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目的:探讨颅脑损伤后慢性脑积水的诊治方法。方法:总结40例颅脑损伤后脑积水的患者,行脑室-腹腔分流术。结果:术后良好28例,中残8例,重残2例,植物状态2例,无手术直接死亡,手术后因肺内感染死亡1例。结论:脑室-腹腔分流可显著改善患者生存质量。 相似文献
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目的 研究基底细胞样乳腺癌的临床病理特点,并分析其免疫组化及超微结构特征。方法采用HE、免疫组化(EnVision法)及电镜技术观察12例基底细胞样乳腺癌。结果12例患者均为女性,年龄35—73岁,中位年龄54岁。肿瘤直径2.4~3cm,无包膜。组织学上肿瘤组织具有推进式的边缘,周围伴淋巴细胞浸润。瘤细胞呈合体细胞样,通常见坏死。所有病例显示为高级别癌,核分裂象易见。4例发生淋巴结转移。免疫组化:ER、PR和HER2均阴性,CK5/612例阳性,CK14阳性9例,EGFR阳性10例。电镜示肿瘤细胞有异型性,胞质内可见张力原纤维丝。结论基底细胞样型乳腺癌具有独特的组织学与免疫表型特征,EGFR蛋白常过度表达,对于EGFR分子靶向治疗可能有效。 相似文献
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逆行输尿管镜手术并发症(附2316例报告) 总被引:1,自引:0,他引:1
目的 总结分析逆行输尿管镜手术并发症的发生原因及防治措施.方法 对本院2004年10月-2010年10月2316例病人2468次逆行输尿管镜手术的临床资料进行回顾性分析.结果 总的并发症发生率7.1%(165/2316),操作失败78例(3.4%);结石移位至肾盂26例(1.1%);输尿管损伤30例(1.3%),其中膀胱壁内段穿孔形成输尿管黏膜下隧道9例(0.4%)、全层穿孔14例(0.6%)、部分断裂4例(0.2%)、黏膜撕脱3例(0.1%);输尿管内双J管移位10例(0.4%);16例(0.7%)出现早期术后并发症,包括严重感染5例(0.2%),持续较严重的血尿6例(0.3%),较严重的肾绞痛5例(0.2%);5例(0.2%)出现远期并发症,包括输尿管狭窄3例、持续存在膀胱输尿管返流2例.大部分的手术并发症(124例,75.2%)发生在操作者使用输尿管镜的最初2年中.结论 严格掌握手术适应证,提高术中操作技巧,采用正确的对应措施,能有效地减少并发症.Abstract: Objectives To summarize the complications of retrograde rigid ureteroscopy as well as their management. Methods A total of 2316 patients accepting retrograde rigid ureteroscopy from Oct 2006 to Oct 2010 were evaluated retropspectively. Results The rate of complications was 7. 1% (165/2316). The complications consisted of the ureteroscopy failure (78 cases, 3.4% ), migration of calcali (26 cases, 1. 1% ), ureteral injury (mucosal false passage [9 cases, 0.4% ], ureteral perforation [ 14 cases, 0.6% ], ureteral part fracture [4 cases,0. 2% ], ureteral avulsion [ 3 cases, 0. 1% ] ), migrated double-J stent ( 10 cases, 0. 4% ). Farly complications were described in 0.7% ( 16 cases): sepsis (5 cases, 0.2% ), serious persistent hematuria (6 cases, 0.3% ), serious renal colic ( 5 cases, 0.2% ). Late complications were ureteral stenosis ( 3 cases, 0. 1% ) and persistent vesicoureteral reflux (2 cases, 0. 1% ). Most (75.2%) of the complications occurred in the first 2 years of that operators used the ureteroscopy. Conclusions Strictly mastering surgical indications, strengthening preoperative training and mastering the surgical technique, taking correct measure is the key to reduce the failure rate and complications of ureteroscopy. 相似文献
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外伤性肾损伤约占儿童腹部外伤的10%,其受伤概率高于脾、肝、肠道及大血管,其中90%为闭合性损伤[1].Margenthaler'等[2]报告超过85%患儿保守治疗有效.但是美国创伤外科协会(American Association for the Surgery of Trauma,AAST)制订的肾损伤诊疗指南中,对于中重度肾损伤(AASTⅢ,Ⅳ,V)是否适用保守治疗仍存在争议.笔者回顾性分析了自1996年1月至2009年10月的69例入院时首选行保守治疗儿童肾损伤临床资料,现报告如下. 相似文献
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本文回顾性分析我院1996年~2002年手术治疗外伤性后颅窝硬膜外血肿22例,以探讨其临床持点及手术效果。 相似文献
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目的 探讨骶神经调节治疗慢性排尿功能障碍的护理措施,为今后护理常规的制定提供依据。方法 回顾分析6例慢性排尿功能障碍病人接受骶神经调节治疗的护理资料。结果 6例骶神经调节测试病人中有5例的客观和或主观指标都改善了50%以上,其中2例接受了永久电极和可程控式骶神经调节器植入术后客观和或主观指标得到了显著改善。术前和术后病人心理稳定,能较好地配合治疗和护理。6例病人随访15~26个月,未发现明显不良反应和并发症。结论 术前积极的心理护理和充分的术前准备是保证骶神经调节治疗顺利进行的关键,术后康复指导和正确的护理是促进病人尽快康复,减少并发症发生的重要措施。 相似文献
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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. 相似文献