前列通宝胶囊治疗前列腺增生症50例

目的 :验证前列通宝胶囊治疗前列腺增生症 (BPH)的临床疗效。方法 :采用前瞻性自身前后对比的方法 ,选择经临床确诊的BPH患者 5 0例 ,口服前列通宝胶囊 ,每次 4粒 ,每日 3次 ,用药 10周。分别于治疗前、治疗后进行国际前列腺症状评分 (I PSS)、生活质量 (QOL)评分、最大尿流率 (MFR)、残余尿量 (RUV )、前列腺体积测定 ,同时对出现的不良反应进行记录。结果 :用药 10周后I PSS平均降低 (7.9± 4 .2 )分 ,QOL评分平均下降 (1.4± 0 .6 6 )分 ,MFR平均升高 (4.2± 2 .8)ml/s ,RUV平均减少 (44 .7± 15 .8)ml,前列腺体积无明显变化。结论 :前列通宝胶囊对改善BPH患者主观症状、客观体征和提高生活质量有明显效果 ,观察期未发现不良反应。     

前列腺增生症术后下尿路症状的病因分析

对前列腺切除术后出现下尿路症状者38例进行尿动力学检查并分析。结果显示：38例中有逼尿肌功能障碍者21例,其中单纯逼尿肌反射低下11例,逼尿肌反射低下伴下尿路梗阻6例、逼尿肌过度活动4例,下尿路梗阻者17例,其中膀胱颈梗阻14例,尿道狭窄3例,认为逼尿肌功能障碍、膀胱颈梗阻是前列腺术下尿路症状的主要原因,尿动力学检查可明确诊断,并为二次治疗的方法提供依据。     

Isolated extraordinary daytime urinary frequency of childhood: a case series of 26 children in Switzerland

BACKGROUND: The term 'isolated extraordinary daytime urinary frequency' designates an abnormally increased diurnal frequency of painless urination in a completely toilet-trained child with normal urinalysis. METHODS: We report the history of 26 children (16 boys and 10 girls; aged between 4.1 and 10 years) who were referred to us between 2002 and 2006 and subsequently diagnosed with this condition. RESULTS: Possible psychosocial problems, or recent emotional stressors, were disclosed in the majority of the children: recent (36 months or less) asylum seekers (n = 9), school-related problems (n = 4), parental divorce (n = 2) or death of the mother (n = 1). Possible dietary causes were observed in 9 patients: oxalate-rich beverages (n = 5) and liberal ingestion of 'acidic' juices (n = 4). A diet low in oxalates was recommended when children were consuming large quantities of oxalate-rich beverages; and a diet low in acidic juice was recommended in those liberally ingesting acidic juices. Reassurance and observation were the approach in the remaining cases. The median duration of the symptoms was 5 months. A longer (p < 0.05) duration was noted in children of asylum seekers. CONCLUSIONS: This functional condition is easily identifiable, but often under- or misdiagnosed. Confounding the condition might result in redundant investigation.     

神经源性膀胱引起排尿障碍的疗效观察

目的：探讨电针治疗神经源性膀胱（ neurogenic bladder,NB）的临床应用疗效。方法回顾性分析笔者医院2012年12月～2014年5月接受治疗的135例神经源性膀胱患者的临床资料。根据病因分为脑卒中组、糖尿病组及脊髓损伤组,每组均为45例。所有患者均采用电针、常规治疗和膀胱功能锻炼相结合的方法治疗。监测3组治疗前、后的膀胱残余尿量（ RV）、初始尿意膀胱容量（ FDV）、最大尿流率（ Qmax）和最大膀胱容量（ MCC）的数值,并进行比较和分析;观察3组不良反应发生情况。结果所有患者治疗均顺利进行,2周后脑卒中组有效率为95．5％,脊髓损伤组有效率为86．7％,均显著高于糖尿病组（60．0％, P＜0．05）;3组患者尿流动力学指标较治疗前均明显改善（P＜0．05）;脑卒中组与脊髓损伤组尿动力学指标分别为Qmax 5．4±7．6ml／s,19．3±3．2ml／s;RV67．2±16．3ml,43．5±12．7ml;FDV87．4±34．9ml,67．9±45．3ml;MCC 321．9±87．3ml,273．6±64.5ml,均优于糖尿病组Qmax 11．8±3．7ml／s,RV 98．7±11．3ml,FDV 173．8±57．9ml,MCC 374．2±90．4ml,P＜0．05）。脊髓损伤组无泌尿系感染发生,糖尿病组有3例,脑卒中组有2例发生泌尿系感染,给予膀胱冲洗及实用抗生素3～5天后症状消失;3组均未出现泌尿系结石、肾积水和肾功能损害等不良现象。结论电针治疗脑卒中性及脊髓损伤性神经源性膀胱可获得理想临床疗效,而其对糖尿病性神经源性膀胱的疗效欠佳。     

