保留阴茎头手术治疗阴茎癌对勃起功能影响的临床研究

目的:评估保留阴茎头手术治疗阴茎癌对勃起功能的影响?方法:回顾性分析31例行保留阴茎头手术治疗的阴茎鳞状细胞癌患者?所有患者术前?术后1个月及3个月采用国际勃起功能指数问卷调查评估勃起功能,并对数据进行统计学分析?结果:31例患者,术前勃起功能正常18人,轻度勃起功能障碍13人?总体患者术前与术后1个月相比,勃起功能评分无统计学差异(P = 0.604),术后1个月与术后3个月相比无统计学差异(P = 0.051),但术前与术后3个月相比差异有统计学意义[(24.61 ± 1.38) vs (25.38 ± 1.02),P = 0.014],术后3个月勃起功能优于术前?术前勃起功能正常组术前?术后1个月?术后3个月勃起功能评分相比差异均无统计学意义(P > 0.05);术前轻度勃起功能障碍组术前?术后1个月?术后3个月勃起功能评分相比差异均有统计学统计意义(P < 0.05)?结论:保留阴茎头手术治疗阴茎癌可以维持并能改善部分患者的勃起功能?对勃起功能的维持主要体现在术前勃起功能正常患者,而对于术前轻度勃起功能障碍患者,手术可以改善勃起功能,并且这种改善效果在术后3个月时表现显著?     

放射性核素89Sr治疗前列腺癌骨转移疼痛的临床研究

目的:探讨晚期前列腺癌骨转移疼痛治疗的方法,评价放射性核素89Sr的疗效与安全性。方法:对15例未接受过任何放疗的晚期前列腺癌骨转移疼痛患者,经静脉注射放射核素89Sr治疗。结果:疼痛治疗的有效率为86.7%,80%患者的肿瘤标记物PSA水平较治疗前轻度下降,26.6%患者出现造血功能抑制。结论:放射性核素89Sr治疗前列腺癌骨转移疼痛较为安全、有效,可以提高患者生活质量。     

应用前列腺特异抗原筛查诊断前列腺癌的临床意义

Objective To evaluate the clinical significance of prostate-specific antigen(PSA)screening in early detection of prostate cancer in Chinese men.Methods PSA screening was performed in 8562 asymptomatic men who had been enrolled for health checkup and all were ≥50 years old.Prostate biopsy was recommended for those with a serum PSA level≥4.0 ng/ml.The pathological and clinical features of the patients with prostate cancer detected by the PSA screening were compared with that of 82 clinically diagnosed prostate cancer patients during the same period.Results Of the 8562 asymptomatic men,719 had PSA levels ≥4.0 ng/ml and biopsy was performed in 295 of them.Fifty-eight prostate cancers were detected.The biopsy rate was 41.0% and positive detection rate was 19.7%.The overall age distribution in the screening group and the clinical groups was not significantly different(P = 0.176).However,41.4%(24/58)of the patients in screening group were ＞75 years old,and significantly more than that in the clinical group(25.6%,P = 0.0491).The proportion of the patients with PSA levels ≥20 ng/ml in the screening group was significantly less than that in the patients of the clinical group(44.8% vs.75.6%,P = 0.0002).Whether in the patients whose age was ＞ 75 years old(P ＜ 0.05)or ≤75 years old (P = 0.0002),the patients in the screening group had significantly lower Gleason scores ＜ 7(60.3% vs.34.1%,P =0.002),more T1 or T2 tumor(87.9% vs.26.8%,P ＜0.0001)and more chance to receive radical prostatectomy(50.0% vs.18.3%,P ＜ 0.0001)than the patients in the clinical group did.However,the distributions of PSA levels at diagnosis and biopsy Gleason scores were not significantly different between the above mentioned two groups(P ＞ 0.05).Conclusion Prostate-specific antigen (PSA)screening is useful for early detection of prostate cancer in Chinese men aged ≥ 50 years.The patients detected by PSA screening usually show a lower PSA level,Gleason scores and early clinical stage disease,and have more chance for radical prostatectomy than the clinically diagnosed patients.     

