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肉眼方法

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Results 6 of 112 patients in group one and 22 of 119 patients in group two were found out hematuria or perirenal hematomas after puncture operation.

结果112例CDE定位引导组中共有6例患者术后出现肉眼血尿和被膜下血肿,119例灰阶超声引导组中共有22例患者出现上述并发症。2种方法在降低穿刺并发症发生率方面有显著性差异(P〈0.01)。

Abstract] objective to explore the accuracy and safety of safety drillprepared for cervical pedicle screw trajectory.methods fourteen adult cadaver specimens of cervical spine(c3~c7)with intact structures including ligaments and perivertebral muscles were reserved and used.according to the radiographic measurements,safety drill was inserted into cervical pedicle individually.the evaluation of the drill's trajectory was carried out by ct scan and three-dimension reconstruction and autopsy.results one hundred and forty drill's trajectories were made.9 holes failed with a perforation rate of 6.4%.conclusion the safety drill prepared for cervical pedicle screw hole is safe and effective and can be applied and popularized clinically.

目的 探索安全钻头应用于颈椎弓根螺钉孔道钻探的安全性与准确性。方法随机取14具福尔马林浸泡的成人颈椎标本(c3~c7),保留完整的脊柱三柱结构及相关的韧带和椎旁肌,根据影像学测量的进钉点和进钉方向,模拟颈椎后路手术过程。选用安全钻头,进行实际的颈椎弓根螺钉孔道的钻探,将孔道行ct扫描,并斜位三维重建孔道形态,并以肉眼直视观察结果为金标准,评价孔道钻探的成败。结果钻探孔道准确率89.3%(125/140),穿孔率6.4%(9/140)。结论安全钻头应用于颈椎弓根螺钉孔道钻探的安全性与准确性均较高,可以在临床上推广使用。

Methods 7 cases of postcaval ureter were retrospectively reviewed regarding to clinical presentation, imaging findings, treatment and prognosis.

方法回顾性分析7例下腔静脉后输尿管患者的症状、影像学柃奄、治疗和随访情况。7例均有右腰胀痛,其中1例有肾绞痛,无肉眼血尿。

The common symptom was painless gross hematuria.The main diagnostic met hods were cystoscopy, retrograde ureteropyelography and ureteroscopy.Operation was chief treatment measure.17 in 28 cases were followed-up.9 patients were su rvival with no tumor, the others died.

首发症状以肉眼血尿最常见,膀胱镜检、逆行输尿管造影和输尿管镜检查是最重要的诊断方法,治疗以手术为主。28例中17例获得随访,其中9例无瘤生存,8例死亡。

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。

"Herophilus first laid the factual groundwork for gross anatomy , the study of structures large enough to see without a microscope."

希罗菲卢斯是进行实地大体解剖的第一人,大体解剖是用解剖刀剖切和肉眼观察的方法来研究有机体的各种结构。这就叫做&解剖学&。

"Herophilus first laid the factual groundwork for gross anatomy, the study of structures large enough to see without a microscope."

希罗菲卢斯是进行实地大体解剖的第一人,大体解剖是用解剖刀剖切和肉眼观察的方法来研究有机体的各种结构。

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