微创经皮输尿管镜下钬激光碎石术治疗上尿路结石

目的 探讨微创经皮输尿管镜下钬激光碎石术治疗上尿路结石的疗效和安全性.方法 回顾性分析2006年10月～2008年8月应用微创经皮输尿管镜下钬激光碎石术治疗42例上尿路结石患者及开放性手术治疗42例上尿路结石患者的临床资料.结果 42例经皮输尿管镜碎石术患者总结石取尽率为97.9%,手术时间平均(80.0±3.9)min,并发症发生率4.7%,平均住院天数为(7.5±0.9)d.42例开放手术患者总结石取尽率为90%,手术时间平均(118.0±5.8)min,并发症发生率12%,平均住院天数为(10.8±0.8)d.结论 微创经皮输尿管镜下钬激光碎石术较开放手术具有损伤小、结石清除率高的特点,是治疗上尿路结石的安全有效的方法.     

尿道段开孔尿管行尿道冲洗预防尿路感染的研究

目的 探讨三腔气囊导尿管尿道段开孔,冲洗尿道预防尿路逆行感染的效果。方法 采用对照组研究 方法,将经尿道前列腺切除术后(TURP)留置尿管的住院患者102例,分为对照组50例,实验组52例。对照组采 用普通三腔气囊导尿管传统护理,实验组应用0.5％碘伏经特制的尿道段开孔三腔气囊导尿管,冲洗尿道及尿道段 尿管,取不同时段的尿作细菌培养。结果 插管后分别于3 d、5 d两组尿培养阳性率比较,差异无显著意义(P> 0.05);7 d、10 d、拔管时,后尿道段尿管细菌培养阳性率差异有显著意义(P<0.05)。与对照组比较,实验组行膀 胱、尿道冲洗后能降低细菌感染发生率。结论 尿道段开孔气囊导尿管行尿道冲洗,可降低尿路逆行感染的发生率, 预防和控制细菌生物膜形成具有临床实用价值。     

Upper urinary tract infection: the current role of CT, ultrasound, and MRI

This article reviewed some of the fundamental concepts in renal inflammatory disease. The difficulties in present terminology were reviewed and our approach discussed. The pathological underpinning of the acute-subacute infections were contrasted with those seen in the granulomatous diseases. The importance of CT in separating emphysematous pyelonephritis from emphysematous pyelitis and perinephric emphysema was stressed. Although ultrasound has been used in the past and is still of value in select situations, we prefer CT for assessment of renal infection. CT examinations show whether the disease is focal or diffuse, whether air is present, whether there is perinephric or pararenal extension, whether an abscess is present, and when the ideal time is for intervention. In severe renal infection in the adult, CT has shown the development of renal scars, perinephric extension, and the spontaneous drainage of Staphylococcus abscesses into nearby calyces.     

尿微量清蛋白检测在上尿路结石早期肾损害中的应用

目的探讨尿微量清蛋白的检测在监测上尿路结石病人早期肾损害中的价值。方法对300例上尿路结石患者分别用速率法和二点终点法检测血尿素氮、肌酐,用免疫散射比浊法检测尿微量清蛋白,另300例对照组只检测尿微量清蛋白。结果上尿路结石患者尿微量清蛋白含量123．7767．90mg／L,明显高正对照组24．21±18．14rag／L（P〈0．001）。尿微量清蛋白检测阳性病例118倒（39．33％）,明显高于血尿素氮、肌酐检测阳性病例36例（P〈0．05）。结论尿微量清蛋白检测是反映早期肾功能损害的敏感指标之一,可作为监测上尿路结石患者早期肾功能变化的指标。     

Upper respiratory tract infections

Upper respiratory tract infections are among the most common acute infections in humans. This review discusses the clinically important aspects of the epidemiology, etiology, clinical presentation, diagnosis, management, complications, and prevention of the common cold, pharyngitis, otitis media, and sinusitis. Most episodes of the common cold and pharyngitis are of viral origin, and curative therapy is not available. Streptococcal pharyngitis, acute otitis media, and sinusitis are secondary to bacterial infections, and antibiotic therapy is important.     

Dual-energy CT of the urinary tract

With the ability to provide structural- and material-specific information with single phase of image acquisition, dual-energy CT has several useful applications in urinary tract imaging such as evaluation of renal mass, CT urography, and characterization of urinary calculi. Although the underlying principle of dual-energy scanning is similar, there are several important differences in the currently available dual-energy scanners and the image processing algorithms used for these scanners. Knowledge of the principle of dual-energy data acquisition and image processing is essential to understand the advantages and limitations of dual-energy CT in urinary tract imaging.