＂一字＂法内眦赘皮矫正术联合睑袋整复术的效果评价

目的 探讨＂一字＂法内眦赘皮矫正术联合睑袋整复术的临床应用效果及评价.方法 由设计的新内眦点处＂一字＂ 法横切开内眦赘皮,切口延至下睑缘5mm左右,分离内眦部的皮下粘连,剪除部分错构组织,形成新的内眦,再将下睑缘切口延至外眦部,切开皮肤、皮下组织,行睑袋整复术,术中将眶隔脂肪释放、重置,紧缩眶隔,去除部分肥厚的眼轮匝肌和松弛的皮肤.结果 本组18例患者,术后均取得较好的治疗效果.随访1~14个月,内眦赘皮消失,基本无瘢痕遗留,双眼间距适当,双睑外形美观,睑袋改善明显,无并发症发生,达到眼周年轻化的良好效果.结论 ＂一字＂法内眦开大术联合睑袋整复术,较好地矫正了内眦赘皮和下睑松弛,达到了眼周年轻化的美容效果.     

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。     

遗尿伴急迫性和排尿延缓性尿失禁患儿膀胱功能的尿动力学评估

目的 探讨夜间遗尿伴白天急迫性尿失禁(UI)和夜间遗尿伴白天排尿延缓性尿失禁(VPI)患儿的尿流动力学表现,为临床治疗提供依据.方法 本研究选取2008年6月至2009年10月间因夜间遗尿伴白天尿失禁诊断的患儿64例,进行详细的体格检查、腰椎X线、泌尿系超声并测定膀胱壁厚度、尿常规,尿动力学检查.将患儿分为UI和VPI两组.结果 UI组与VPI组比较:膀胱壁厚度较正常增厚比例(5%比20%,P＜0.05),两组中伴随尿痛、便秘等显著临床症状(13%比36%,P＜0.05).最大尿流率VPI组与UI组分别为(20.2±9.0)ml/s、(14.1±11.6)ml/s(P＜0.05),最大尿道压VPI组与UI组分别为(152.3±47.5)cmH2O、(107.7±40.3)cmH2O(P＜0.05).结论 VPI患儿更易出现躯体不适及明显临床症状,VPI的尿动力改变和临床症状明显较UI严重,这些儿童有必要常规行尿动力学检查了解膀胱功能,为规范治疗提供依据.

Abstract：

Objective To evaluate the urodynamic parameters of the children with enuresis nocturna accompanied by daytime urgency incontinence(UI) or daytime voiding postponement incontinence(VPI).Methods From June 2007 to October 2009,a total of 64 children who had enuresis nocturna accompanied by daytime UI or daytime VPI were recruited in this studv.The urodynamics parameters including uroflowmetry,bladder pressure-volume,and static urethral pressure were examined and recorded.The physical examination,X-ray radiography,ultrasonography and urinalysis were of UI patients had thicker bladder wall(P＜0.05).Pain with urinating and constipation occurred in 13% UI patients,and 36%VPI patients(P＜0.05).The maximum flow rate in VPI patients was higher than that in UI patients(20.20±9.02 vs.14.09±11.56 ml/s,P＜0.05).Maximum urethral pressure in VPI patients was higher than that in UI patients(1 52.3±47.5 vs 107.7±40.3 cmH2O,P=0.003).Conclusions The symptoms and urodynamic dysfunction of the children with enuresis nocturna accompanied by VPI are more severe than those of the UI patients.The therapeutic plan should be made according to the urodynamic evaluations of these patients.     

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.     

特应性和非特应性哮喘患儿血清总IgE、FeNO和外周血EOS的相关性研究

目的 探讨特应性哮喘和非特应性哮喘患儿血清总免疫球蛋白E(IgE)水平、呼出气一氧化氮(FeNO)水平和外周血嗜酸性粒细胞(EOS)的相关性。方法 收集我院儿科特应性哮喘患儿105例、非特应性哮喘患儿84例以及对照患儿80例。通过采用化学发光法检测血清总IgE水平、使用NO分析仪检测FeNO水平及通过自动血细胞分析仪检测外周血EOS计数和比例。比较各组血清总IgE水平、FeNO水平及外周血EOS计数和比例的差异。Logistic回归分析特应性哮喘的影响因素，受试者工作特征(ROC)曲线分析3个指标对特应性哮喘的预测价值。结果 与对照组和非特应性哮喘组相比，特应性哮喘组血清总IgE水平、FeNO水平及外周血EOS计数和比例升高(P<0.05)。Logistic回归分析结果显示，外周血EOS比例(OR=1.259,95%CI:1.039～1.525)、血清总IgE水平(OR=1.003,95%CI:1.001～1.005)、FeNO水平(OR=1.087,95%CI:1.019～1.158)升高是特应性哮喘患儿发病的影响因素。ROC曲线结果显示，外周血EOS比例(AUC=0.789,...     

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.