四种不同方法治疗肾囊肿的临床价值

目的探讨不同方法治疗肾囊肿的临床价值。方法回顾性分析2001年4月~2004年3月158例肾囊肿患者的临床资料,其中B超引导下经皮肾穿刺注射无水乙醇硬化治疗48例、后腹腔镜手术治疗86例、小切口手术治疗11例及传统的经腰部切口治疗13例。平均随访时间12个月(3~24个月)。随访时间为治疗后1、3、6、12、24个月,B超复查囊肿大小。结果后腹腔镜组创伤小、恢复快、疗效可靠。小切口组创伤较小、医疗费用较低,但手术野暴露较差。传统经腰切口组创伤大,恢复慢但疗效可靠。B超穿刺组安全简便,但远期复发率较高。结论不同方法治疗肾囊肿各有优缺点,腹腔镜手术应列为首选。     

泌尿系结石U100plus激光碎石术

目的：探讨U100^plus激光碎石机治疗泌尿系结石的临床疗效。方法：对81例泌尿系结石患者行U100^plus激光治疗，分析其碎石成功率及并发症。结果：81例患者一次成功77例，2～6周内结石全部排净，发生并发症4例，输尿管结石移位3例，1例肾盂结石术后形成石阶。结论：使用U100^plus治疗泌尿系结石高效、安全。     

Extracellular vesicles: Toward a clinical application in urological cancer treatment

Extracellular vesicles are nanometer‐sized lipid membranous vesicles that are released from almost all types of cells into the extracellular space. Extracellular vesicles have gained considerable attention in the past decade, and emerging evidence suggests that they play novel roles in mediating cancer biology. Extracellular vesicles contain pathogenic components, such as proteins, DNA fragments, messenger ribonucleic acids, non‐coding ribonucleic acids and lipids, all of which mediate paracrine signaling in the tumor microenvironment. Extracellular vesicles impact the multistep process of cancer progression through modulation of the immune system, angiogenesis and pre‐metastatic niche formation through transfer of their contents. Therefore, a better understanding of their roles in urological cancers will provide opportunities for novel therapeutic strategies. In addition, the contents of extracellular vesicles hold promise for the discovery of liquid‐based biomarkers for prostate, kidney and bladder cancers. Here, we summarize the current research regarding extracellular vesicles in urological cancer and discuss potential clinical applications for extracellular vesicles in urological cancer.     

Corino-andrade disease (familial amyloidotic polineuropathy type I) in Spain: Urological and andrological disorders

In our hospital, we have followed a group of patients with familial amyloidotic polyneuropathy (FAP), type I. This disease is characterized by a progressive sensitive-motor and autonomic polyneuropathy. The amyloid fibrils of FAP I contain a mutant transthyretin (TTR) molecule. More than 90% of TTR production occurs in the liver. Thus, therapy with liver transplantation has proved useful. All our patients received this treatment. In this study we describe the urological and andrological disorders caused by FAP type I in 12 patients with low bladder pressure and bladder neck obstruction with micturition disorders. In some males, it was accompanied by impotence and retrograde ejaculation produced by autonomic neuropathy. We believe hepatic transplantation may be the best treatment for this disease.     

The combinatorial use of propofol-fentanyl-ketamine for sedoanalgesia in patients undergoing urological procedures

Objectives:To compare sedoanalgesia achieved using propofol-fentanyl-ketamine (PFK) combination with general anesthesia (GA) in terms of safety, hemodynamic stability, and perioperative complications.Methods:Patients in the GA group were anesthetized using fentanyl (2 μg kg-1) and propofol (2 mg kg-1). The PFK group was anesthetized using a mixture of which each one ml contains 0.005 mg of fentanyl, 5 mg of propofol, 5 mg of ketamine, and 2 mg of lidocaine. Patients received an initial dose of 0.05 ml kg-1, followed by 0.05 mg kg-1 60 seconds later. Maintenance boluses of 0.025 ml kg-1 were administered every 3-5 minutes. Respiration occurred spontaneously through a simple face mask with 3 L min-1 O₂.Results:The GA group had 37 (37%) patients develop hypotensive episodes, compared to one (1%) episode in the PFK group (p<0.001). Five (5%) patients in the PFK group had an episode of transient O₂ desaturation, compared to one (1%) patient in the GA group (p=0.212). The duration of induction and termination of anesthesia were significantly shorter in the PFK group (p<0.001).Conclusion:The PFK combination herein described is safe, effective, and provides intraoperative hemodynamic stability in patients with multiple comorbidities undergoing urological procedures.     

腹腔镜在泌尿外科重建手术中的应用

目的 为了提高腹腔镜在泌尿外科重建手术中的应用。方法 复习近年来有关文献，阐述了腹腔镜在泌尿外科重建手术中的适应证、临床操作要点和并发症等。结果 临床上已确立的腹腔镜重建手术如肾孟成形、根治性前列腺切除术和睾丸固定术；其他操作如肾部分切除术、肾动脉瘤修补术、输尿管输尿管吻合术、回肠输尿管成形术和膀胱扩大术等是新进展性手术。结论 期望未来的腹腔镜手术将会增加，并发展成为先进和复杂的泌尿外科重建手术的选择方法。     

泌尿系肿瘤病人术前疾病不确定感与焦虑抑郁的相关性研究

[目的]调查泌尿系肿瘤病人术前疾病不确定感和焦虑及抑郁状况,分析两者之间的关系。[方法]采用便利抽样方法选取泌尿外科住院病人50名,采用Mishel的疾病不确定感量表评估病人的疾病不确定感,采用医院焦虑与抑郁量表测量病人的焦虑和抑郁水平。[结果]病人的疾病不确定感总得分为91.94分±9.73分,呈中等水平。焦虑得分为6.76分±3.18分,17例病人存在焦虑情绪;抑郁得分为4.68分±2.99分,10例病人存在抑郁情绪。疾病不确定感中不明确维度得分与焦虑呈正相关(r=0.31,P0.05),与抑郁得分呈正相关(r=0.33,P0.05)。[结论]泌尿系肿瘤病人术前存在中等程度的疾病不确定感,且与病人的焦虑及抑郁相关。通过为病人提供疾病相关信息,降低病人疾病不确定感,可能改善病人焦虑、抑郁程度。