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21.
张丽杰 《中国煤炭工业医学杂志》2015,18(5)
目的 探讨3M Cavilon液体敷料在治疗癌症晚期患者大小便失禁所致失禁性皮炎的应用效果.方法 将84例大小便失禁的癌症晚期患者随机分成观察组42例和对照组42例.对照组采用常规皮肤护理,观察组在常规护理的基础上使用3M液体敷料进行皮肤护理,观察二组皮肤护理的效果.结果 使用3M液体敷料治疗组疗效明显优于常规护理组,二组比较差异有统计学意义(P<0.05),失禁性皮炎的愈合时间短于对照组,二组比较差异有统计学意义(P<0.05).结论 3M液体敷料的应用可有效的隔离排泄物对皮肤的刺激,尽早使用可以使大小便失禁患者保持皮肤完整性,减少了晚期癌症患者由于失禁性皮炎导致的疼痛和不适. 相似文献
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The purpose of this paper is to describe the current modalities of pelvic floor imaging: pelvic floor and endoanal ultrasonography, cystourethrography, evacuation proctography, dynamic colpocystoproctography, magnetic resonance imaging and endoanal magnetic resonance imaging.As there are no set standards for prescribing imaging tests in pelvic floor disorders, we drew up a table of tests to be performed according to the anatomical abnormality observed on physical examination or functional sign reported by the patient. 相似文献
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PURPOSE: Prediction of success after anterior sphincter repair
for incontinence is difficult. Standard multivariate
analysis techniques have only 75 to 80 percent accuracy.
Artificial intelligence, including artificial neural networks,
has been used in the analysis of complex clinical data and
has proved to be successful in predicting the outcome of
other surgical procedures. Using a neural network algorithm,
we have assessed the probability of success after
anterior sphincter repair. METHODS: Prospective anorectal
physiology data of 72 patients undergoing anterior sphincter
repair was collected between 1995 and 1999. Complete
data sets of 75 percent of the series were used to train an
artificial neural network; the remaining 25 percent were
used for data validation. The output was continence grading,
ranging from 0 to 4 (worse to continent). RESULTS: The
outcome at 3, 6, and 12 months postoperatively was obtained
and assessed. The best correlation between actual
data value and artificial neural network value was found at
12 months (r = 0.931; P = 0.0001). Clear correlations also
were found at three months (r = 0.898; P = 0.0001) and six
months (r = 0.742; P = 0.002). Results of applying a net to
details excluding pudendal nerve latency were poor. CONCLUSIONS:
Artificial neural networks are more accurate (93
percent correlation) than standard statistics (75 percent)
when applied to the prediction of outcome after anterior
sphincter repair. This assessment also confirms the usefulness
of pudendal latency in the prediction of anterior
sphincter repair outcome. The results obtained highlight
the obvious usefulness of artificial neural networks, which
could now be used in a prospective evaluation for application
of the technique. 相似文献
25.
Melih Balci Altug Tuncel Ovunc Bilgin Yilmaz Aslan Ali Atan 《International braz j urol : official journal of the Brazilian Society of Urology》2015,41(2):312-318
Purpose
To report our intermediate experience in treating patients with severe incontinence using an adjustable perineal male sling with a tissue expander.Materials and Methods
An adjustable male sling procedure was performed on 21 patients with severe incontinence. The underlying etiology of urinary incontinence was radical prostatectomy in 13 patients, open prostatectomy in 5 patients and transurethral prostate resection in 3 patients. The difference between the classical and the adjustable sling is that in the latter there is a 25 mL tissue expander between the two layers of polypropylene mesh with an injection port. Adjustment of the sling was performed with saline via an inflation port, in case of recurrence or persistence of incontinence.Results
The mean age of the patients was 66.2±7.3 (50-79) years and mean pad usage was 6.4±0.6 per day. The mean follow-up time was 40.1±23.2 (6-74) months. The balloon was postoperatively inflated on average with 11.6±5.7 (5-25) mL. After the mean 40.1 months of follow-up, 16 of the 21 patients (76.2%) were dry (11 patients, 0 pads; 5 patients using safety pads), 3 patients (14%) had mild and 2 (9.8%) had moderate degree post-prostatectomy urinary incontinence (PPI). The average maximum urine flow rate of the patients was 15.6±4.7 (10-31) mL/s. No residual urine was found. In 2 patients, all parts of the device were removed due to infection and discomfort, and in 3 patients only the inflation component was removed due to local scrotal infection.Conclusions
Our results show that using an adjustable perineal male sling with a tissue expander seems to be an efficient, and safe surgical treatment option in patients with PPI. 相似文献26.
Incontinence after lateral internal sphincterotomy 总被引:7,自引:0,他引:7
Dr. Julio García-Aguilar M.D. Carlos Belmonte Montes M.D. Jose Javier Perez M.D. Linda Jensen R.N. Robert D. Madoff M.D. W. Douglas Wong M.D. 《Diseases of the colon and rectum》1998,41(4):423-427
PURPOSE: This study was designed to evaluate the anatomic and functional consequences of lateral internal sphincterotomy in patients who developed anal incontinence and in matched controls. METHODS: The study includes 13 patients with anal incontinence after lateral internal sphincterotomy and 13 controls who underwent the same operation and were continent and satisfied with the results of the procedure. Patients underwent clinical evaluation, anorectal manometry, pudendal nerve terminal motor latency testing, and endoanal ultrasonography. RESULTS: Sphincterotomies were longer in incontinent patients (75vs. 57 percent), but the resting pressure and length of the high-pressure zone were not different between groups. Surprisingly, maximum voluntary contraction was higher in incontinent patients than in continent controls (136vs. 100 mmHg). Rectal sensation and pudendal nerve terminal motor latency were similar in both groups. The defect in the internal sphincter was wider in incontinent patients than in continent controls (17.3vs. 14.4 mm), but these differences were not statistically significant. The thickness of the internal sphincter measured by endoanal ultrasound was identical in both groups, but the external sphincter was thinner in incontinent patients both at the site of the sphincterotomy (6.8vs. 8.1 mm) and in the posterior midline (7.1vs. 8.6 mm). CONCLUSIONS: Anal incontinence after lateral internal sphincterotomy is directly related to the length of the sphincterotomy. Whether secondary to preoperative sphincter abnormality or the result of lateral internal sphincterotomy, the external sphincter is thinner in incontinent patients than in continent controls.Read at the meeting of The American Society of Colon and Rectal Surgeons, Montreal, Quebec, Canada, May 7 to 12, 1995. 相似文献
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Young Hwii Ko Rafael F. Coelho Ananthakrishnan Sivaraman Oscar Schatloff Sanket Chauhan Haidar M. Abdul-Muhsin Rair Jose Valero Carrion Kenneth J. Palmer Jun Cheon Vipul R. Patel 《European urology》2013