体外冲击波碎石术治疗上尿路结石的临床分析

目前,体外冲击波碎石术(ESWL)已经成为上尿路结石最主要的治疗方法。我们采用ESWL治疗上尿路结石患者1456例,其中有复杂的上尿路结石,包括直径>2cm以上的结石、肾盂内的鹿角形结石、输尿管结石等,均取得良好的效果,现报告分析如下。1资料与方法1.1一般资料:本组共1456例,其中男性843例,女性613例;年龄4～83岁,平均39岁。复杂上尿路结石35例,其中2cm以上的肾盂结石25枚,鹿角形结石10枚;输尿管结石1347枚,2cm以上的输尿管结石13枚,双侧输尿管结石26枚。1.2方法:采用深圳产惠康V型X线B超双定位碎石机,工作电压12KV,冲击次数700～3500次。…     

自拟排石益肾汤辅助体外冲击波碎石治疗上尿路结石

目的：探讨上尿路结石在ESWL治疗后辅以自拟排石益肾汤对结石清除率的影响。方法：将符合条件的300例患者按结石的部位随机分成3组,在ESWL治疗后再分成两组,一组给予常规治疗作为对照,另一组除给予常规治疗外,增加排石益肾汤100 mL/次,2次/d,持续1个月,将随访1个月和采取ESWL以外的治疗方法作为每位患者的研究终点,每个患者分别在治疗1、2、3、4周末通过B超或KUB了解结石排出情况,结果：把所有研究的患者按结石部位分成肾盂结石组、输尿管上段结石组、输尿管下段结石组。在治疗组中,结石排出率分别为66.7%、83.7%和95.2%,明显高于对照组的54.2%、57.2%和71.2%。结论：ESWL治疗上尿路结石后辅以排石益肾汤可显著提高结石清除率。     

体外冲击波碎石治疗上尿路结石的疗效观察

目的总结体外冲击波碎石(ESWL)治疗上尿路结石的临床经验。方法对147例上尿路结石碎石病例在病例选择、碎石、排石及碎石后并发症的防治等方面进行回顾分析。结果 147例均碎石成功,3月内结石排尽率为89.1%,所有病例均并发短暂的腰痛和血尿,输尿管石街3例,发热2例。结论为了提高ESWL治疗上尿路结石的疗效,需重视病例的选择、优化碎石条件、积极预防和处理碎石后并发症。     

孤立肾输尿管结石致急性肾功能衰竭的ESWL治疗

孤立肾尿路结石致急性肾功能衰竭属于危急重症,处理不当将直接威胁患者生命。我院1998年。2006年对28例输尿管结石致孤立肾急性肾功能衰竭患者采用体外冲击波（ESWL）治疗,取得满意疗效,现报告如下。     

ESWL治疗输尿管中段结石386例效果分析

目的:观察和总结ESWL治疗输尿管中段结石的临床疗效.方法:2000 - 10 ～2011 - 10本院连续无选择收治的386例输尿管中段结石患者,采用体外碎石术(ESWL)的临床资料进行了回顾性分析.结果:386例输尿管中段结石患者中,一次性治愈295例,二次治疗后治愈78例,尚有13例经三次治疗后治愈.结论:ESWL治疗输尿管中段结石,是一种快捷,有效的治疗方法.     

体外冲击波碎石机治疗尿路结石2060例临床分析

体外冲击波碎石机应用临床以来，为泌尿系统结石患者提供了一种的非手术治疗方法，经过ESWL治疗尿路结石2060例，取得满意效果。     

彩超定位体外冲击波碎石治疗输尿管结石

目的:评价彩超定位下体外冲击波碎石(ESWL)治疗输尿管结石的疗效、价值。方法:回顾性分析经彩超明确诊断的1 542例输尿管结石患者(双侧5例,单侧多发9例)在彩超定位下行ESWL的资料。结果:彩超定位准确率为100%,输尿管结石体外冲击波碎石1次碎石成功占90.0%,2次占7.0%,3次占2.3%,总碎石成功率为99.2%。12例3次碎石变化不大,放弃ESWL治疗,改为其他治疗。结论:彩超定位下行ESWL治疗输尿管结石定位准确、安全快捷、可重复、价廉、术中监测方便、无辐射等,具有非常高的临床应用价值。     

CT值对输尿管下段结石选择治疗方法的指导意义

目的探讨CT值对于输尿管下段结石选择治疗方法的价值。方法选择不同CT值的三组(A组HU<700,B组HU 700~1 000,C组HU>1 000)输尿管下段结石的患者,分别行体外碎石(ESWL)+药物治疗,治疗后有变化但还有未排出的结石,间隔10~14 d后再行2次或3次ESWL。治疗后3~6个月复查。结果 A组(n=45)患者中43例结石排出占95.6%,B组(n=31)患者中23例结石排出,占74.2%,C组(n=36)患者中15例患者结石排出占41.7%,均未出现明显并发症。结论输尿管下段结石的CT值对指导治疗方法的选择有重要价值,HU<700的患者应首选ESWL。     

