Causes and prevention of dysuria after hyperplasia of prostate operation

Objective To investigate cause and prevention of dysuria after hyperplasia of operation.Methods To analyze 66 cases of dysuria after hyperplasia of prostate operation retrospectively.Result The most common reasons to dysuia are orderly stenosis of bladder neck;inflammatory edema of bladder neck;urethral stricture;rehyperplasia of remained prostate tissue;neruogenic bladder;prominence of ureteral crest;clot obstruction;Conclusion Prevention of dysuria after hyperplasia of prostate operation consists in preoperative satisfied diagnosis and correct treatment in operation and after operation.     

Clinical analysis of 95 cases of cervical tuberculous lymphadenopathy associated with abscess formation北大核心CSCD

Objective To explore the clinical features and surgical treatment of cervical tuberculous lymphadenopathy associated with abscess formation. Methods The clinical data of 95 cases of cervical tuberculous lymphadenopathy associated with abscess formation were reviewed and analyzed retrospectively. All the patients were treated in Shenzhen Third People’s Hospital during the period from February 2012 to May 2014. Results The mean age of the 95 patients was (27.8±8.2) years. The average duration of the disease was 4.0 months. The tuberculous lymphadenopathy was most frequently found in Level IV cervical lymph nodes. Thirtyfour patients were complicated with pulmonary tuberculosis. History of surgical treatment for tuberculous cervical lymphadenopathy was reported in 26 cases. Sixty-five patients were managed with incision and drainage plus dress changing. Twenty-two patients underwent abscess rinsing, excision and primary wound closure. And 8 patients received excision of ulcers and sinuses, and lymphadenopathy cleaning. The average healing time was (2.11±1.76) months for incision and drainage. Abscess and ulcer reoccurred in 18 of the 65 patients after healing completely by incision and drainage. All the patients treated by the other two surgical modalities were cured as primary healing except 2 patients, who received local flap grafting after primary surgery. Conclusions Cervical tuberculous lymphadenopathy associated with abscess formation has special features in diagnosis and treatment. Surgical approach is usually effective if optimized for individual patients. © 2018, Editorial Department of Chinese Journal of Infection. All rights reserved.     

根治性经尿道汽化电切术治疗浸润性膀胱癌的探讨

目的 探讨根治性经尿道膀胱肿瘤汽化电切术治疗浸润性膀胱癌的疗效.方法 2008年2月至2010年2月对36例浸润性膀胱癌患者,施行了根治性经尿道膀胱肿瘤汽化电切术,手术参照根治性经尿道膀胱肿瘤电切术原则,肿瘤部位切除至膀胱外脂肪层.术后给予卡介苗膀胱灌注治疗,随访3～24个月.结果 2年内复发12例,复发率33.3%(12/36),对复发者再次行经尿道膀胱肿瘤汽化电切术.2年内死亡6例,病死率16.7%(6/36).结论 对年老体弱不能耐受或不愿意接受膀胱全切的浸润性膀胱癌患者可施行根治性经尿道膀胱肿瘤汽化电切术,以达到延长生命,提高生活质量的目的.

Abstract：

Objective To assess the efficacy of radical transurethral electrovaporization for invasive bladder cancer. Methods Thirty-six patients with invasive bladder cancer from february 2008 to February 2010 were treated by transurethral electrovaporization resection of bladder tumor (TURBT). The operation procedure was based upon the principle of radical transurethral resection for bladder tumor. The tumor was resected to fatty layer outside the bladder wall. After operation Bacillus Calmette-Guerin (BCG) irrigation of bladder was given,all patients were followed up for 3 to 24 months. Results The recurrence occurred in 12 cases in 2 years,with a recurrence rate of 33. 3% (12/36). These recurrence cases were treated with TURBT again. Six cases dead in 2 years,with a mortality of 16. 7% (6/36). Conclusion TURBT is suitable for those who are older or weak,and not medically fit for radical cystectomy or those who refuse the open surgery,which can prolong the survival time and improve the quality of life.     

