高频超声和3.0T磁共振检查男性淋球菌性尿道旁腺炎的比较

目的 探讨男性淋球菌性尿道旁腺炎的形态特征。 方法 使用Siemens Acuson X300实时超声显像仪和Philips Achieva 3.0T磁共振联合检查11例男性淋球菌性尿道旁腺炎患者。 结果 高频超声影像均表现为管道状回声,境界清,边缘光整,内部呈弱回声,一端为盲端,一端和外界相通。走行方向与尿道平行。管道直径0.7 ~ 1.3 mm（平均1.1 ± 0.2 mm）,管道长度7.0 ~ 12.0 mm（平均8.4 ± 0.6 mm）。其中2例管道状回声内见液性暗区。3.0T磁共振检测不到男性尿道旁管。 结论 高频超声能检测出男性淋球菌性尿道旁腺炎的形态特征,为手术治疗提供有价值的超声图像。     

淋球菌感染引起的男性尿道旁腺微囊肿一例北大核心CSCD

患者男,30岁.因尿道外口左侧红肿,中央针眼大小孔12周,于2011年1月12日来我科就诊.患者于2010年10月有非婚性接触史,3d后,自觉尿痛、尿频、尿急、尿道口溢脓,自服头孢羟氨苄、罗红霉素无好转;2周后尿道外口左侧出现红肿,稍疼痛,5d后红肿中央出现一针眼大小孔,挤压后有脓性分泌物自小孔溢出.在某医院就诊,取尿道分泌物和尿道外口左侧红肿区小孔分泌物涂片,革兰染色,白细胞内均见到革兰阴性双球菌,淋球菌培养阳性.     

淋球菌感染引起的男性尿道旁腺微囊肿一例

患者男,30岁.因尿道外口左侧红肿,中央针眼大小孔12周,于2011年1月12日来我科就诊.患者于2010年10月有非婚性接触史,3d后,自觉尿痛、尿频、尿急、尿道口溢脓,自服头孢羟氨苄、罗红霉素无好转;2周后尿道外口左侧出现红肿,稍疼痛,5d后红肿中央出现一针眼大小孔,挤压后有脓性分泌物自小孔溢出.在某医院就诊,取尿道分泌物和尿道外口左侧红肿区小孔分泌物涂片,革兰染色,白细胞内均见到革兰阴性双球菌,淋球菌培养阳性.     

获得性男性尿道旁管囊状扩张一例

有关男性尿道旁管的文献不多［１］,我们报道1例淋球菌感染引起的男性尿道旁管囊状扩张……     

男性阴茎附属腺和皮肤淋球菌感染皮损的高频超声研究

【摘要】 目的 了解男性阴茎皮肤和附属腺淋球菌感染皮损的超声影像学表现及其临床意义。方法 2014年1月至2021年1月在常熟市第一人民医院皮肤科纳入经实验室检查确诊且既往未接受过相关治疗的男性阴茎皮肤和附属腺淋球菌感染患者。使用SIEMENS ACUSON X300实时超声显像仪检测阴茎体表淋球菌感染皮损,探头频率7.5 ~ 15 MHz。高频超声影像表现为管状液性暗区者仅予头孢曲松1 g单剂肌内注射;椭圆形液性暗区者,切开引流同时予头孢曲松1 g肌内注射,每天1次,共5 d;低回声区、混合回声区者予头孢曲松1 g肌内注射,每天1次,共5 d,治疗后1个月结节仍不消退者,局部切除结节。治疗后1个月复诊并观察疗效。结果 共收集32例男性阴茎皮肤和附属腺淋球菌感染患者,年龄（28.54 ± 3.27）岁,均有非婚性接触史,非婚性接触至症状出现时间为（4.45 ± 1.03） d,病程（8.64 ± 1.87） d。皮损均单发,位于尿道外口16例（50.00%）,龟头7例（21.88%）,包皮系带旁5例（15.62%）,阴茎缝4例（12.50%）。皮损表现：窦道样损害16例（50.00%）,脓肿9例（28.13%）,结节7例（21.87%）,皮损处均有触痛。高频超声检查：16例（50.00%）表现为管状液性暗区,7例（21.88%）为椭圆形液性暗区,5例（15.62%）为低回声区,4例（12.50%）为混合回声区。16例（50.00%）淋球菌感染累及尿道海绵体,5例（15.62%）累及阴茎海绵体,11例（34.38%）累及阴茎皮下。经治疗,32例均痊愈。结论 高频超声可用于男性阴茎皮肤和附属腺淋球菌感染患者的皮损评估和治疗方案的选择。     

淋球菌性尿道旁腺炎2例

例1.男,25岁.因排尿疼痛、流脓3 d,于2004年3月5日来我所就诊.患者3 d前尿道有脓性分泌物排出,伴尿频、尿痛,同时发现尿道外口边缘有一小孔,内有黄色分泌物溢出,系带左侧有一结节,伴疼痛.自服阿奇霉素数日后,尿道内无分泌物流出,尿频、尿痛亦消失,但尿道外口小孔仍有分泌物溢出,结节未消退.     

