经尿道前列腺电切术联合小切口膀胱切开取石治疗前列腺增生并发膀胱结石

目的 探讨经尿道前列腺电切术（TURP）联合耻骨上小切口膀胱切开取石治疗前列腺增生（BPH）并发膀胱结石的疗效及安全性.方法 回顾性分析采用TURP联合小切口膀胱切开取石治疗BPH并发膀胱结石患者36例的临床资料.结果 36例均一次手术成功,取石率100%.手术时间55～110 min,平均72.5 min,出血量40～160 ml,平均90.5 ml.术后留置膀胱造瘘管3～4 d,留置双腔气囊导尿管5～7 d,术后住院5～8 d.全部患者无手术死亡,无术中、术后大出血,无膀胱穿孔、前列腺电切综合征（TURS）和闭孔神经反射发生.术后随访5～46个月,平均20.5个月.未见结石复发及尿失禁、尿道狭窄等并发症,IPSS降至1～8分.平均Qmax上升至15.2 ml/s,残余尿量〈20 ml.结论 TURP联合耻骨上小切口膀胱切开取石术可作为治疗BPH并发膀胱结石的首选方法.     

前列腺增生并不同大小膀胱结石的微创治疗

目的探讨前列腺增生(BPH)并膀胱结石的微创治疗方法。方法对于<1.2cm的膀胱结石,采用经尿道前列腺电切术(TURP)后,夹取结石;对于1.2～3cm的膀胱结石,采用先气压弹道碎石,后TURP的方法;对3～4cm及小的多发结石,采用先小切口经膀胱卵园钳夹取,并经切口放气囊尿管为造瘘管,后TURP的方法;对于>4cm或大的、多发复杂膀胱结石,采用先膀胱小切口取石,并膀胱造瘘,后TURP的方法。结果所有病例均一期手术成功,取石率100%拨管后患者排尿通畅。结论针对不同大小的结石,采用不同的取石方法,同期行TURP,可达到微创、安全的目的。     

TURP加小切口膀胱切开取石术治疗前列腺增生合并膀胱结石46例

目的探讨基层医院开展良性前列腺增生(BPH)合并膀胱结石同期手术的治疗方法。方法对46例BPH合并膀胱结石患者行经尿道前列腺电切术(TURP)加耻骨上小切口膀胱切开取石。结果 46例患者手术均获得成功,膀胱结石取净率100%。膀胱切开取石时间为10～25min,平均18min;TURP时间为30～120min,平均70min。术后患者住院时间6～8天,平均7天。患者拔除尿管后排尿通畅,尿线粗。结论同期行TURP加耻骨上小切口膀胱切开取石术治疗BPH合并膀胱结石,具有取石时间短、操作简单、经济、安全有效等优点,尤其适合膀胱较大结石或多发结石患者,值得在基层医院推广应用。     

前列腺增生合并膀胱结石39例治疗体会

目的:讨论前列腺增生合并膀胱结石治疗方法和疗效.方法:回顾39例前列腺增生合并膀胱结石的临床资料,分别采取直接经尿道取石、气压弹道碎石和耻骨上小切口膀胱切开取石等治疗方法.然后经尿道前列腺电切术(TURP).结果:对于前列腺增生合并膀胱结石患者的治疗,根据结石大小、质地分别选用直接经尿道取石、气压弹道碎石和膀胱切开取石...     

不同方法联合TURP治疗前列腺增生并膀胱结石

目的探讨前列腺增生症合并膀胱结石的微创治疗方法。方法对48例前列腺增生合并膀胱结石患者,根据结石大小数目分别采用经尿道电切镜直接取石、膀胱镜下大力钳碎石、电切镜监视下联合小切口取石与前列腺电切相结合。结果所有48例患者中无改开放手术,术后无结石残留,无排尿障碍等并发症。结论电切镜下直接取石、经膀胱镜下大力钳碎石、电切镜监视下小切口取石与前列腺电切相结合,是治疗前列腺增生合并膀胱结石的简单安全、效果满意的方法。     

经尿道前列腺等离子剜出术加膀胱切开取石处理高龄高危前列腺增生合并膀胱多发结石效果观察

目的探讨经尿道前列腺等离子剜出术加膀胱切开取石处理高龄高危前列腺增生合并膀胱多发结石的疗效。方法对13例高龄高危良性前列腺增生并发膀胱多发结石患者采取经尿道前列腺等离子剜出术加膀胱切开取石术进行治疗。结果该组患者经尿道前列腺等离子剜出术手术时间50～60min，平均56．5min；膀胱切开取石术时间20—25min，平均22min。13例患者均安全度过围手术期。术后排尿通畅，无手术切口感染。结论同期行经尿道前列腺等离子剜出术加膀胱切开取石处理高龄高危前列腺增生合并膀胱多发结石方法简单，创伤小、手术时间短，疗效肯定，值得推广。     

