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131.
直视下尿道内切开术的再认识 总被引:7,自引:0,他引:7
目的:观察直视下尿道内切开术(DVIU)的长期疗效,重新评价DVIU的临床应用价值。方法:回顾性分析2003年1月~2007年1月收治的65例尿道狭窄或闭锁患者行DVIU及术后随访的临床资料:狭窄长度0.5~2.0cm,平均1.2cm。其中≤1.0cm者25例,1.1~2.0cm者40例。30例行尿道超声检查测量尿道瘢痕厚度,其中瘢痕厚度≤1cm者10例,〉1cm者20例,瘢痕长度和厚度均≤1cm者9例。结果:65例共行DVIU72例次,72例次内切开手术均获得成功。63例获得随访,随访时间24~60个月,平均40.5个月。48例(76.2%)因狭窄复发而最终接受开放手术。尿道超声显示瘢痕厚度≤1cm的10例中,只有1例接受手术;瘢痕厚度〉1cm的20例中,18例接受手术;瘢痕长度和厚度均≤1cm的9例均未行手术。结论:DVIU适合于狭窄段和瘢痕厚度均〈1cm的患者,切开次数以1次为宜,手术疗效与严格掌握适应证密切相关。 相似文献
132.
目的:探讨尿道狭窄患者围手术期尿液TGF-β1浓度变化情况以及影响该浓度的相关因素.方法:使用ELISA试剂盒对29例尿道狭窄患者术前1个月及术后1个月尿液中TGF-β1进行测定及记录.同期取泌尿系统其他手术的14例患者作为对照组,测定其术后1个月尿液中TGF-β1浓度.结果:检测结果显示实验组在接受手术治疗后尿液中TGF-β1含最较对照组有显著增高(P<0.05).同时实验组患者术前和术后尿液TGF-β1浓度也存在明显差异(P<0.05).在相关性因素的分析中,前尿道狭窄患者术后尿液中TGF-β1含量的变化幅度较后尿道狭窄患者更为显著(P<0.05),同时采用自体组织替代技术较传统端端吻合技术以及内镜切开技术更能引起尿液中TGF-β1的明显变化(P<0.05).但年龄、既往手术次数均未能引起患者术后TGF-β1的变化.结论:狭窄部位、手术方式都与患者尿液中 TGF-β1的含量存在一定的联系,而年龄及既往手术史等因素未发现与患者体内TGF-β1含量有较大的联系. 相似文献
133.
BACKGROUND: Inappropriate use of the category of atypical squamous cells of undetermined significance (ASCUS) can result in overtreatment or undertreatment of patients, which may decrease the cost effectiveness of screening. Quality assurance tools, such as the ASCUS to squamous intraepithelial lesion ratio (ASCUS:SIL) and case review, are imperfect. High-risk HPV (hrHPV) testing is an objective test for a known viral carcinogen, and hrHPV may be more useful in monitoring the quality of ASCUS interpretations. METHODS: hrHPV rates for cytologic diagnoses and patient age groups were calculated for a 2-year period. All hrHPV results for ASCUS and SIL over a 17-month period were analyzed by patient age group, over time, and by individual cytopathologist to compare hrHPV rates with the corresponding ASCUS:SIL. RESULTS: The hrHPV positive rate for SIL was >90%, and it was 32.6% for ASCUS. Stratification by patient age showed that approximately 50% of patients younger than 30 years and older than 70 years of age were hrHPV positive, whereas other patients had a lower rate ranging from 14% to 34%. The overall ASCUS:SIL was 1.42, and the overall hrHPV positive rate was 39.9%. Over time and by individual cytopathologist, the hrHPV rate performed similarly to the ASCUS:SIL. The analysis by patient age showed a high statistical correlation (R(2) = 0.9772) between the 2 methods. CONCLUSIONS: Despite differences between these techniques, the hrHPV rate closely recapitulates the ASCUS:SIL. When used together, the 2 methods can complement each other. The desirable hrHPV-positive range appears to be 40% to 50%; however, this may vary based on the patient population. The hrHPV rate is as quick and cost effective as determining the ASCUS:SIL. 相似文献
134.
