusor overactivity disappeared in 10 (20 %). The leakage was not found in 6 (12 %) in leakage point pressure measurement. Moreover, the frequency of voiding (28±5 times/72 h), frequency of leakage (10±5 times/72 h), total scores of ICI-Q-SF(10±3), max detrusor uninhibited contraction pressure (18±8 cmH20) and detrusor unin-hibited contraction duration (8±3 s) were significantly lower than those before treatment (43±8 times/72 h, 20±6 times/72 h, 17±3, 27±9 cm H2O and 13±6s,P<0.01). Maximal voided vol-ume(225±48 ml), normal desired cystometric capacity (210±48 ml), maximal cystometric capacity (247±48 ml), Valsalva leak point pressure (94±11 cm H2O) and maximal urethral closure pressure (59±8 cm H2O) were significantly higher than those before treatment (159±37 ml, 141±39ml, 178±36ml, 81±15 cm H2O and 55±8 cm H2O, P<0.01). The effective rate during three months follow up was 60%, similar to time after treatment (P>0.05). Conclusions Pelvic floor electrical stimulation and pelvic floor training could be a useful therapy to treat women with IDO and SUI. It is both convenient and economical.