回肠代膀胱扩大术治疗氯胺酮导致膀胱挛缩患者围手术期的护理

目的探讨回肠代膀胱扩大术治疗氯胺酮导致膀胱挛缩患者围手术期的护理要点。方法选取行回肠代膀胱扩大术治疗的因服用氯胺酮导致膀胱挛缩的患者6例,从术前、术后、并发症的处理及出院指导4个方面总结该类患者的护理要点。结果患者均手术顺利,肝肾功能恢复正常,经过精心护理,患者均治愈出院,临床疗效满意。结论回肠代膀胱扩大术是治疗氯胺酮导致膀胱挛缩的有效手段,精心的护理是患者手术成功及术后恢复的必要手段。     

后腹腔镜肾输尿管全切加腹膜后肾周区域淋巴结清扫与开放手术治疗UUT-TCC疗效比较

目的:探讨后腹腔镜技术与开放手术治疗上尿路移行细胞癌(upper urinary tract transitional cell carcinoma,UUT-TCC)的效果及优势。方法:回顾性分析2009年11月~2012年12月间,我院采用后腹腔镜下肾输尿管根治性切除术加腹膜后肾周区域淋巴结清扫术治疗肾盂输尿管癌患者23例(腹腔镜组),并与同期14例行传统开放性肾输尿管切除术患者(开放术组)的手术时间、出血量、肿瘤学预后等指标进行比较。结果:腹腔镜组患者经术后病理检查,肾盂癌24例,输尿管癌10例,输尿管癌伴膀胱癌3例,其中腹腔镜组和开放组淋巴结转移各1例。同时研究发现:①腹腔镜组与开放术组比较,手术时间缩短,出血量明显减少,术后肠胃功能恢复快,术后住院时间短,差异有统计学意义(P0.05);②两种术式肿瘤学预后在远处转移方面,腹腔镜组更少,差异有统计学意义(P0.05)。结论:后腹腔镜下肾输尿管全长切除加经尿道膀胱袖状切除并腹膜后肾周区域淋巴结清扫治疗UUT-TCC具有创伤小、痛苦少、术后恢复快等优点,可能有更好的肿瘤学预后。     

规范应用颈腰椎脊柱融合术

<正>脊柱融合术是以病椎为中心,从上位到下位正常脊椎间行植骨术,使病椎与周围节段形成骨性融合成为力学整体的手术,是和神经减压、内植物固定并列的三大必不可少的脊柱外科技术。从1911年Hibbs和Albee介绍脊柱融合术起,经过100多年发展,随着手术理念的改进和移植物、手术器械的更新,脊柱融合术的术式推陈出新,并广泛用于治疗各种脊柱疾病。国内各大医院都开展了该项技术,甚至不少并未真正掌握该技术的基层医院     

正常人腰椎间盘的MRI测量及其临床意义

目的:为国人开展腰椎间盘人工髓核假体(prostheticdicsnucleus,PDN)置换术提供影像解剖学资料。方法:对56例正常人的腰椎间盘(男44例,女12例)MRIT2加权像中髓核矢状径、横径,椎间隙前、中、后高度进行了测量。所选PDN假体为目前统一规格:前后径为12mm,高度分别为5mm、7mm、9mm。结果:髓核矢状径、横径及椎间隙高度均数之间无明显性别差异(P>0.05)。髓核矢状径均大于12mm,但大于24mm在L2/3中为23.2%,L3/4中21.4%,L4/5中21.4%,L5/S1中16.1%。椎间隙后高较低,5mm~9mm者在L2/3中为85.7%,L3/4中82.1%,L4/5中82.1%,L5/S1中58.9%,大于9mm者L2/3中0%,L3/4中1.8%,L4/5中1.8%,L5/S1中3.6%。结论:国人中大多数人腰椎间盘内仅可容纳单枚PDN假体,适合高度为5mm或7mm,可因人而异选择。     

非胰岛素依赖型糖尿病患者脂蛋白(a)的变化及其与糖尿病肾病的关系

非胰岛素依赖型糖尿病患者脂蛋白（ａ）的变化及其与糖尿病肾病的关系杨正刚王战建王秀芬冯忠军刘宽芝我们以病例对照研究方式观察了非胰岛素依赖型糖尿病（ＮＩＤＤＭ）患者脂蛋白（ａ）［Ｌｐ（ａ）］的变化，并探讨与糖尿病肾病的关系。一、对象和方法１．对象：ＮＩＤ...     

Aetiology and outcome of acute renal failure secondary to war related trauma and infectious disease in Croatia

Summary: The aim of our study was to explore the aetiology and the outcome of acute renal failure (ARF) during the war in Croatia. of the 2132 patients admitted to our hospital between April 1990 and November 1992 due to war related trauma, 11 (0.5%) developed ARF. We believe that the development of ARF in these patients was secondary to an overwhelming septic process. Most of our patients suffered from multiple organ failure. of the 11 patients suffering from ARF due to war related trauma only four recovered (63.6% had died). We attribute the lethal outcome to the progression of the septic process. Patients who developed ARF due to infectious diseases unrelated to trauma had a different prognosis. Acute renal failure caused by the Hantan virus ran a benign course, in both its oliguric and non-oliguric form. Patients who developed ARF as a complication of leptospirosis also had a good prognosis. Although ARF is usually of a multifactorial genesis, our study aimed to emphasize the importance of disseminated septic processes as a cause of ARF.     

Medical Progress in China }， RECENT ADVANCES IN OBSTETRICS AND GYNECOLOGY IN CHINA

With the progress in perinatology, due attention has been paid to Women Health Care in the last few years in China. Since 1985 when the OB/GYN Society set up a Section for Women Health Care, several symposia have been held on women health care from early childhood to the elderly. In 1988, under the guidance of the Preventive Medical Association, maternal and child health care workers came together to organ- ize the Sociaty of Women and Children Health Care.     

日本岛津DSA血管机常见应用故障剖析

剖析了数字减影设备在介入放射治疗手术中因使用、操作不当造成DSA设备应用故障的实例，而合理使用、熟练操作是可以减少或避免该类应用故障的发生。