手术治疗阴茎异常勃起6例分析

目的 :探讨阴茎异常勃起的诊断和手术治疗效果。方法 :回顾性分析 6例阴茎异常勃起患者的临床资料。 6例患者分别经阴茎头阴茎海绵体分流术 ,阴茎海绵体抽吸冲洗术 ,阴茎海绵体股静脉分流术 ,阴茎海绵体大隐静脉分流术 ,阴部内动脉栓塞术 ,阴茎海绵体白膜修补术等手术治疗。结果 :除 2例行大隐静脉阴茎海绵体分流术患者外 ,其余 4例全部恢复了性功能。结论 :阴茎异常勃起早期可行阴茎海绵体抽吸冲洗后 ,局部注入阿拉明 ,如超过 2 4h后应积极手术治疗 ,如延迟治疗 ,将增加阳萎发生的风险。     

缺血性阴茎异常勃起的护理

总结17例缺血性阴茎异常勃起患者的护理。缺血性阴茎异常勃起的主要治疗方法有保守治疗、阴茎海绵体穿刺放血、阴茎头阴茎海绵体分流术。做好患者的心理护理、用药护理,加强阴茎海绵体穿刺冲洗的观察及护理,阴茎头阴茎海绵体分流术前做好患者准备、术后密切病情观察,可提高缺血性阴茎异常勃起的治愈率。     

2例以阴茎异常勃起为首发症状的慢性粒细胞白血病患者的护理

目的总结以阴茎异常勃起为首发症状的慢性粒细胞性白血病患者的治疗及护理。方法采用COM-TEC血细胞分离机进行白细胞分离去除术,同时联合羟基脲等药物化疗;对阴茎异常勃起长时间不能缓解者,行阴茎海绵体分流术;护理上加强心理护理。结果2例患者经过心理护理,白细胞去除术及阴茎海绵体分流术伤口的护理,阴茎异常勃起症状完全消失,疴隋稳定。结论以阴茎异常勃起为首发症状的慢性粒细胞性白血病患者的治疗选择白细胞去除术联合化疗,效果明显;对阴茎异常勃起长时间不能缓解者行阴茎海绵体分流术,可最大限度地保留患者的勃起功能,避免阴茎海绵体纤维化。     

阴茎异常勃起的急诊诊治10例分析

目的:探讨阴茎异常勃起的急诊诊断和治疗方法。方法:回顾性分析10例阴茎异常勃起患者的临床资料。结果:治疗后消退10例,复发2例,勃起功能障碍3例。结论:临床表现、血气分析和彩色多谱勒检查能明确诊断和分型。阴茎海绵体穿刺抽吸冲洗术,阴茎头—阴茎海绵体分流术及介入治疗是治疗低血流量型和高血流量型阴茎异常勃起的重要方法。     

前列腺素E1致阴茎异常勃起一例的急救与护理对策

目的 探讨药物过量致阴茎异常勃起的治疗与护理。方法 行阴茎海绵体一尿道海绵体分流与阴茎头一阴茎海绵体分流术，加强围手术期的身心护理、局部处理。结果 患者术后顺利康复出院。结论药物过量致阴茎异常勃起经及时、适当的治疗与护理，预后良好。对特殊的外籍病例推行亲情沟通护理，从生理、心理、社会多层次、全方位进行情感交流，有助于取得忠者的信任和合作，促进康复。     

以阴茎异常勃起为首发症状的白血病5例并文献复习

目的 :探讨阴茎异常勃起为首发症状的白血病的诊断和治疗原则。方法 :回顾性分析了 5例首诊入住泌尿外科 ,以阴茎异常勃起为首发症状的白血病患者的临床资料。结果 :5例阴茎异常勃起均为慢性粒细胞白血病所致 ,均伴有不同程度的脾肿大和血象异常。1例阴茎尿道海绵体分流 ,1例阴茎海绵体切开 ,3例行海绵体抽吸冲洗术。1例海绵体部分纤维化 ,勃起功能障碍 ,余 4例均取得了较好疗效。结论 :以阴茎异常勃起为首发症状的白血病误诊率高。对白血病性阴茎异常勃起应采用综合方法治疗 ,化疗是主要的治疗措施 ,阴茎持续勃起时间长者应尽早行外科处理。     