TURP联合耻骨上小切口膀胱切开取石术治疗BPH并发膀胱结石

良性前列腺增生症（BPH）并发膀胱结石的传统手术方法均采用耻骨上膀胱切开取石、前列腺切除术,也有采用经尿道前列腺电切术（TURP）加弹道碎石术。我院2005年1月至2008年9月对BPH并发膀胱巨大结石的48例患者行经尿道前列腺汽化电切术（TURP）联合耻骨上小切口膀胱切开取石术,疗效满意,现报告如下。     

前列腺增生合并膀胱结石34例治疗体会

目的探讨前列腺增生合并膀胱结石的处理方法。方法根据前列腺大小,膀胱结石大小及数目,采取电切镜钩夹法,经尿道碎石法及耻骨上小切口切开膀胱取石法,同期行经尿道前列腺电切术。结果1例膀胱穿孔改为开放手术,34例皆无电切综合症,术后皆无结石残留,排尿通畅。结论对前列腺增生合并膀胱结石,应根据前列腺大小,结石大小及数目,选择不同的术式处理,做到手术安全有效。     

TURP联合膀胱小切口切开取石术治疗BPH并发膀胱结石26例临床分析

目的探讨经尿道前列腺电切术(TURP)联合膀胱小切口切开取石术治疗前列腺增生症(BPH)并发膀胱结石的临床效果。方法对26例BPH并发膀胱结石患者行TURP联合膀胱小切口切开取石术治疗的临床资料进行回顾性分析。结果 26例手术均获得成功,取石率为100%,术中、术后无输血,无一例发生经尿道前列腺电切综合征。结论 TURP联合膀胱小切口切开取石术治疗BPH并发膀胱结石可获得满意的疗效和安全性,适合在基层医院开展。     

3种手术方法治疗良性前列腺增生的临床分析

目的比较经尿道电切术(TURP)、经尿道前列腺汽化电切术(TUVP)和经尿道等离子双极电切术(PKRP)3种方法治疗良性前列腺增生的疗效,分析其在临床上使用的特点。方法分别使用TURP、TUVP及PKRP治疗的112例良性前列腺增生患者,比较手术时间、术中出血量、术后膀胱冲洗时间、留置导尿管时间、总体住院时间、前列腺症状评分(IPSS)、剩余尿量(RUV)、最大尿流率(Qmax)、生活质量评分(QOI)比较差异及并发症发生率。结果除TUVP组1例因尿道狭窄无法手术外,其余均手术成功。PKRP与TURP、TUVP比较手术时间有显著统计学差异(P<0.05),TURP、TUVP及PKRP3组在平均住院时间上无显著统计学差异(P>0.05),PKRP组与TURP、TUVP组在术中出血量、术后膀胱冲洗时间、留置导尿管时间有显著统计学差异(P<0.05)。3组病例术后主观症状均较术前明显改善,比较有显著统计学差异(P<0.05),术后3组间症状改善程度无显著统计学差异(P>0.05)。PKRP组与TURP组、TUVP组并发症比较有显著统计学差异(P<0.05)。结论 TURP、TUVP及PKRP治疗BPH均有较好的疗效,PKRP有术中出血少、视野清楚、并发症少等优点,临床上治疗BPH较安全的方法 。     

卡马西平联用尼美舒利相关粒细胞缺乏症

1例78岁男性患者因带状疱疹神经痛、慢性阻塞性肺疾病合并感染,给予头孢唑肟钠（2.25 g静脉滴注,1次/d）、卡马西平（0.2 g口服,2次/d）、尼美舒利（100 mg口服,2次/d）、二羟丙茶碱（0.5 g静脉滴注,1次/d）、甲钴胺（0.5 mg口服,3次/d）、地塞米松（5 mg,静脉滴注1次）、盐酸哌替啶（25 mg,肌内注射1次）和盐酸布桂嗪（100 mg,肌内注射3次）等药物治疗。第7天,停用头孢唑肟钠,改为磷霉素钠（8 g静脉滴注,1次/d）。第11天,血常规检查示白细胞计数1.6×10^9/L,中性粒细胞0.03,中性粒细胞绝对值0.1×10^9/L,淋巴细胞绝对值0.9×10^9/L。立即停用所有药物,给予对症支持治疗。第15天,外周血白细胞计数0.9×10^9/L,中性粒细胞0.02,中性粒细胞绝对值0.1×10^9/L,淋巴细胞绝对值0.7×10^9/L。行骨髓穿刺检查,诊断为粒细胞缺乏症。第17天患者出现右肺气胸、肺不张。第20天出现急性呼吸衰竭、多脏器衰竭合并重症感染,经抢救无效死亡。     

