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1.
全膀胱切除-回肠新膀胱术26例报告   总被引:1,自引:0,他引:1  
目的:探索全膀胱切除术后保留较好生活质量的手术方法,方法:按经典方法行全膀胱切除术,但术中尽量保留膀胱外括约肌及膜部尿道,并取约60cm带血管蒂的末段回肠,于肠系膜对侧缘纵形剖形成肠片,再将该肠片以“W”形折叠、,缝合为球形的新膀胱。双侧输尿管断端吻合于球形新膀胱、新膀胱的底部与尿道残端吻合。结果:1994.4-2000.4进行该手术26例,其中23例术后能自控排尿、无尿失禁、每次排尿量200-600mL。3例术后排尿困难。所有患者术后血电解质基本正常。B超检查无肾、输尿管扩张积水,膀胱造影无膀胱输尿管返流,膀胱尿道镜检查无尿道肿瘤复发。结论:新膀胱术术后有良好的排尿功能,膀胱容量大、压力低、自控排尿功能好,术后并发症少,是浸润性膀胱癌手术方式的一个优良选择。  相似文献   

2.
采用经尿道切除膀胱特殊部位的肿瘤65例。其中乳头状移行细胞癌61例(92.8%);乳头状瘤4例(6.2%)。膀胱后壁肿瘤用侧方移动的方法进行切割;膀胱侧壁肿瘤切除先行闭孔神经封闭,电流强度应尽量小些;男性尿道内口肿瘤同时伴有前列腺肥大时,电切器不能放置肿瘤处,先行部分膀胱颈或前列腺切除后再行肿瘤切除;输尿管口处肿瘤应将输尿管口与肿瘤一起切除;切除顶部肿瘤时应将电切器倒转180°,膀胱内充盈液体约150ml,左手在耻骨上向下推压膀胱,右手操作电切器切除肿瘤。术后用BCG75 mg加N.S20ml按Lamm方法进行膀胱灌注,随访1~5年,其中3~4年肿瘤复发者6例占9.2%。  相似文献   

3.
目的:探讨、对比原位可控回结肠代膀胱术及原位可控结肠代膀胱术优缺点及其并发症的防治.方法:回顾性分析原位可控回结肠代膀胱术及原位可控结肠代膀胱手术患者临床资料,总结出防治原位可控回结肠及结肠代膀胱术并发症的有效可行防治方法.结果:原位回结肠代膀胱术13例中发生早晚期并发症2例,占15.3%,其中早期并发症1例(尿漏),晚期并发症1例(输尿管新膀胱吻合口狭窄),结肠代膀胱术12例中发生早晚期并发症5例,占41.6%,其中早期并发症3例(尿漏2例,粘液分泌过多1例),晚期并发症2例(输尿管新膀胱吻合口狭窄1例,新膀胱输尿管反流1例).结论:回结肠原位代膀胱术后尿液可控率高,原位自主排尿,提高患者生活质量,术后近期及远期随访效果较好,具有临床应用价值.大量临床及尿流动力学研究表明,回结肠代膀胱是各种肠代膀胱中较理想的手术方式.  相似文献   

4.
目的观察琥珀酸索利那新用于小儿尿道下裂术后膀胱痉挛的临床疗效及其安全性评价.方法将入选的60例小儿尿道下裂患者根据个体病情选择适当的尿道成形术,术后将患者随机分为两组.实验组(30例)患儿于手术当日起口服琥珀酸索利那新,3 mg/次,1次/d,服用7 d;对照组(30例)患儿在出现膀胱痉挛疼痛时予以吲哚美辛直肠栓剂25 mg作镇痛处理.记录术后7 d患儿膀胱痉挛每日发作次数、膀胱痉挛平均持续时间;记录患儿术后3 d内每日排尿次数、单次排尿量和急迫性尿失禁次数;观察患儿术后并发症尿道瘘和尿道狭窄、不良反应的发生情况.结果实验组术后每日膀胱痉挛次数、膀胱痉挛持续时间、术后3 d内平均排尿次数和急迫性尿失禁次数均显著低于对照组(P0.05),而单次排尿量明显高于对照组(P0.05).比较两组患者术后尿道瘘和尿道狭窄发生率,差异均无统计学意义(P0.05).实验组患者服用琥珀酸索利那新后未出现严重不良反应.结论琥珀酸索利那新能够有效预防和治疗小儿尿道下裂术后膀胱痉挛,术后并发症、不良反应发生率低,符合临床应用的有效性和安全性.  相似文献   