Clinical effect of combined application of Maizhiling tablets and salmon calcitonin after artificial femoral head replacement in elderly patients with femoral neck fracture

Objective To study the clinical effect of Maizhiling tablets combined with salmon calcitonin in the treatment of elderly femoral neck fracture after artificial femoral head replacement and the influencing factors of hip joint function 6 months after operation. Methods Prospective research methods were used in this article.A total of 84 elderly patients with femoral neck fracture who underwent artificial femoral head replacement in the Affiliated Hospital of North China University of Science and Technology from January 2017 to June 2019 were selected and randomly divided into the treatment group (41 cases) and the control group (43 cases) by the random number table method.The treatment group was treated with Maizhiling tablet and salmon calcitonin nasal spray plus basic calcium; the control group was treated with basic calcium.Independent sample t test was used to compare the visual analogue score (VAS) on the 5th day after operation, the time of complete disappearance of congestion in thigh, and the time of first ambulation after operation between the two groups.The bone mineral density (BMD) of contralateral femoral neck and Harris score of hip joint function were compared between the two groups at 14 days, 3 months and 6 months after operation by repeated measurement variance analysis.Multivariate Logistic regression was used to analyze the influencing factors of hip joint function at 6 months after operation. Results VAS score on the 5th day after surgery: (6.34±1.54) points in the treatment group and (7.02±1.50) points in the control group.Complete regression time of thigh congestion: (12.12±2.27) d in the treatment group and (13.88±2.58) d in the control group.The first postoperative activity time was (5.93±1.52) d in the treatment group and (7.84±1.05) d in the control group, and the differences of the above indexes between the two groups were statistically significant (t value was 2.051, 3.313, 6.673, respectively, all P<0.05). The BMD values of the contralateral femoral neck in the treatment group were (0.543±0.123), (0.561±0.119), (0.606±0.105) g/cm2 at 14 days, 3 months and 6 months after operation, and (0.530±0.092), (0.517±0.089), (0.526±0.090) g/cm2 in the control group.The results of variance analysis of repeated measurements showed that Fintra-group=55.726, P<0.01; Finter-group=4.206, P<0.05; Finteraction=57.654, P<0.01.There were significant differences between 3 months, 6 months and 14 days after operation in the treatment group (all P<0.01), and between 3 months and 6 months after operation (P<0.01). In the control group, there was significant difference between 14 days and 3 months (P<0.01), and between 3 months and 6 months (P<0.01); 6 months after operation, the difference was statistically significant (P<0.01). The Harris scores of hip joint in the treatment group were (82.12±8.18), (85.49±6.61), (87.10±6.57) points and (78.91±5.75), (81.44±6.42), (83.67±6.97) points in the control group.The results of repeated measurement ANOVA showed that Fintra-group=64.526, P<0.01; Finter-group=6.529, P<0.05; Finteraction=0.501, P>0.05.There were significant differences between 3 months, 6 months and 14 days after operation (all P<0.01). There were significant differences between 3 months and 6 months after operation (P<0.05). There were significant differences between the groups 14 days, 3 months and 6 months after operation (P<0.05 or P<0.01). Multivariate logistic regression analysis showed that age(OR=1.318, 95%CI1.002-1.732, P=0.048) and treatment method (OR=29.168, 95%CI 1.030-824.623, P=0.048) were risk factors for hip function on the replacement side, and Harris score of hip function 14 days after surgery (OR=0.624, 95%CI 0.447-0.873, P=0.006) were protective factors for hip function 6 months after surgery. Conclusion Maizhiling tablets and salmon calcitonin nasal spray have good effects on removing blood stasis, relieving pain, effectively improving bone mineral density and promoting the recovery of joint function after artificial femoral head replacement for senile femoral neck fracture.The younger age of patients, postoperative treatment with Maizhiling tablets combined with salmon calcitonin and good recovery of hip function in 14 days after operation are the protective factors of good hip function in 6 months after operation. © 2021, Chinese Medical Journals Publishing House Co.Ltd. All rights reserved.     