Amin A. Nanji David J. Stewart Nadia Z. Mikhael 《Cancer chemotherapy and pharmacology》1986,17(3):274-276
Summary The usefulness of pretreatment biochemical parameters in the prediction of nephrotoxicity associated with cisplatin treatment was studied. Twenty-two patients, who received 29 cycles of cisplatin, were evaluated. Cisplatin was given every 3–4 weeks with saline and mannitol. Azotemia occurred in almost all patients and was transient, peaking 1–2 weeks after therapy. The change in serum creatinine from baseline to peak correlated inversely with pretreatment serum albumin (r=-0.73; P<0.01) and with pretreatment uric acid (r=0.76; P<0.01). Ten patients with uric acid level of <6 mg/dl were receiving allopurinol. The competition between organic anions and cisplatin for excretion may, in part, explain the protective effects of hypouricemia. Hypoalbuminemia affects peritubular oncotic pressure and may in turn affect platinum excretion. Hypoalbuminemia also reduces the half-life of cisplatin, exposing the kidney to more of the unbound filterable drug.Supported by a grant from Health and Welfare, Canada 相似文献
135.
尿道压监测下球部尿道悬吊术治疗男性获得性尿失禁 总被引:6,自引:2,他引:4
目的探讨尿道压监测下球部尿道悬吊术治疗男性获得性尿失禁的疗效。方法2000年lO月至2004年9月收治男性获得性尿失禁25例,年龄18~81岁,平均66岁。其中后尿道狭窄行尿道成形术后6例,根治前列腺切除术后4例,良性前列腺增生(BPH)行经尿道前列腺电切术(TURP)后6例,BPH行前列腺摘除术后9例。尿失禁病程1~12年,平均4年。完全性尿失禁8例,压力性尿失禁17例,需尿垫1~5块/d,平均3块/d。术前均经盆底肌锻炼无效。尿动力学检查平均最大尿道压52cm H2O(1cm H2O=0.098kPa)。平均功能性尿道长度1.4cm。均在尿道压监测下行球部尿道悬吊术。结果手术结束时平均尿道压96cm H2O,平均功能性尿道长度3.5cm。术后完全控尿21例,尿失禁改善3例,排尿困难1例,经膀胱颈部电切后排尿通畅。术后1个月B超检查剩余尿均〈20ml;23例平均最大尿流率15ml/s。随访1年以上22例,1例于术后2年死于脑溢血,2例于术后1年和2年压力性尿失禁复发,其余19例排尿和控尿良好。结论尿道压监测下球部尿道悬吊术是治疗男性尿失禁的有效方法。 相似文献
136.
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138.
Recent evidence describing a suboptimal clinical outcome in women with
hydrosalpinges who undergo in-vitro fertilization (IVF) and embryo transfer
suggests a potential deleterious effect of this fluid on in- utero embryo
development. Consequently, we evaluated in-vitro mouse embryo development
in the presence of hydrosalpingeal fluid (HF) collected from 10 infertile
women of reproductive age. Chemical analyses showed both similarities and
differences of these fluids to reported values for fluids collected from
non-diseased Fallopian tubes. The HF had a significant deleterious effect
upon mouse embryo cleavage and development to the expanded and hatched
blastocyst stage, although the effect was variable among patients. Dilution
of HF to 30% concentration with culture medium failed to negate this
effect. This argues against the effect resulting from a relative lack of
critical, supportive component(s) in the HF. Additionally, further
experiments performed with cultures under an oil overlay significantly
reduced the embryotoxicity of the HF. This evidence suggests there may be a
lipophilic factor that can impair embryo development. The relatively poor
IVF-embryo transfer success in women with proximally patent hydrosalpinges
may be explained, at least in part, by reflux of a lipophilic embryotoxic
factor(s) into the uterine cavity.
相似文献
139.
140.