肾癌的肾外表现分析

目的：探讨肾癌的肾外表现在肾癌早期诊断及预后评估中的临床意义。方法：对1988—2001年经手术和病理检查证实为肾癌的372例临床资料进行回顾性分析。结果：发现253例(68．0％)有各种肾外表现,主要表现为血沉快,血压高,食欲不振,消瘦,乏力,贫血,发热,肝功能紊乱,高钙血症及红细胞增多症,其中82例(32．4％)是以肾外表现为首发症状。结论：肾外表现有助于肾癌的早期诊断。肾癌的治疗以手术切除为主,肾癌的肾外表现不能作为手术禁忌证。     

尿道瓣膜病的临床诊治

目的总结尿道瓣膜病的诊断和治疗要点。方法回顾分析12例后尿道瓣膜病和1例前尿道瓣膜病的临床资料,13例均采用手术治疗,其中7例采用经尿道瓣膜电切术,6例采用输尿管镜钬激光瓣膜内切开术。结果所有患者均由尿道镜检查确诊尿道瓣膜病。手术治疗顺利,9例术后排尿梗阻症状明显缓解,4例留置膀胱造瘘管训练膀胱功能,3个月后排尿通畅。随访6个月~3年,患者排尿均通畅,无尿道狭窄发生,有肾积水者缓解或消失。结论详细病史及影像学检查是尿道瓣膜病重要的诊断依据,尿道镜检查可以确诊,早期通过经尿道瓣膜电刀或钬激光内切开术可取的良好的治疗效果。     

勃起功能障碍的治疗进展

勃起功能障碍（Erectiledysfunction,ED）的治疗方式在近10年获得了飞速的进展,从磷酸二酯酶抑制剂（PDE-5i）的临床广泛应用,新型PDE-5i的市场准入,到阴茎假体的临床应用.从基因治疗到目前热门的干细胞治疗勃起功能障碍的理论提出及治疗方式的初步尝试,为ED的治疗提供了新的研究方向.随着分子生物学对ED病因和形成机制研究的深入,转基因治疗在不久的将来会成为治愈ED最有效的方法之一.     

经尿道汽化与电切治疗前列腺增生症

目的 探讨经尿道汽化与电切联合治疗良性前列腺增生症（ＢＰＨ）的临床效果。方法 观察术中出血量、手术时间、电切综合症，比较手术前后前列腺症状评分（ＩＰＳＳ）、生活质量（ＱＯＬ）、最大尿经Ｑｍａｘ和术中、术后并发症。结果 本组４５例，平均年龄６９岁，病程６年，平均手术时间６０ｍｉｎ，术中出血５０ｍｌ，术后留置导水管３－７ｄ，术后ＩＰＳＳ〉ＱＯＬ、Ｑｍａｘ明显改善，电切综合征ＴＵＲＳ１例（２．２％），３     

基因缺陷对精子发生的影响

男性每 2 0人中就有一位患不育症 ,男性不育症中至少 3 0 %存在基因缺陷。生育基因涉及睾丸发育、精子发生、内分泌和旁分泌的调节。关于精子发生 ,尤其应关注Yq11区 ,这里分布着一些精子发生基因。随着ICSI的出现和分子生物学技术的发展 ,人们发现基因缺陷影响了精子发生 ,继而引起不育。而ICSI虽为男性不育症的治疗带来了希望 ,但也可能使这种遗传缺陷传给下一代 ,因此对基因缺陷的检测并避免传给下一代是迫切要解决的问题     

特殊淋病5例报告

例1：男，37岁，病期3个月，发病前有冶游史。检查：龟头冠状沟包皮内侧面见3处绿豆大小不规则园形糜烂面，上覆黄白色脓液，四周为褐红色晕。尿道口涂片G-双球菌(-)，糜烂处涂片G-双球菌( )。诊断：淋菌性包皮龟头炎。经抗淋治疗2周后愈合。     

抗淋汤治疗淋病20例报道

淋病是我国当前性传播性疾病之一．由于淋球菌的耐药菌株不断出现，我们应用中医中药治疗淋病20例，报道如下：