神经生长因子早期治疗中重度新生儿缺氧缺血性脑病的疗效

Objective To observe the curative efects of never growth factor (NGF)on neonates with moderate and severe hypoxic-ischemic encephalopathy (HIE). Methods Eighty-six neonates with HIE were randomly divided into NGF treatment group and control group. The control group (42 cases)were received routine treatment (including cerebrolysin and citicoline) ;the treatment group (44 cages)were given NGF on the basis of routine treatment as early as possible (within 6 hours after birth). Brain CT, neonatal behavioral neuro-logical assessment(NBNA) and children' s development center of China(CDCC) at 3 and 6 months after birth were proformed in both groups. Results Brain CT, NBNA and CDCC markers in treatment group were better than those in control group (P＜ 0. 05). There were great diferences between two groups (P＜ 0. 01). Conclusion Using NGF on the basis of the routine treatment as early as possible after resuscitation can reduce markely the severity of asphyxia induced brain damage in neonates. It is very effective using NGF in treating HIE in neonates.     

宫颈上皮内瘤变750例诊断与治疗分析

目的 探讨宫颈上皮内瘤变(CIN)的诊断与治疗方法 及其临床效果.方法 收集2004年1月至2009年6月在上海交通大学医学院附属第一人民医院松江分院经细胞学筛查、阴道镜活检、组织病理学诊断为CIN者作为分析对象.根据病变程度和患者意愿实施药物、物理、宫颈锥切和子宫切除治疗.依据切除标本病理诊断,追加手术或放化疗.治疗后6、24个月随访,比较分析病理诊断及治疗效果.结果 宫颈癌三阶梯筛查诊断CIN 750例,其中CIN Ⅰ 460例,CINⅡ180例,CINⅢ 110例.接受治疗578例,其中药物治疗46例,6个月后病灶消失32例、持续10例、升级2例、癌变2例;物理治疗13例,无复发;锥切治疗435例,术后诊断升级34例,复发4例;子宫切除治疗84例,术后诊断升级11例,无复发.升级和复发病例均行相应补充治疗.各级CIN采用物理、锥切、子宫切除治疗2年有效率均达98%以上,药物治疗有效率为69.7%.阴道镜活检浸润癌漏诊率为2.2%,锥切后子宫切除标本病灶残留率为16.2%.结论 阴道镜检查多点活检早期诊断CIN具有极高的准确性和特异性.宫颈锥切是CIN的主要治疗方法.CINⅢ无生育要求者宫颈锥切后子宫切除.药物保守治疗CIN要慎重.

Abstract：

Objective To investigate the diagnosis and treatment of cervical intraepithelial neoplasia and their clinical effect Methods The cases who were diagnosed as CIN through cytology, colposcopy biopsy and histopathological diagnosis were collected from January 2004 to June 2009 in Songjiang Hospital Affiliated to Shanghai Jiaotong University School. Drug therapy, physical therapy, cervical conization and hysterectomy were performed according to the lesion degree of CIN and patients' willingness. Some cases were further treated with surgery, radiotherapy or chemotherapy according to the pathological findings of the initial excision specimens. With long-term follow-up at 6,24 months after the treatment,we performed a comparative analysis on pathological diagnosis and therapeutic effects. Results Seven hundred and fifty cases of CIN were diagnosed after cervical cancer screening,among which,460 cases of CIN Ⅰ ,180 cases of CINⅢⅡ and 110 cases of CIN Ⅲ. Five hundred and Senventy-eight cases received treatment, among which, 46 cases received drug treatment After 6 months, focus disappeared in 32 cases, sustained in 10 cases, upgraded in 2 cases and canceration occurred in 2 cases. 13 cases received physical therapy,no recurrence occured. Four hundred and thirty-five cases received conization treatment, 34 cases with focus upgraded and 4 case recurred after the operation. 84 cases received hysterectomy, of which, 11 cases focus upgraded after the operation and no recurrence. The cases with focus upgraded or recurred all received additional treatment. The effective rate of physical therapy,conization treatment and hysterectomy on all grades of CIN was more than 98% at 2 years, and 69. 7% of drug treatment. The omission diagnostic rate of colposcopy guided biopsy on invasive carcinoma was 2. 2% , and the residual rate of focus of hysterectomy specimens after conization was 16. 2% . Conclusion Colposcopy including multi-point biopsy has high accuracy and specificity in early diagnosis of CIN . Cervical conization is the main method of the treatment of CIN. Patients with CIN Ⅲ and without desire of fertility should consider the removal of the uterus after cervical conization. Drug conservative therapy of CIN should be chosen carefully.     