5.
目的:探讨子宫全切术后合并膀胱阴道瘘的发病机理及防治方法。方法:对1986年1月-2006年1月收治的38例子宫全切术后遗留膀胱阴道瘘患者进行手术修补,并分析其发病机理、防治方法。结果:解剖层次不清,手术操作不当,是并发膀胱阴道瘘的主要原因。经手术修补后半年和1年随访,甲级愈合35例,乙级愈合3例,手术治愈率92.11%。结论:阴道残端高位膀胱瘘,采用经腹腹膜外膀胱外进行修补,是比较合理的手术途径。  相似文献   

6.
在我国大多数医院只有在子宫脱垂的病例方实行阴式子宫全切除术,正常位置的子宫几乎都选择腹式全宫切除术。而在西德目前阴式子宫全切除术的实施远远超过了腹式子宫全切除术。在妇科手术领域里这项手术显得特别活跃,有许多经验值得我们借鉴。 1 阴式子宫全切除术的优点、手术指征和合并症 1.1 阴式子宫全切除术的优点无腹部手术切口及疤痕,很少因损伤腹膜而造成粘连、腹膜炎和肠梗阻等;没有术后剧烈的伤口疼痛;恢复快,平均住院时间短;术后残端吸收热、感染和血肿的发生率低。  相似文献   

7.
为寻找新的膀胱再生术 ,采用乙状结肠 (或回肠 )剔除粘膜扩大再生膀胱的方法 ,进行了 1 4条狗的实验研究和 4例患者的临床应用研究。第一批 5条狗全部死亡 ,第二批 9条狗除 1条死亡外 ,余 8条存活。 4例病人均获成功。术后随访 ( 4.5~ 1 2 )年 ,都能自控排尿 ,生活质量明显提高。该法基本符合解剖生理要求 ,不致体内水电紊乱 ,疗效好 ,并发症少 ,是一种较理想的新的膀胱再生术  相似文献   

8.
目的:对筋腹外、筋膜内、半腹膜外筋膜内三种子宫除术进行对比。方法:将210例子宫全切除患按不同术式分为3组,就其平均手术时间,术中出血、损伤、术后病率进行回顾性分析。结果:平均手术时间,筋膜外、筋膜内较半腹膜外筋膜内子宫全切除快半h,半腹膜外筋膜内子宫全切除术中出血稍多,但术后病率明显低于其它两种。结论:三种术式各有优缺点,临床医生应根据病人实际及自己的操作水平,选择不同术式。  相似文献   

9.
分析对比不同切除术治疗子宫肌瘤对患者卵巢功能的影响以及治疗效果的差异性。从医院2020年2月—2021年8月接诊治疗的子宫肌瘤患者中,依据探究设计条件选取58例作为研究对象,其中29例施行全子宫切除术(称作“对照组”),下余29例采用次全子宫切除术(称作“观察组”)。统计分析2组患者术后卵巢功能各项指标变化,对比2组患者并发症发生率、对卵巢功能的影响以及治疗效果。行切除术后2组患者卵巢功能指标均有不同变化,在相同时间段(术后1个月),观察组患者雌激素(E2)、血清卵泡激素(FSH)、促黄体激素(LH)水平均优于对照组,差异有统计学意义(P<0.05);但术前2组患者卵巢功能检查各项指标基本接近,差异不明显(P>0.05);并发症发生率方面,观察组显著低于对照组,差异对比P<0.05。切除术对女性卵巢功能均有影响,只是影响程度有别,相比之下,次全子宫切除治相对影响较小,并发症低,患者预后好、康复快,但就根治效果而言,全子宫切除术应是理想选择。  相似文献   

