Stone extraction with loop ureteral catheter versus ureteroscopy in small distal ureteral stones—retrospective comparison of 547 consecutive patients

BackgroundTo evaluate whether stone extraction with a loop ureteral catheter (LUC) in distal ureteral stones is associated with a higher frequency of ureteral strictures compared to treatment with primary ureteroscopic stone removal (p-URS) or ureteroscopic laser lithotripsy (l-URS).MethodsFive hundred and forty-seven consecutive patients were primarily endourologically treated for distal ureteral stones in our department between 2005 and 2019 and included in the study protocol. Data was retrospectively obtained from the patients’ charts and medical reports as well as from office-based urologists. Data analysis was performed using Fisher’s exact test, Mann-Whitney test or Student’s t-test as appropriate. A level of P<0.05 was assigned statistical significance.ResultsFour hundred and twelve patients were treated by URS (p-URS n=304, l-URS n=108) and another 135 by LUC stone extraction. Median follow-up was 41 [2–159] months. There was no difference between the groups concerning age, gender, proportion of patients with ureteral stenting, operating time, hospitalization or readmission rates. The number of ureteric strictures was small in all procedures [n=3 (1.0%) in p-URS, n=2 (1.9%) in l-URS and n=2 (1.5%) in LUC] and there was no difference between the groups concerning this serious complication (p-URS vs. LUC: P=0.6465; l-URS vs. LUC: P=0.9999).ConclusionsIn small distal stones, LUC stone extraction still is an alternative to URS procedures in stone management with comparable results concerning postinterventional ureteral strictures. In experienced hands, it still has its value in accurately selected patients.     

B超,ERCP对胆管结石的诊断价值

报告疑有胆管结石的２００例术前Ｂ超,ＥＲＣＰ检查与手术的对照结果,分析了两种检查各自的优点及不足．结果认为Ｂ超可作为胆管结石的初选检查,再行ＥＲＧＰ确诊,以提高胆管结石的正确诊断率     

体外培育牛黄的药学研究

目的：解决牛黄原料匮乏问题，为民族医药工业发展提供充足的优质牛黄原料药。方法：根据胆红素钙结石体内形成的原理和生物化学过程，应用现代生物工程技术，在体外牛胆囊胆汁内培育牛胆红素钙结石(体外培育牛黄)；采用电镜扫描、红外光谱法、紫外分光光度法等检测体外培育牛黄的性状、结构、成分和主要成分含量。结果：体外培育牛黄呈类球形，椋黄色；有同心层纹状结构，扫描电镜下见呈网状结构，网架富集胆红素钙颗粒；含胆红素、胆酸、胆固醇、磷脂、去氧胆酸、牛磺酸、糖蛋白、18种氨基酸及21种微量元素；在避光、密封、防潮条件下存放三年稳定。结论：体外培育牛黄的性状、结构、成分、含量与天然牛黄相似。     

输尿管镜下气压弹道碎石术治疗146例输尿管中下段结石

目的:探讨在输尿管镜下气压弹道碎石术治疗输尿管中下段结石的疗效及临床价值。方法:回顾性分析经输尿管镜气压弹道碎石术治疗输尿管中下段结石146例。结果:一次性碎石成功率95%(138/146),2例联合应用体外震波碎石(ESWL)术成功(1.4%),因结石质硬失败6例(4.2%)。结论:输尿管镜气压弹道碎石术治疗输尿管中下段结石具有安全、可靠、创伤小及并发症少等优点,可作为输尿管中下段结石的首选方法。     

金桃消石散治疗胆囊结石临床研究

目的:观察金桃消石散治疗胆囊结石的临床疗效及其对胆囊收缩功能的影响。方法:选择胆囊结石患者67例,随机分为治疗组和对照组。治疗组32例,口服金桃消石散;对照组35例,服用胆石通。共治疗4个月,分别于治疗前及治疗后,B超检测胆囊结石及胆囊排空率变化情况。结果:治疗组痊愈6例,显效9例,有效15例,无效2例;对照组痊愈2例,显效6例,有效18例,无效9例,两组治疗后胆囊排空率均较治疗前好转,但治疗组与对照组比较,疗效更为显著。结论:金桃消石散可以明显改善胆囊的收缩功能,是治疗胆囊结石有效的方剂。     

牙结石病人的ABO血型分布

目的探讨牙结石病人的ABO血型分布。方法分析200例牙结石患者(男119名,女81名)的A,B,O,AB血型,并与健康对照组人群进行比较。结果牙结石患者中A型血出现频率明显高于其他血型(P<0.01),与对照组相比A血型患者牙结石的相对危险率明显增加(RR=1.58)。结论牙结石的发病机会与A血型有明显关联。     

胆管镜联合腹腔镜治疗肝胆管结石的临床效果分析

目的探讨胆管镜联合腹腔镜治疗肝胆管结石的临床效果。方法选择本院外科利用胆管镜联合腹腔镜治疗肝胆管结石的47例患者为腹腔镜组,采用传统开腹手术切开肝胆管取石的47例患者为开腹组,比较两组疗效。结果腹腔镜组手术时间较长,但术中出血量、平均住院时间及术后并发症发生率明显低于开腹组,差异有统计学意义（P〈0.05）。结论胆管镜联合腹腔镜治疗肝胆管结石出血量少,并发症少,能有效减轻患者的痛苦,值得临床推广。