淋菌性尿道旁腺炎1例

<正>1临床资料患者男,51岁。排尿隐痛5d。5d前出现排尿隐痛,未予重视;3d前上述症状加重,同时发现尿道外口下方有一针尖大小的小孔,有黄白色脓性分泌物自小孔溢出。患者否认近期有非婚性生活史,否认既往反复尿道感染史。系统检查未见异常,右侧腹股沟淋巴结肿大。皮肤科情况:尿道内未见分泌物,尿道外口6点钟方向有一针尖大小孔,挤压后有黄白色脓性分泌     

罗红霉素综合治疗男性非淋菌性尿道炎临床观察

1998年 3月～ 12月 ,我们用江苏扬子江药业集团生产的罗红霉素胶囊治疗男性非淋菌性尿道炎(ＮＧＵ) 136例 ,获得满意疗效 ,现报告如下。1　临床资料　 136例患者均有非婚性交史 ,在我科性病门诊诊断为ＮＧＵ。年龄 2 8.3± 5 .4岁 (17～ 4 7岁 ) ,病程 2 6 .5± 7.2天 (8天～ 5年 )。既往曾用多种抗生素治疗 ,但仍有尿道刺痒、尿急、尿痛 ,会阴部坠胀不适 ,挤压尿道有浆液性分泌物溢出。实验室检查 :尿道分泌物及前列腺按摩液 ,①涂片镜检多形核白细胞数 (ＰＭＮ)≥ 5个 /油镜视野 (× 10 0 0 )。②淋球菌培养阴性。③沙眼衣原体 (ＣＴ)阳性…     

原发淋球菌性系带旁腺脓肿及尿道炎一例

患者男,22岁.因系带旁红肿伴疼痛5 d,尿痛伴分泌物3 d来我科就诊.5 d前包皮系带处红肿伴疼痛,渐增大到花生米大小,中央出现溃破,挤压有脓性分泌物.3 d前患者出现尿痛,尿道口红肿,可见较多脓性分泌物流出.7 d前有非婚性生活史.既往无尿道炎病史.体检:各系统检查未见异常.皮肤科检查:系带左侧红肿,约花生米大小,挤压痛,中央可见溃破,有较多脓性分泌物,尿道口可见大量脓性分泌物.实验室检查:沙眼衣原体抗原试验、解脲脲原体培养均阴性.尿道及系带旁分泌物分别涂片革兰染色,多形核白细胞内找到革兰阴性双球菌,同时将尿道及系带旁分泌物分别行淋球菌培养,均见到圆形、稍凸、湿润、光滑、透明的菌落,氧化酶试验阳性.诊断:原发淋球菌性系带旁腺脓肿及尿道炎.治疗:给予头孢曲松0.25 g肌内注射,每日1次,共5 d,2周后复诊,脓肿消退,遗留瘢痕.     

淋球菌性尿道口尿道旁腺炎和包皮炎一例

患者男,21岁.因尿道外口右侧红肿,中央脓头,破损后溢脓9 d,包皮内板糜烂8 d,于2008年7月15日来我科就诊.就诊前9 d,尿道外口右侧红肿、疼痛,中央出现一脓头,破溃后形成一针眼大小孔,有脓液自小孔溢出.就诊前8 d包皮内板绿豆大红斑,后破溃、糜烂,糜烂面渐扩大、上覆脓性分泌物,微痛.否认有尿道溢脓及尿痛、尿频、尿急等症状.发病前4天有非婚性生活史.以往有淋菌性尿道炎病史.     