Clinicopathologic characteristics of prostatic stromal sarcoma with rhabdoid features: A case report

BACKGROUND Prostatic stromal sarcoma presenting with rhabdoid features is extremely rare,and only four cases have been reported in the English-language literature to date.Accordingly, there is no absolute definition of this group of tumors as yet, and our overall understanding of its morphological features, therapeutic regimen and prognosis is limited.CASE SUMMARY A 34-year-old male patient was referred to our hospital to address a 2-mo history of hematuria and progressive dysuria. Pelvic computed tomography scan revealed a 6.0 cm × 5.2 cm × 7.2 cm mass in the prostate, with bladder invasion.The patient underwent transurethral prostatectomy as upfront therapy. He refused further treatment and died of uncontrollable tumor growth 3 mo after surgery. Pathology analysis revealed the stroma to be pleomorphic, with a huge number of atypical spindle cells. Rhabdomyoblastic cells, with abundant eosinophilic cytoplasm, were detected. The spindle cells were positive for vimentin, INI1 and β-catenin, and the rhabdomyoblastic cells were positive for MyoD1, myogenin and INI1. The spindle cells and epithelial cells were sporadically positive for P53.CONCLUSION The prostatic stromal sarcoma tumor was immunoreactive for β-catenin,suggesting a role for the Wnt/β-catenin pathway in this tumor type.     

微创后侧入路肌关节囊瓣重建在人工髋关节置换中的疗效观察

Objective To compare the short-term effects of myocapsular flap repair through minimal posterior approach in Hip arthroplasty with traditional posterior approach in hip arthroplasty in elderly femoral neck fractures. Methods From August 2007 to may 2009, a total of 126 femoral neck fracture patients were randomly divided into two groups, with 63 patients treated with myocapsular flap repair through minimal posterior approach (the modified group), and 63 patients treated with traditional posterior approach (the traditional group). Fifty-eight patients underwent the first-ever total hip replacement and 68 patients underwent artificial double-acting femoral head replacement. Eighty-four cases were inserted with cemented implants and 42 cases with uncemented. Data of incision length, operation time, blood loss volume, drainage amount, blood transfusion volumes were recorded separately. Postoperative complications related to the surgery and hip joint function were also documented. Function of hip joint was scored with Harris scale. All data were statistically analyzed. Results Five patients died within 1 year of surgery, and 4 patients dropped out. All the remained 117 patients were followed up for 12 - 24 months. There were no significant difference in age, type of fracture and artificial the incision length in the modified group was significantly shorter than that in the traditional group([ 10. 5 ± 2. 4 ]cm vs [ 17. 2 ± 3.6 ] cm, t = 3. 012, P = 0. 004). The average operating time was significantly shorter in the modified group compared to the traditional group (t = 2. 455, P = 0. 038). Blood loss, drainage amount, blood transfusion volumes in the modified group were less than those in the traditional group( t = 3.211,2. 986 and 3. 352 ,Ps ＜ 0. 01, respectively). Conclusion Myocapsular flap repair through minimal posterior approach in Hip arthroplasty is a reasonable, mini invasive technique for hip replacement in older with a less blood loss and shorter operating time.fractures     