微通道经皮肾镜取石术治疗上尿路结石2724例经验总结

目的探讨微通道经皮肾镜取石术(MPCNL)治疗上尿路结石的有效性和安全性。方法对我院泌尿外科2004年1月至2013年12月收治的MPCNL治疗上尿路结石2 724例的临床资料进行回顾性分析。结果本组共2 724例患者(2 835个肾),行MPCNL 3 078次。其中,Ⅰ期手术2 696次(87.59%),Ⅱ期手术357次(11.60%),多次手术25例(0.81%)。采用单通道碎石2 786例(98.27%),双通道碎石44例(1.55%),三通道碎石5例(0.19%)。术后患者行ESWL和(或)输尿管软镜辅助治疗173例(6.35%)。手术时间(120.4±50.5)min。MPCNL术后总结石清除率91.2%,行ESWL和(或)输尿管软镜辅助治疗后结石清除率为94.1%。住院时间(10.6±3.2)d。术中或术后输血61例(2.24%),因出血严重术后行选择性肾动脉栓塞术8例(0.29%)。术后肾破裂致肾切除1例(0.04%)。术后发现结肠损伤1例(0.04%)、胸膜损伤5例(0.18%)。术后感染性休克28例(1.03%),其中因感染性休克死亡1例(0.04%)。术后7 d因肺栓塞致死亡1例(0.04%)。结论微通道经皮肾镜取石术具有创伤小、并发症少、结石清除率高等优点。治疗上尿路结石安全、可靠、高效。     

ESWL治疗肾下盏结石6230例疗效分析

自1980年体外冲击波碎石术（Extracorporeal shock wave lithotripsy, ESWL）问世以来,ESWL已成为上尿路结石的重要治疗手段。肾下盏结石在肾结石中占有很高的比例,而ESWL对肾下盏结石的排空率较低。笔者对1988～2007年以来行ESWL治疗的6230例肾下盏结石进行了回顾性调查,旨在探讨肾下盏结石治疗的有效方法,现将结果报道如下：     

Optimization of the system of medical service of students of Cadet Schools of the Ministry of Defense of the Russian Federation

One of the factors of the successful military career guidance Cadet schools students is preserving and promoting their health. Medical support of children and adolescents aged 10-17 years should include the full range of medical and preventive measures defined for this group. The state of providing outpatient care for pupils at the Cadet School in St. Petersburg was studied. These results show that full medical care in accordance with the standards can be based only on children's health clinics. It is important that the organization of medical support pupils cadet schools should be cooperate with civilian health care.     

带状疱疹83例误诊原因分析

带状疱疹是由水痘—带状疱疾病毒引起的皮肤科常见疾病。其主要的病理损害,一是受累神经的严重炎症性浸润,继而导致受侵犯神经节内神经细胞变性、坏死;二是皮肤的水泡。迅速抑制神经节和相应的感觉神经纤维的充血、水肿和坏死,防止粘连形成,达到迅速镇痛、改善皮损,缩短病程及防止后遗症的发生是治疗的关键。因而,尽早明确诊断,     

Estimation of accumulated dose of radiation by method of ESR-spectrometry of dental enamel of mammals

ESR-spectrometry was used to investigate radiation-induced paramagnetic centers in enamel of mammals: carnivores (polar bear and fox), ungulates (reindeer, European bison, moose), and man. Values at half the microwave power saturation of the radiation signal, P_1/2, evaluated at room temperature, was found to range from 16 to 26 mW for animals and man. A new approach to discrimination of the radiation induced signal from the total ESR spectrum of reindeer enamel is proposed. ‘Dose-response’ dependencies of enamel of different species mammals were measured within the dose range from 0.48 up to 10.08 Gy. Estimations of ‘radiosensitivity’ enamel of carnivores and ungulates showed good agreement with radiosensitivity enamel of man by ESR method.     

Analysis of the results of the international comparison of activity measurements of a solution of Fe

The results of an international comparison of activity measurements of a solution of ⁵⁵Fe organized by the BIPM in 2005 are reported and analysed. This exercise, which follows the procedures of the CIPM mutual recognition arrangement to update older comparisons, is a renewal of the comparison organized by the BIPM that took place in 1978. A EUROMET comparison was organized in 1996 specifically to compare activity measurements of a ⁵⁵Fe solution by means of liquid-scintillation techniques. Results of these three comparisons are presented and discussed in this paper.

The radionuclide solution was provided by the NPL, which also distributed the samples to the participants. The activity of the ampoules was measured by 16 laboratories using 12 methods producing 25 results. Some general considerations on uncertainty assessments pertaining to the different techniques used are drawn. The outcome of four different estimators is compared from which the presence of at least one outlier can be confirmed. Further measurements should be made to try to reduce the discrepancy between the results. To date the outcome of the present comparison does not show an improvement to that of the 1996 comparison.     

Evaluation of the results of various technics of non-surgical therapy of varicocele

A new method of non-surgical treatment of varicocele syndrome is described: it consists in sclerotherapy of spermatic vein by trans-femoral percutaneous catheterization with balloon-catheters. In 8 cases venous thrombosis has been induced by direct electric clotting. The techniques and a 6 months follow-up are discussed. It is pointed out that this procedure should be considered as the method of choice for tubular lesions and sub-fertility prophylaxis in young people and in childhood.     

延迟性脾破裂误漏诊原因分析

目的探讨延迟性脾破裂误漏诊原因和预防措施.方法回顾性分析总结12例延迟性脾破裂中的诊断和误漏诊的经验与教训.结果本组延迟性脾破裂的误漏诊5例(41.66%).对多发伤与脾破裂并存可能认识不足,外伤史轻微或伤员隐瞒外伤史,缺乏腹痛-缓解-突然再腹痛的典型病史,缺乏“对冲性脾破裂”力学分析和整体化诊断思路等为其误漏诊的主要原因.结论详细的外伤史和全面系统检查,重视腹以外多发伤掩盖腹内脏器伤及延迟性脾破裂可能.确立外伤-腹内脏器伤-脾破裂整体化诊断思路.不间断地辅以B超检查脾形态学变化和腹内有无积液,腹腔穿刺确定有无血腹、X线胸腹部检查观察左侧胸肋角和膈肌运动情况、必要时CT检查以尽早发现脾包膜下血肿,降低延迟性脾破裂误漏诊率.