不同术式膀胱阴道瘘修补术治疗妇科手术后膀胱阴道瘘的临床分析

目的:分析探讨不同术式膀胱阴道瘘修补术治疗妇科手术后膀胱阴道瘘的疗效。方法:回顾性分析北京大学第三医院泌尿外科2009年4月至2015年11月收治的12例膀胱阴道瘘患者的临床资料。12例患者均有妇科手术史:其中行子宫全切术10例,行盆腔肿物切除术1例,行膀胱电切术1例。从手术损伤致出现阴道漏尿的病程为5~12个月,平均8.4±2.9个月。膀胱镜检查测量瘘口直径0.3~2cm,平均(1.1±0.6)cm。12例均为单发瘘口。结果:6例患者行经阴道途径膀胱阴道瘘修补术。平均手术时间为(105.0±32.0)min,平均术中出血(4.5±1.2)mL,平均术后住院时间(3.0±1.5)d。6例患者术后6个月未见复发;3例患者行经腹腔镜途径膀胱阴道瘘修补术。平均手术时间为(345.3±192.3)min,平均术中出血(83.3±28.9)mL,平均术后住院时间(10.3±3.2)d。2例随访6月未见复发,1例术后6月发生膀胱阴道瘘复发,行二次手术修补;1例患者采用开放经腹腔途径膀胱阴道瘘修补术。手术时间为234min,术中出血200mL,术后住院时间40d。术后出现伤口脂肪液化,予定期换药治疗后好转,随访6月未见复发;1例患者发生Studer原位新膀胱阴道瘘,采用经腹经阴道联合途径的手术方式,手术时间为224min,术中出血100mL,术后住院时间20d,随访6月未见复发;1例患者因瘘口较小采用膀胱镜下膀胱阴道瘘口电凝术,手术时间为10min,术中出血2mL,术后住院时间2d,术后出现不自主漏尿,复查膀胱镜仍可见膀胱后壁瘘口,遂留置尿管1月,1月后行经阴道膀胱阴道瘘修补术,随访6月未见复发。结论:妇科手术导致的膀胱阴道瘘可以通过手术修补治愈。经阴道修补手术成功率高,术后恢复较快。对于能够经阴道显露、分离及缝合的膀胱阴道瘘尽可能行经阴道修补手术。     

射频电刀联合中药外敷治疗肥大增生型酒渣鼻的临床疗效观察

目的 观察射频电刀微雕整形修复联合中药治疗肥大增生型酒渣鼻的安全性和有效性.方法 将确诊为肥大增生型酒渣鼻的患者38例,随机分为射频刀A组(13例)、射频刀B组(13例)和普通电刀组(12例).射频刀A组采用射频电刀微雕整形修复+复方紫草油纱,射频刀B组采用射频电刀微雕整形修复+抗生素油纱,普通电刀组采用普通电刀切除增...     

Effect of the Recombinant Human Epidermal Growth Factor Ointment on Cutaneous Surgical Wounds Compared to Antibiotic Ointment

BackgroundApplying antibiotic ointment after skin surgery can decrease infection and improve scar. Epidermal growth factor (EGF) is known to be able to promote the growth and movement of epidermal cells to stimulate wound healing. Recombinant human EGF (rhEGF) ointment can be used in wet closed dressing to promotes wound healing and prevent complications by maintaining a wet environment.ObjectiveTo compare the efficacy of rhEGF ointment and conventional antibiotic ointment after cutaneous resection.MethodsPatients who had excision procedures in two or more sites were enrolled. Each wound was assigned to the rhEGF group or the antibiotic ointment group. Wounds were subjected to Physician Global Assessment (PhGA), Patient Global Assessment (PGA), and Patient satisfaction assessment (PSA). The length and area of wounds, and melanin and erythema index (MI and EI) were also assessed for these wounds.ResultsAmong 11 patients with a total of 20 pairs of resection sites, PhGA, PGA, MI, and EI showed no significant difference between rhEGF and antibiotic ointment groups. However, changes in length and area of wounds showed significant differences between the two groups.ConclusionRhEGF ointment showed similar short-term cosmetic results with antibiotic ointment, and improved surgical results in regards of the wound size. Applying rhEGF could reduce the use of antibiotic ointments for cutaneous clean (class I) wound surgery.     