Traction combined with manual therapy on 70 cases of cervical spondylopathy

Background:Traction of cervical vertebrae is an effective method in treatment of cervical spondlopathy.Manual therapy can correct dysfunction,has the effects of function exercises and has an active significance to the rehabilitation of mixed cervical spondylopathy.Combination of these two methods could enhance therapeutic effects and do good to functional recovery.Objective:To observe effects of traction combined with nanual therapy on mixed cervical spondylopathy.Subjects:70 cases of mixed cervical spondylopathy from January 2000 to January 2001 were investigated including 49 males and 21 females,aged 21-48(mean:34.8)years old with disease course 1 week t 6 months.All cases were treated by non-operative therapy.Among these patients,numbness of upper limbs,22 cases,pain at neck,shoulder,back,40 cases.Pressure measurement by compression of neck was positive in 10 cases,brachial plexus pulling test was positive in 5 cases and lowering head test was positive in 11 cases.X-ray and CT examination showed abnormal curvature,hypertrophy of front and back edges of vertebrae,narrow intervertebral fossa in 51 cases,protrusion of intervertebral disc in 35 cases,prolapse in 25 cases,calcification of posterior langitudinal ligament in 48 cases.All cases were randomly divided into treatment group(n=36) and control group(n=34).there was comparability between two groups at age,sex,disease condition.brae:Traction began with 6 kg and 1 kg was increased every day.Maximal weight to male was 17 kg and female was 15 kg.Intermittent traction was wadopted,relaxing for 5 seconds after 5 seconds of traction.(2)Manual therapy:relaxing neck,pulling neck,lifting neck.Corresponding acupoints were compressed with thumb along brachial nerve.If the acupoint were selected correctly and “De qi” was felt,the patient,might feel comfortable after manual therapy.In the end.rolling and rotating manipulation,beating were adopted at neck,back and relaxing manipulation was adopted to upper libs 2 weeks was 1 therapeutic course.Simple manual therapy was adopted in control group.Main evaluation indexes:Marked:Clinical symptons disappeared,nedk could move freely and function recovered;Effective:Clinical symptoms disappeared basically and neck could take basic movement freely;Ineffective:no obvious alternation after treatment.Result:Marked:33 cases(92%)in treatment and 29 cases (85%)in control group;Effective:3 cases(8%)in treatment group and 4 cases(12%)in control group,Inefective:0 case in treatment group and 1 case(3%)in control group.Therapeutic effect in treatment group were superior to that in control group.Conclusion:Traction of cervical vertoebrae combined with manual therapy had an obvious effect on mixed cervical spondylopathy in relieving spasm of neck muscle and restoring of articular tunction.     

Rehabilitation nurse after temporomandibular arthroplasty

Background:Femoral subtrochanteric fracture means fractures happened 5 cm away from inferior margin level of samll trochanter.Most of this kind of fracure in unstable fractures caused by trauma mostly and characterized with large malposition,splintered and difficult to be treated.It will lead to a series of severe complications if treated improperly.Objective:To evaluate the clinical effect of the remoral interlocking intramedullary nailing for the treatment of subtrochanteric fracture.Unit:Department of Orthopedics,First Hospital of Suzhou Univerisyt Subjects:2 cases combined with fracture of shaft of femur in 10 cases of subtrochanteric fracture,including 7 males and 3 females,age 22-48 years,average age 32.8 years,4 cases suffered left side,6 cases suffered right side.8 cases of road accident,1 case of falling trauma and 1 case of crash trauma.All the cases were treated with closes reduction except 2 cases combined with fracture of shaft of femur.According to Seinsheimer classification:2 cses of ⅡB type,3 cases of ⅡC type,3 cases of Ⅲ A type,2 cases of Ⅳtype,all these 10 cases were closure trauma.Intervention:Patients received traction 5-7 days afte hos pitalization to relieve pain and maintain length of suffered limb.We took full-length X-ray of other side femur to estimate length and diameter of intramedullary pin,After lateral position,we mede 6-8cm incision along near end of femoral larger trochanter to near lateral side obliquely,cut fasciae of gluteus maximus muscle longitudinally along incision,identified level of inferior fasciae of gluteus maximus muscle,touched inside pyriform recess,pored at pyriform recess along longitudinal axis of shaft of femur,pore localizing in the middle of femur,reduced fracture under X-ray,inserted guide to distal end and dilated marrow tp 13cm.Then we put intramedullary pin with proper lentth and diameter at level of the top of larger trochanter,locked distal and approximate ends with interlocked pin.Incision need to be extended to needed length to distal end along larger trochanter,borke partly the starting point of vastus lateralis if patients received incisive reduction,expose fracture and reduce under direct,look.Patients received CPM knee joint function exercises after operation;patients load weight completely after fracture healed.Patients received routine X-ray exams 6 and 12 weeks after operation,if only few callus formed around the fracture,we suggest removing distal interlocked pin.Result:All the patients were followed up for 12-25 months,average 16.3 months.All the fractures were healed.Conclusiong:Femoral interlocked intrameduallary pin treating sbutrochanteric fracture is an ideal nternal fixation method.     