保留盆腔自主神经的低位直肠癌根治术对患者排尿和性功能的影响

目的 探讨保留盆腔自主神经的低位直肠癌根治术对患者排尿和性功能的影响,以及局部复发率.方法 对我院2002年1月至2008年8月保留盆腔自主神经(PANP)的低位直肠癌根治术156例(研究组)与一般低位直肠癌根治术100例(对照组)患者术后自主排尿的情况,男性阴茎勃起功能、射精功能,女性性高潮变化,以及局部肿瘤复发率进行观察比较.结果 研究组患者术后排尿功能、男性阴茎勃起功能、射精功能以及女性性高潮保存率明显高于对照组,2组比较均有统计学意义(P<0.01).局部复发率两组比较差异无统计学意义(P>0.05).结论 保留盆腔自主神经的低位直肠癌根治术能较好保留直肠癌患者术后的排尿和性功能,不增加局部复发率.     

保存植物神经的直肠癌根治术对排尿和性功能的影响

目的 探讨中下段直肠癌患者行保存植物神经的肿瘤根治术对排尿和性机能的影响。方法 根据不同病情实施不同保存植物性神经的直肠癌根治术１８８例：Ｄｕｋｅｓ Ａ期９８例,完全保存神经;Ｂ期７８例,保存一侧或两侧神经;Ｃ期１２例,只保存Ｓ３、４神经。结果 术后自行排尿时间平均为：Ａ期８．５ｄ,Ｂ期９．０ｄ,Ｃ期１６．８ｄ。保存勃起和射精机能者：Ｄｕｋｅｓ Ａ期分别是９６．９％和１００％;Ｂ期是４７．４％和５０％;Ｃ期均为０。术后肿瘤局部复发者占１２．８％（２４／１８８）,其中Ｄｕｋｅｓ Ａ、Ｂ、Ｃ期分别为４．１％、２０．５％和３３．３％。５年生存率Ｄｕｋｅｓ Ａ、Ｂ、Ｃ期分别是７７．６％、５２．６％、３３．３％。结论 保存植物神经的直肠癌根治术,在不增加局部复发率和减少５年生存率的同时,可明显提高患者的生存质量。     

糖尿病性膀胱尿动力学研究

目的为了评价糖尿病患者排尿异常与膀胱和逼尿肌行为间的关系.方法44例糖尿病患者接受影像或普通尿动力学检查及I-PSS评价.将糖尿病性膀胱划分为逼尿肌受损型和感觉受损型.结果17例糖尿病患者诊断为糖尿病性膀胱,27例糖尿病患者尿动力学结果正常.糖尿病性膀胱患者与尿动力学正常的糖尿病患者相比,尿流率中大多数参数具有显著性差异;主观症状评分梗阻指数显著性增高,但刺激症状指数两组无显著性差异.结论梗阻指数升高而刺激指数无显著性升高可能是糖尿病性膀胱尿动力学的特征性改变.尽管尿流率和I-PSS评价不能特异性区分逼尿肌受损情况,但为进一步进行尿动力学检查提供了有益的参考.     

开塞露纳肛促进排尿8例疗效观察

对8例术后不能排尿患者采用开塞露纳肛，其能有效减少尿潴留的发生。     

Translation and Linguistic Validation of the Korean Version of the Dysfunctional Voiding Symptom Score

Although studies on pediatric dysfunctional voiding are increasing, there have not been enough efforts to validate the Dysfunctional Voiding Symptom Score (DVSS) questionnaire. Therefore, we aimed to translate and validate the DVSS into Korean. The DVSS questionnaire was validated between January and October, 2013. Two bilinguals independently translated the English version of the DVSS questionnaire into Korean, and then reconciled the forward translation of the Korean version. The original DVSS was back-translated into English, then assessed for equivalence to the original. Cognitive debriefing interviews with 5 patients to test the interpretation of the translation were made, then modified and distributed to 48 patients for re-evaluation. A statistical analysis of inter-scale correlation, and test re-test consistency was performed with the Cronbach''s alpha coefficient. The changes from patient interviews were reflected in the final version. In an intra-class correlation, the Cronbach''s alpha was high in all of the questions (0.97, P < 0.001). Test re-test Cronbach''s alpha analysis of reproducibility was higher than 0.8 for all of the 10 questions (P < 0.001). Translation and linguistic validation of Korean version of the DVSS questionnaire was completed by a proper process, with high reliability and validity.

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