颅脑损伤患者并发肺部感染的护理体会

目的：为了使并发肺部感染的病人更多、更好、更早的痊愈。方法：通过对32例颅脑外伤并发肺部感染病人的严密观察,采取更换体位、超声雾化、有效排痰训练等有效的护理措施干预,从而控制了肺部感染。结果：痊愈17例,占53.1%;显效12例,占37.5%,无效2例,占6.2%;死亡1例,占3.1%;实践证明,有效的护理干预对提高患者治疗成功率有着重要意义。     

Satisfaction with information and its relationship with adherence in patients with chronic pain

□ Due to the nature of chronic pain it would be expected that patients are highly adherent to their pain medication. However, results from this study have shown that 23 per cent of patients often or always avoid using their pain medication, 13.4 per cent often or always alter dosages, and 10.3 per cent often or always stop taking their medication for a while. This suggests intentional non‐adherence to pain medication □ Less than 50 per cent of respondents were satisfied with information provided on side effects, what to do if side effects occur, and possible interactions with other medication □ Patients' satisfaction with information about their medication was related to self‐reported adherence; greater satisfaction was associated with higher self‐reported adherence     

Genomic profiling associated with recurrence in patients with rectal cancer treated with chemoradiation

PURPOSE: Stage II and III adenocarcinoma of the rectum has an overall 5-year survival rate of approximately 50%, and tumor recurrence remains a major problem despite an improvement in local control through chemotherapy and radiation. The efficacy of chemoradiation therapy may be significantly compromised as a result of interindividual variations in clinical response and host toxicity. Therefore, it is imperative to identify those patients who will benefit from chemoradiation therapy and those who will develop recurrent disease. In this study, we tested whether a specific pattern of 21 polymorphisms in 18 genes involved in the critical pathways of cancer progression (i.e., drug metabolism, tumor microenvironment, cell cycle regulation, and DNA repair) will predict the risk of tumor recurrence in rectal cancer patients treated with chemoradiation. PATIENTS AND METHODS: A total of 90 patients with Stage II or III rectal cancer treated with chemoradiation were genotyped using polymerase chain reaction (PCR)-based techniques for 21 polymorphisms. RESULTS: A polymorphism in interleukin (IL)-8 was individually associated with risk of recurrence. Classification and regression tree analysis of all polymorphisms and clinical variables developed a risk tree including the following variables: node status, IL-8, intracellular adhesion molecule-1, transforming growth factor-beta, and fibroblast growth factor receptor 4. CONCLUSION: Genomic profiling may help to identify patients who are at high risk for developing tumor recurrence, and those who are more likely to benefit from chemoradiation therapy. A larger prospective study is needed to validate these preliminary data using germline polymorphisms on tumor recurrences in rectal cancer patients treated with chemoradiation.     

甘草酸单铵结合氦-氖激光治疗银屑病62例

目的用甘草酸单铵结合低能量氦-氖激光,观察治疗银屑病患者。方法62例寻常型银屑病患者,分为两组,A组用低能量氦-氖激光血管内照射,同时用甘草酸单铵静脉滴注,共36例;B组仅用甘草酸单铵,共26例。通过30d治疗。结果总有效率82.2%,其中A组有效率88.9%,B组73.1%(经Ridit检验,U＝2.76,P＜0.01),两组差异有极显著性意义。结论甘草酸单铵结合氦-氖激光治疗银屑病,比单用甘草酸单铵效果好。     

A fetus with meckel-gruber syndrome associated with isomerism

Abstract. Meckel-Gruber syndrome (MKS) is an autosomal recessive lethal malformation. As far as we know, the rate of incidence for the syndrome is 0.02 per 10,000 births. It is estimated that Meckel-Gruber syndrome accounts for 5% of all neural tube defects in Finland. Objective. The aim of this study is to present a case of a fetus with Meckel-Gruber syndrome associated with complete left isomerism. Method. The fetus was obtained after medical interruption of the pregnancy during the fifteenth gestational week. The mother was 36 years old and in a consanguineous marriage. The antenatal ultrasound examination revealed a polymalformative syndrome, leading to a postmortem examination. The fetopathological study of the fetus was conducted at the Centre for Maternity and Neonatology, Tunis, Tunisia, in 2008. Results. The female fetus had a significantly deformed ballooning abdomen, pes equinovarus, flexion of the wrist and a total posterior cleft palate. The central nervous system abnormalities were occipital encephalocele, cystic dilatation of the fourth ventricle, agenesis of corpus callosum and hydrocephalus. The study of the internal organs found dextrocardia, irregular lobulation of the lungs, left isomerism, and polysplenia. The microscopic examination revealed bilateral cystic dilation of the kidneys, fibrous proliferation of the liver and ectasic dilatation of the billiary ducts, representing a ductal plate malformation of the liver. Conclusion. The case is diagnosed with Meckel-Gruber syndrome associated with complete left isomerism, cleft palate and possibly Dandy-Walker syndrome.