Preliminary Scientific "Program at a Glance" with short titles,for complete info please review the abstract.

Abstract

The aim of this study was to assess the value of transrectal sonourethrography in the diagnosis of dysuria after bipolar transurethral plasmakinetic prostatectomy (TUPKP). Seventy-seven male patients with dysuria after TUPKP underwent transrectal sonourethrography. The clinical data were then compared with the surgical outcomes. The following pathologies were diagnosed: Bladder neck atresia (17/77), bladder orifice strictures (15/77), membranous urethral strictures (21/77), pars cavernosa urethral stricture (12/77), residual prostate gland (5/77), external urethral orifice stricture (2/77), calculi in the prostatic urethra (2/77), flap in the internal urethral orifice (2/77), and postoperative dysfunction of the bladder detrusor muscle (1/77). Transrectal sonourethrography is a reliable diagnostic method for numerous pathologies that occur in patients with dysuria after TUPKP and is a clinically useful tool.     

经尿道膀胱颈电切治疗女性膀胱颈梗阻

目的 回顾性分析76例女性膀胱颈梗阻的诊断及治疗经验.方法 自2000年5月～2005年5月,采用Gyrus双极等离子环状电切袢,对76例临床诊断为膀胱颈梗阻的女性患者行膀胱颈电切术.切除部位依膀胱镜下梗阻性质的不同,切除5、7点或6点.术后对症状改善不明显的患者,再次行膀胱颈电切或配合定期尿道扩张.结果 76例中,经一次膀胱颈电切后自觉排尿症状明显改善者62例;14例改善不明显者,术后1个月复查膀胱镜,5例切除深度不够者再次电切,9例定期行尿道扩张.术后随访3～6个月,排尿通畅,感觉满意.结论 经尿道膀胱颈电切治疗女性膀胱颈梗阻疗效确切,值得推广.     

前列腺电切术后排尿困难的原因分析及预防

[摘要] 目的 探讨前列腺增生症经尿道电切术后出现排尿困难的原因及预防措施。 方法 对本院2001年1月-2007年9月收治经尿道前列腺电切术后出现排尿困难的146例患者的临床资料进行分析。结果 腺体残留41例，尿道外口狭窄35例，后尿道狭窄24例，前尿道狭窄8例，膀胱结石14例，膀胱结石伴后尿道狭窄7例，前列腺癌8例，膀胱颈纤维化5例，后尿道结石2例，神经源性膀胱2例。 结论: 尿道外口狭窄、前尿道狭窄、后尿道狭窄、膀胱结石及腺体残留是引起术后排尿困难的主要原因。充分的术前准备、合理的术中操作及术后处理是减少前列腺点切术后患者排尿困难的有效措施。     

前列腺汽化电切术与经膀胱前列腺摘除术治疗前列腺增生对比分析

目的探讨对比前列腺汽化电切术与经膀胱前列腺摘除术治疗前列腺增生的临床治疗效果及并发症。方法对213例前列腺汽化电切术患者及145例行经膀胱前列腺摘除术患者临床资料进行分析总结。结果两组患者术后国际前列腺症状评分与生活质量评分的改善无明显差异,前列腺汽化电切术组术后膀胱冲洗时间短、恢复快。前列腺汽化电切术组术后发生尿道外口狭窄及术后继发出血形成血凝块堵塞尿管几率稍高。结论前列腺汽化电切术与经膀胱前列腺摘除术治疗前列腺增生效果无显著差异,两种手术术后并发症无显著差异,但前列腺汽化电切术具有不需切开膀胱对患者打击小、创伤小、恢复快的优点。     