1例阴茎异常勃起症病人的护理

阴茎异常勃起症是一种与性刺激和性欲无关的阴茎持续性痛性勃起[1]。临床较少见,大部分原因不清,少部分与阴茎或会阴部外伤、白血病、服用抗精神病药、镰状细胞贫血、阴茎背静脉栓塞等有关[2]。2005年9月我科收治1例阴茎异常勃起症病人行阴茎头、阴茎海绵体分流术,效果满意。现报告如下。1病例简介病人,男,36岁,因阴茎无性欲持续勃起10余天入院。查体:阴茎极度勃起,表面暗红,明显触痛,呈持续性,病人感阴茎胀痛伴排尿困难。病人10年前患精神分裂症,长期服用氯丙嗪等抗精神病药物,诊断为阴茎异常勃起症。立即给予阴茎海绵体冲洗法治疗,效果不…     

慢粒白血病伴阴茎异常勃起误做手术后的中西医治疗（附2例报告）

阴茎异常勃起为慢性粒细胞白血病少见并发症，而误作手术的病例更为罕见。我科曾收治2例因阴茎异常勃起曾在外院行阴茎海绵体分流术后，患者伤口出血，局部肿胀，异常勃起无改善，经中西医结合治疗阴茎勃起消失，取得满意疗效。     

1例藻酸双酯钠致阴茎异常勃起病人的护理

阴茎异常勃起(priapism)是一种与性刺激和性欲无关的阴茎持续性勃起状态超过4 h的病理状态.临床上较少见,也是泌尿外科急症之一.根据血流动力学可分为高流量和低流量两类.前者临床少见,主要为外伤引起.后者又称缺血性异常勃起,由多种原因引起,是临床最常见的一种类型.引起低流量阴茎异常勃起的原因较多,如血液病、药物、神经系统疾病和非血液性恶性肿瘤等.2010年10月我科收治1例因静脉输注藻酸双酯钠后出现阴茎异常勃起,急诊行阴茎头、阴茎海绵体分流术,效果满意.现将护理介绍如下.     

白细胞去除术联合化疗治疗以阴茎勃起为首发症状慢粒1例

以阴茎勃起为首发症状的慢性粒细胞性白血病(慢粒)临床少见,笔者运用治疗性白细胞去除术联合化疗治疗1例,取得满意效果. 1 病例资料和方法 患者,男性,32岁.因阴茎异常勃起、疼痛36h入院.入院前无明显诱因出现阴茎持续勃起、疼痛,在当医院用多种办法治疗无效,转入佛山市第一人民医院,拟"阴茎勃起查因"收住外科.行"阴茎海绵体穿刺放血术"治疗,效果不明显.     

Embolization for massive urethral hemorrhage

Priapism is the term given to a prolonged, painful penile erection, unaccompanied by sexual desire. Most cases of priapism occur as a result of engorgement of the cavernous body of the penis due to intrinsic or extrinsic venous outflow obstruction, which is termed veno-occlusive priapism. However, in a small number of patients, the cause is related to uncontrolled arterial inflow due to trauma and resultant laceration of cavernosal arteries. This form of disease has been termed high-flow priapism and usually occurs in association with genitoperineal trauma. Most incidents of high-flow arteriogenic priapism result from genitoperineal trauma, such as that caused by sliding on a wooden bar or falling astride a ladder. We experienced a patient with a high-flow priapism due to urethral trauma caused by a misplaced Foley catheter. The treatment consisted of superselective arterial embolization of the bilateral internal pudendal arteries using metallic microcoils, which resulted in the subsequent detumescence of the penis with no complications. This case showed that bilateral arteriocavernosal fistulae can be successfully treated by superselective arterial embolization.     