Wunddebridement des Ulcus cruris et pedis: Einfluss auf die Heilung und die Effektivität verschiedener Methoden

Aim: To evaluate the evidence on the impact of different debridement techniques on healing and their efficacy in the treatment of leg ulcers. Methods: Web‐based search (PubMed) for trials investigating surgical, enzymatic, autolytic, osmotic, ultrasound‐assisted, and biosurgical wound debridement on leg ulcers with regard to healing and efficacy. Results: Both surgical and hydrosurgical methods proved to be effective debridement techniques. For conventional surgical debridement, a significantly greater reduction of the wound surface area and a higher healing rate were reported. Studies on autolytic, osmotic, and enzymatic wound debridement showed effective debridement for krill enzymes, dextranomer and manuka honey. Only for manuka honey was there a significantly greater reduction of the wound surface area compared to standard treatment. One study comparing fibrinolysin/DNAse with placebo and one comparing autolytic with enzymatic debridement showed no significant differences between the respective techniques. Trials on ultrasound‐assisted wound debridement reported a positive impact on healing. A significant wound surface area reduction was demonstrated in one of them. Maggot therapy led to effective debridement. The largest trial showed no significantly improved healing. Conclusions: Further studies are needed to strengthen the evidence for a significant impact of wound debridement on the healing of leg ulcers.     

Surgical therapy of the acne tetrad

On the basis of a 3 years experience with surgical treatment of acne tetrad (acne conglobata, apocrine acne) in 22 patients, we can draw the following conclusions: 1. Radical surgical excision yields better long-term results than local incision. Recurrences are mostly the result of non-radical surgery. 2. In cases of limited acne--especially if it is localized either in the axilla or the groin--primary wound closure may be successfully attained. 3. Gentamycin chains may support the primary wound healing in defect closures of infected areas. 4. In the axilla, we suggest wound closure by myocutaneous island flaps as the best procedure after extensive excision. 5. Specific antibiotic protection, perioperatively, according to previous culture and sensitivity testing can guarantee a postoperative course free from infection. 6. Open wound therapy with secondary healing of the soft tissue defects proved to be the treatment of choice in perineal procedures. 7. In view of the poor prognosis of conservative methods in chronic acne, and because of the risk of subsequent manifestation of chronic septicemia, early surgical excision is desirable.     

包皮环切吻合器(商环)外置式包皮环切术616例临床分析

目的:探讨一次性包皮环切吻合器(商环)外置式包皮环切术的临床疗效及不良反应,便于临床医生学习和掌握商环的临床应用技巧,减少并发症的发生。方法:回顾性分析616例包皮过长和包茎患者,年龄7~82岁,平均26岁,其中包皮过长545例,包茎71例,伴尖锐湿疣9例,已婚232例,未婚384例,对手术时间、术中出血、术后感染、水肿、疼痛、伤口裂开、环大小的选择及术后外观满意度等进行观察。结果:手术平均时间为(6.34±0.52)min,术中出血量为(0.2±0.1)m L,术中疼痛评分为(2.45±1.21)分,术后24h疼痛评分为(4.72±0.83)分,取环时疼痛评分为(5.35±1.24)分;术后感染13例(2.1%),轻度水肿310(50.3%),取环后2~4周基本消除;中度水肿56例,占9.1%,取环后嘱患者热敷、按摩,2~3个月后水肿基本消除;伤口裂开延迟愈合3例(0.5%),术后渗血5例(0.8%),未做处理;术后外观满意度96.3%(593/616)。结论:商环外置式包皮环切术手术时间短,方法简单、易掌握,术中出血少、术后感染低、疼痛轻、并发症少,切口外形美观、满意度高,优于传统的环切术,特别适合基层医院开展。     

Rapid wound healing of scalp wounds devoid of periosteum with milling of the outer table and split-thickness skin grafting

Background Excision of large scalp tumours may result in exposed bone devoid of periosteum. The resultant surgical defects may be too large to close by either primary closure or local cutaneous flap. The denuded bone usually precludes the immediate placement of a skin graft. Objectives  To describe our experience with milling the outer cortical table of the skull in order to promote granulation and hasten wound healing. Methods  In 11 patients, we expanded existing techniques of exposing diploic veins in the cancellous bone by completely milling the exposed outer table of the scalp bone with a rose head burr driven by a pneumatic power drill. After induction of punctate bleeding a split‐skin graft was placed in the same session and secured with a tie‐over foam dressing. Dressing was removed 7 days after surgery. All patients received perioperative antibiotics. Informed consent was obtained prior to the procedure. Results  In all 11 patients a healing of the split‐thickness skin graft was observed within 1 week. Conclusions  The combination of extensive exposure of cancellous bone and an immediate split‐thickness skin graft reduces convalescence time from multiple weeks to 7 days. This is beneficial in older patients sparing them from frequent visits to the doctor. Furthermore, early closure may reduce the risk of infection.