前列腺增生症术后排尿困难的原因及预防

Dysuriaisthemostcommoncomplicationafterhyperplasiaofprostateoperation．Todecreasethehappenofthiscomplication，weanalyzedretrospectivelyallthecasesofdysuriaafterhyperplasiaofprostateoperationinrecent６years，reportasfollow：１Subjectsandmethods１．１Subjects６６casesarefromJan１９９５toJan２００２，age５０～８４，average６７，including５３casesofsuprapubictransvesicalprostatectomyand１３casestransurtheralelectricprostatectomy．１．２MethodsAllthepatientsreceivedurodynamicexamina－tion，includ…     

经尿道前列腺电切术后再入院的原因及治疗探讨

目的分析经尿道前列腺电切(TURP)术后患者再入院的原因,探讨治疗方法。方法TURP术后再入院患者30例。腺体残留或复发12例,10例再次行TURP;尿道狭窄8例,3例行尿道扩张术,3例行尿道内切开,1例行尿道外口成形术,1例行耻骨上膀胱造瘘术;TURP术后继发出血6例,行经尿道膀胱冲洗加电凝止血;神经原性膀胱功能障碍1例,行耻骨上膀胱造瘘术;前列腺癌2例,行睾丸切除术;TURP术后尿失禁1例,使用阴茎集尿器。结果30例患者23例行手术治疗,术后随访8个月至7年,平均随访3.5年。效果满意21例(91.3%),2例尿道狭窄术后需要定期尿道扩张。结论术前准确诊断,合理选择手术方式及术中术后正确处理是预防患者术后再次入院的关键。     

腔内手术治疗后尿道狭窄与闭锁(附46例报告)

目的 探讨腔内手术治疗后尿道狭窄与闭锁,提高后尿道狭窄腔内手术成功率.方法 后尿道狭窄患者46例,狭窄段长度0.8～2.5 cm,平均1.5 cm.均行尿道内切开及尿道瘢痕电切术治疗.结果 43例手术成功,手术成功率93.5%（43/46）,其中38例一次成功,5例因狭窄复发而行2、3次腔内手术成功;3例失败原因均为术中尿道出血多视野不清晰而改为开放手术治疗.患者术后均定期行尿道扩张.32例随访6～36个月,排尿通畅.结论 腔内手术治疗后尿道狭窄及闭锁,方法简单,安全有效,是治疗后尿道狭窄的首选方法.术后尿道扩张是预防再狭窄的重要手段.     

耻骨后保留尿道前列腺摘除术

目的：提高良性前列腺增生症开放手术治疗效果。方法：从1999年6月－2002年1月我院对61例Ⅲ、Ⅵ度良性前列腺增生患者行耻骨后保留尿道前列腺摘除术,其中对伴中叶增生、膀胱经石≤3.0cm者采用膀胱颈“T”形切开,以切除过多的膀胱颈后唇粘膜及取石。结果：61例手术腺体切除彻底,术后恢复快。随访6个月－3年,未发现严重的并发症,疗效满意。结论：该术式对Ⅲ、Ⅳ度良性前列腺增生症是较为理想的开放性手术方式。     

经尿道前列腺电切术后高危前列腺增生患者精神障碍的影响因素分析与护理对策

目的探讨经尿道前列腺电切术后高危前列腺增生患者精神障碍的影响因素分析及护理对策。方法选取我院2017年2月至2019年2月高危前列腺增生经尿道前列腺电切术患者80例,其中11例术后发生精神障碍,69例术后未出现精神障碍。通过问卷调查、查阅病例等方式,收集患者年龄、糖尿病、高血压、冠心病、膀胱痉挛、脑缺氧及术后血钠等资料,采用logistic回归分析法进行分析。结果经统计学处理,患者膀胱痉挛、脑缺氧及低钠血症为精神障碍发生的独立危险因素。结论高危前列腺增生经尿道前列腺电切术后患者精神障碍发生率较高,严重影响其正常生活,明确术后出现精神障碍的危险因素,给予其相应的防护措施,从而避免或减少精神障碍的发生。