海绵窦区硬脑膜动静脉瘘致2型糖尿病患者眼肌麻痹一例的诊治及文献复习

[目的]结合文献复习,提出海绵窦区硬脑膜动静脉瘘致2型糖尿病患者眼肌麻痹的临床诊断和治疗策略.[方法]回顾分析本院1例由于海绵窦区硬脑膜动静脉瘘致眼肌麻痹的2型糖尿病患者的临床资料.[结果]脑血管数字减影造影（DSA）显示＂左侧海绵窦区硬脑膜动静脉瘘＂,行＂颅内动静脉瘘栓塞术＂后患者上睑下垂症状及眼球运动逐渐改善.[结论]眼肌麻痹的病因复杂.对于糖尿病患者突发的颅神经受损,除了考虑糖尿病神经系统并发症外,还需排除其他颅内占位性病变及海绵窦区硬脑膜动静脉瘘可能,必要时可行影像学检查以明确病因.     

The effect of propylene glycol on antipyrine clearance in humans

To evaluate the potential interaction of propylene glycol on hepatic drug oxidation, antipyrine disposition was measured in 10 healthy subjects who received 1.2 gm antipyrine alone on one occasion and 1.2 gm antipyrine with propylene glycol on a second occasion. Propylene glycol was given as a 5 ml dose every 4 hours during the 48 hours of the study. Propylene glycol had no effect on antipyrine half life (11.7 hours control vs. 12.1 hours treatment), clearance (42.6 vs. 39.2 ml/min), or volume of distribution (42.1 vs 41.9 L). At a dose similar to that used as a vehicle for administration of other drugs, propylene glycol had no significant effect on antipyrine clearance in humans.     

Screening of urine by one-dimensional and pulsed-field gradient two-dimensional 1H NMR spectroscopy: intoxication by propylene glycol in an infant patient

1H NMR spectroscopy is a promising method for the analysis of physiological fluids in clinical medicine. In the course of screening the urine of patients by 1D- and pulsed-field gradient 2D 1H NMR spectroscopy at 500 MHz, we encountered a case with a very high excretion of propylene glycol compared to others who received similar doses of the medication. In this case, the propylene glycol was scarcely metabolized by the patient. Propylene glycol is widely used as a safety material which is transformed into pyruvate and lactate in the healthy body. In this paper, we discuss how NMR spectroscopy can be a useful method for screening a patient intoxicated with propylene glycol.     

不同剂量乌司他丁治疗感染性休克的临床研究

【目的】研究不同剂量乌司他丁（UTI）对感染性休克患者的临床疗效。【方法】将60例感染性休克患者随机分为三组,每组20例。对照组（I组）予常规治疗;II组和Ⅲ组在常规治疗基础上分别加用UTI100kU和200kU静脉滴注,12h1次;均连用7d。检测三组患者治疗前及治疗1周后血浆降钙素原（PCT）、肿瘤坏死因子一cdTNF-a）、白介素一6（IL一6）的水平,记录休克恢复时间、平均住院天数和28d病死率,比较三组患者各指标间的差异。【结果】治疗前三组患者血浆各指标间差异无统计意义（P〉0．05）。治疗1周后Ⅱ、Ⅲ组患者血浆PCT、TNF_口、IL一6的水平,休克恢复时间、平均住院天数和28d病死率明显低于I组（P〈0．01）;Ⅲ组患者各指标明显低于Ⅱ组（P〈O．01）。【结论】UTI能有效降低感染性休克患者血浆PCT水平,抑制过度的炎症反应,具有抗休克、降低平均住院天数和病死率的作用,且呈明显的量效关系。     

以癫痫发作为主的幕上海绵状血管瘤的显微手术治疗

【目的】探讨以癫痫发作为主的幕上海绵状血管瘤显微手术方法和疗效。【方法】对1999年至2009年本院收治的以癫痫发作为主的幕上海绵状血管瘤共38例,在显微镜下行切除术,术中彻底切除病灶和周围的胶质瘢痕以及含铁血黄素层。【结果】术后影像学检查显示38例海绵状血管瘤均全切除;癫痫发作得到控制,癫痫缓解率超过90％。【结论】显微手术切除海绵状血管瘤及其周围的胶质瘢痕和含铁血黄素层是控制癫痫发作的有效方法。     

Inhibition of tobramycin diffusion by binding to alginate.

