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Section two Evaluation on Function of Obstructive Kidney by Perfusion Imaging with Multi-slice Spiral CTObjective: To investigate the diagnostic value for hydronephrotic kidney by perfusion imaging with multi-slice spiral CT, and to compare the results with those of Doppler Ultrasonography.
10只健康成年日本大耳白,雌雄不限,在右侧输尿管部分梗阻模型制作前,应用多普勒超声及多层螺旋CT灌注成像进行相关参数检查;然后按Cheng的方法制作右侧输尿管部分梗阻模型,4周后再次检查。
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The mouse was carried out half nephric duct ligation to induce the renal interstitial fibrosis animal model,afterwards,to set up three groups,control group,sham operation group(intragastric administration with normal sodium according to 10ml/kg weight),treatment group...
采用小鼠单侧输尿管结扎法诱导肾间质纤维化的动物模型,用盐酸青藤碱治疗,并设对照组、假手术组(小鼠每日按10m l/kg体重用生理盐水灌胃,直至治疗结束)、治疗组(选用正清风痛宁缓释片按每日30mg/kg体重给小鼠灌胃,连续3周,),检测血尿素氮、血肌酐、血清层粘连蛋白、纤维连接蛋白的含量,免疫组化法测肾脏组织转化因子β1(TNF-β1)的表达并进行肾脏病理学的观察。
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Results Out of the4527paˉtients treated by ESWL,stones were excreted completely from4512patients within2weeks;12patients who had comˉplication of the urethra stone street were cured by transcutaneous nephrocentesis,nephrostomy and ureterolithotomy through uretercystoscope;stones weretaken out by operation from the other3patients,from whom the excretion of stones was not possible.
结果 经ESWL治疗的4527例泌尿系结石病人中,4512例在2周内排尽结石,12例并发输尿管&石街&,加用经皮肾穿刺造瘘和输尿管镜取石治疗,3例中转手术治疗。
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Results Out of the4527paˉtients treated by ESWL,stones were excreted completely from4512patients within2weeks;12patients who had comˉplication of the urethra stone street were cured by transcutaneous nephrocentesis,nephrostomy and ureterolithotomy through uretercystoscope;stones weretaken out by operation from the other3patients,from whom the excretion of stones was not possible.
目的 探讨ESWL治疗泌尿系结石的效果。方法回顾性分析经ESWL治疗的4527例泌尿系结石病人。结果经ESWL治疗的4527例泌尿系结石病人中,4512例在2周内排尽结石,12例并发输尿管&石街&,加用经皮肾穿刺造瘘和输尿管镜取石治疗,3例中转手术治疗。
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; Objective; To explore the CT findings and causes of perinephric edema associated with ureteral obstruction.
; 目的;探讨急性输尿管梗阻时肾周积液的CT表现、积液来源。
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Objective To investigate the clinical value of intravenous pyelography, retrograde pyelography, B-type ultrasonic inspection, computerized tomography and magnetic resonance urography in the diagnosis of postcaval ureter.
作者:黄科峰,赵国宏,席涛,张婷,薛宝山,陶飞,韩俊玲,黄金山,王刚,孟安启,吴勇军,周保成目的探讨IVP、RP、B超、CT及MRU诊断下腔静脉后输尿管的临床价值。
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Methods A retrospective analysis was performed in 14 cases of urinary obstruction among 1090 cases of transplanted kidney in the year 2000-2006, including 9 cases of vesicoureteral anastomotic stricture, 6 of whom received a second vesicoureteral anastomosis, one had infection surrounding the renal graft and ureter end necrosis, two ureteral anastomosis with bladder muscle flap, and one stenostomia aerocyst distention under ureteroscope.
回顾总结2000-2006年我院1090例肾移植患者中的14例移植后上尿路梗阻患者,其中输尿管膀胱吻合口狭窄9例,6例行膀胱输尿管二次吻合手术,1例移植肾周感染输尿管末段坏死采用移植肾近端新鲜存活输尿管与自体输尿管吻合,1例采用膀胱肌瓣代移植输尿管,1例采用输尿管镜下气囊扩张后放置双J管。
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The main manifestations are the renal parenchyma internal low density focus, morphological changes, calcification and possible complicating uronephrosis, ureter, urinary bladder and kidney pathological changes and damages.