[3H]tobramycin bound to sodium alginate and to exopolysaccharide prepared from two mucoid strains of Pseudomonas aeruginosa. Binding to sodium alginate was similar to binding to exopolysaccharide, both in the dependence on tobramycin concentration and in the maximum binding observed at saturation. Incorporation of sodium alginate into agar plates reduced the zone sizes of growth inhibition caused by tobramycin. The reductions in zone sizes were quantitatively accounted for by the binding of tobramycin to sodium alginate during diffusion of the antibiotic away from the well in which it had been placed at the start of the experiment. However, the binding of tobramycin to the exopolysaccharide of P. aeruginosa, and the resulting inhibition of diffusion of the antibiotic, did not significantly increase the penetration time of a spherical microcolony with a radius of 125 micron, such as might be found in the respiratory tract of a patient with cystic fibrosis (from a 90% penetration time of 12 s in the absence of exopolysaccharide to one of 35 s with an exopolysaccharide concentration of 1.0% [wt/vol]).     

儿童白血病运用HD-MTX化疗临床护理路径的应用探讨

【目的】探讨临床护理路径（CP）在综合治疗、护理白血病患几应用大剂量甲氨蝶呤（HD-MTX）化疗的临床意义和效果,规范该类患儿在治疗过程中的护理行为。【方法】将28例急性淋巴细胞白血病（ALL）患儿,运用HD-MTX化疗共104个疗程,按入院次序的前后分为试验组和对照组,每组52例次,试验组应用临床路径管理,对照组按照常规的工作模式管理,比较两组患儿的平均住院日、住院费用、感染发生率、化疗药物的毒副作用所致并发症、病人满意度。【结果】试验组患儿的平均住院日、医疗费用、感染发生率、化疗药物不良反应发生率显著少于对照组（P〈O．05）。【结论】ALL运用HD-MTX化疗时应用CP管理,是深化临床优质护理服务内涵一条切实可行的有效途径。     

Propylene glycol accumulation associated with continuous infusion of lorazepam in pediatric intensive care patients

OBJECTIVE: To determine if propylene glycol accumulates in children receiving continuous lorazepam infusion and, if accumulation occurs, to determine if it is associated with significant laboratory abnormalities. DESIGN: Prospective study. SETTING: A tertiary care pediatric intensive care unit. PATIENTS: Eleven intubated pediatric intensive care patients receiving continuous lorazepam infusion for sedation. INTERVENTIONS: Propylene glycol accumulation was determined by comparing concentrations at baseline, after 48 hrs, and at end of therapy. Laboratory abnormalities were determined by comparing serum lactate and osmolar gap at baseline, after 48 hrs, and at end of therapy. Correlation between the cumulative dose of lorazepam received and the propylene glycol concentration measured at the end of therapy was determined. MEASUREMENTS AND MAIN RESULTS: Patients aged 1-15 months were studied. Lorazepam infusion rates ranged from 0.1 to 0.33 mg.kg.hr and lasted 3-14 days. Propylene glycol accumulated significantly in patients receiving continuous infusion of lorazepam. The propylene glycol concentration increased during the study from 86 +/- 93 microg/mL at baseline to 763 +/- 660 microg/mL at the end of the study ( p=.038). A statistically significant correlation between the cumulative dose of lorazepam received and propylene glycol concentration at the end of therapy was demonstrated ( r(2)=.65, p<.005). However, the propylene glycol accumulation was not associated with significant laboratory abnormalities. Neither serum lactate concentrations nor osmolar gap were significantly elevated over baseline. CONCLUSION: Propylene glycol accumulated significantly in pediatric intensive care patients receiving continuous lorazepam infusion, and propylene glycol concentration correlated with the cumulative lorazepam dose the patient received. However, significant laboratory abnormalities due to propylene glycol accumulation were not observed.