结果 肾结核的CT表现随病程、病理的变化而变化,主要表现为实质内低密度灶、形态改变、钙化,并可合并肾积水、输尿管膀胱和肾周改变以及肾功能损害等。
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objective to evaluate efficacy of extracorporeal shock wave lithotripsyfor treating ureteral stones in situ,investigate the cause of higher re-treatment rate.methods total of 687 patients with ureteral stone were received eswl between january 2000 and december 2004,included 455 male(66.2%) and 232 female(33.8%) patients,6 cases have bilateral ureteral calculi,12 cases have unilateral multiple calculi.hence,together 709 ureteral calculi were treated.patients upper ureteral calculi were treated in the supine position,for lower ureteral calculi patients were turned prone.to reduce eswl-induced renal trauma and pain,using lower energy source,adjusted power setting from 9.8 to 13.2kv,limited 1500 shock wavs per one session.no auxiliary procedure were used before eswl.the stone size was measured as the surface area of stone length by stone width on x-ray film.the interval between two treatment sessions was two weeks.results of 709 ureteral calculi,the overall stone free rate was 97.3%(690 calculi),re-treatment rate was 34.1%(292 calculi).according to the performed treatment sessions,one session 467 calculi,the mean stone size 37.27mm2,stone free rate 65.4%(464 calculi).two sessions 138 calculi,the mean stone size 62.48mm2,stone free rate 18.4%(131calculi).three sessions 52 calculi,the mean stone size 79.60mm2,stone free rate 7.1%(50calculi).four sessions 19 calculi,the mean stone size 101.63mm2,stone free rate 2.4%(17calculi).fivesessions 33 calculi,the mean stone size 119.33mm2,stone free rate 3.9%(28 calculi).overall 19 cases(2.7%)turned to other treatment modalities.of 335 upper ureteral calculi,303 achieved stone free (95.8%),re-treatment rate was 38.5%(129 calculi).of 374 lower ureteral calculi,369 achieved stone free(98.7%),re-treatment rate was 30.2%(113 calculi).the re-treatment rate of upper ureteral calculi was higher than lower ureteral calculi(p<0.05,χ2=5.40).the difference of stone-free rate between upper and lower ureteral calculi was no significant(p>0.05,χ2=0.15).conclusion eswl should be considered first line therapy for ureteral stone still.stone burden are the main variable of higher re-treatment rate,upper ureteral stone may moving with respiring during eswl.so efficinet shock wave was decreared,re-treatment rate become higher.
目的 评估体外震波碎石治疗输尿管结石的疗效,探讨再治疗率高的原因及输尿管结石的治疗选择。方法回顾2000年1月~2004年12月间eswl治疗输尿管结石的临床资料687例,男455例(66.2%),女232例(33.8%),平均年龄46.6岁(15~83岁)。有双侧输尿管结石6例,单侧多发性输尿管结石12例(4颗1例,3颗2例,2颗9例),共计输尿管结石709颗(含透光结石13颗)。应用上海爱申公司生产的desunit6030型碎石机,c臂x线球管做结石定位。上段输尿管结石(肾盂输尿管交界处至骶髂关节上缘)取仰卧位,下段输尿管结石(骶髂关节上缘下至输尿管口)取俯卧位。为减少eswl引起的肾损伤和疼痛,应用较低的能量,震波发生器电压从9.8~13.2kv,震波频率1.5s。每次治疗设定为1500次震波。治疗后3天摄腹部平片或b超,以后每隔7日重复检查。假如结石未碎或有残留结石最长径>3mm以上,再次eswl,两次治疗的间隔时间为两周。结石的大小用x线片上的表面积(mm2表示。结果 709颗输尿管结石总的治愈率为97.3%(690颗),再治疗率34.1%(242颗)。其中一次治疗467颗,平均结石大小37.27mm2,治愈464颗(65.4%),3颗改治疗;两次治疗138颗,平均结石大小62.48mm2,治愈131颗(18.5%),7颗改治疗;第1和第2次治疗治愈率(1个月治愈率)为83.8%。3次治疗52颗,平均结石大小79.60mm2,治愈50颗(7.1%),2颗改治疗;4次治疗19颗,平均结石大小101.63mm2,治愈17颗(2.4%),2颗改治疗;5次及5次以上治疗33颗,平均结石大小119.33mm2,治愈28颗(3.9%),5颗改治疗。总计19颗(2.7%)结石改变治疗方式。上段输尿管结石335颗,治愈321颗(95.8%),再治疗129颗(38.5%)。下段输尿管结石374颗,治愈369颗(98.7%),再治疗113颗(30.2%)。经χ2检验,上、下段输尿管结石的再治疗率差异有显著性(χ2=5.40,p<0.05),治愈率差异无显著性(χ2=0.15,p>0.05)。不良反应:血压升高13例(1.9%),震波区域疼痛26例(3.8%),震波进入处皮肤点状淤血33例(4.8%),肉眼血尿128例(18.6%),均于第2、3天自行消失。结论 eswl目前仍是输尿管结石的第一线治疗,结石的大小是再治疗率高的主要因素。结石的位置有影响,上段输尿管结石可随呼吸移动,有效震波次数减少,再治疗率比下段输尿管结石高。eswl前注重病例筛选可降低再治疗率。
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metanephrogenic blastema:生后肾原基
(2)生后肾原基:生后肾原基(metanephrogenic blastema)是中肾嵴尾端的中胚层组织受输尿管芽的诱导而产生的. 中肾嵴的细胞密集并呈帽状包围在尿管芽的末端,即成为生后肾原基. 生后肾原基的外周部分演变为肾的被膜,内侧部分形成多个细胞团,
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horseshoe kidney:蹄铁形肾
蹄铁形肾(horseshoe kidney)是最常见的肾融合异常,双侧肾脏下极于中线处以肾实质或纤维组织相连. 胚胎发生第4周到第6周,输尿管芽进入肾胚基,并共同向上迁移旋转. 在此过程中,如双侧后肾组织距离过近,可导致双肾下极融合,
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mesonephric duct:中肾管
(1)5周人胚胚体后半部:中肾管(mesonephric duct)尾端入泄殖腔(cloaca). 输尿管芽(ureteric bud)已分化为输尿管和后肾(metanephros)的一部分. 输尿管仍与中肾(mesonephros)末段相连. (2)6周人胚胚体后半部:泄殖腔头端已被尿直肠隔分成两部分,