10.
报告了经尿道电功除膀胱肿瘤(TURBT)42例,共50次,其中T1期41次,T2期7次,T3期2次;术后定期行膀胱镜检查和膀胱灌注噻哌化疗.随访结果:复发2例,再发5例,死亡4例.笔者认为;该手术简便,创伤小,恢复快,住院时间短或不需住院,可保留完整的膀胱,生命质量高.  相似文献   

11.
There are numerous geometric objects stored in the spatial databases. An importance function in a spatial database is that users can browse the geometric objects as a map efficiently. Thus the spatial database should display the geometric objects users concern about swiftly onto the display window. This process includes two operations:retrieve data from database and then draw them onto screen. Accordingly, to improve the efficiency, we should try to reduce time of both retrieving object and displaying them. The former can be achieved with the aid of spatial index such as R-tree, the latter require to simplify the objects. Simplification means that objects are shown with sufficient but not with unnecessary detail which depend on the scale of browse. So the major problem is how to retrieve data at different detail level efficiently. This paper introduces the implementation of a multi-scale index in the spatial database SISP (Spatial Information Shared Platform) which is generalized from R-tree. The difference between the generalization and the R-tree lies on two facets: One is that every node and geometric object in the generalization is assigned with a importance value which denote the importance of them, and every vertex in the objects are assigned with a importance value,too. The importance value can be use to decide which data should be retrieve from disk in a query. The other difference is that geometric objects in the generalization are divided into one or more sub-blocks, and vertexes are total ordered by their importance value. With the help of the generalized R-tree, one can easily retrieve data at different detail levels.Some experiments are performed on real-life data to evaluate the performance of solutions that separately use normal spatial index and multi-scale spatial index. The results show that the solution using multi-scale index in SISP is satisfying.  相似文献   

12.
Language markedness is a common phenomenon in languages, and is reflected from hearing, vision and sense, i.e. the variation in the three aspects such as phonology, morphology and semantics. This paper focuses on the interpretation of markedness in language use following the three perspectives, i.e. pragmatic interpretation, psychological interpretation and cognitive interpretation, with an aim to define the function of markedness.  相似文献   

13.
理论推导与室内实验相结合,建立了低渗透非均质砂岩油藏启动压力梯度确定方法。首先借助油藏流场与电场相似的原理,推导了非均质砂岩油藏启动压力梯度计算公式。其次基于稳定流实验方法,建立了非均质砂岩油藏启动压力梯度测试方法。结果表明:低渗透非均质砂岩油藏的启动压力梯度确定遵循两个等效原则。平面非均质油藏的启动压力梯度等于各级渗透率段的启动压力梯度关于长度的加权平均;纵向非均质油藏的启动压力梯度等于各渗透率层的启动压力梯度关于渗透率与渗流面积乘积的加权平均。研究成果可用于有效指导低渗透非均质砂岩油藏的合理井距确定,促进该类油藏的高效开发。  相似文献   

14.
Future mobile communication systems aim at providing very high data transmission rates, even in high-mobility scenarios such as high-speed wheel-track trains, maglev trains, highway vehicles, airplanes, guided missiles or spacecraft. A particularly important commercial application is the strong and increasing worldwide demand for high- speed broadband wireless communications (up to 574.8 km/ h test speeds or 380 km/h commercial speeds) in railways, providing data, voice and video services for applications such as onboard entertainment services to passengers, train control, train dispatch, train sensor status handling and sur- veillance. In such high-mobility scenarios, there are a number of communication challenges, including fast hand- over, location updating, high-speed channel modeling, estimation and equalization, anti-Doppler spreading tech- niques, fast power control, and dedicated network architec- ture. Because signal transmission in very high-speed scenarios will inevitably experience serious deterioration, it is imperative to develop key broadband mobile communi- cation techniques for such high-speed vehicles.  相似文献   

15.
16.
Instead of following Fock’s expansion,we solve the Schrodinger equation for some quantum mechanical manybody systems such as electrons in atoms and charged excitons in quantum wells in a similar way in hyperspherical coordinates by expanding the wave functions into orthonormal complete basis sets of the hyperspherical hannonics(HHs)of hyperangles and generalized Laguerre polynomials(GLPs)of the hyperradius.This leads the equation to  相似文献   

17.
As an American modern novelist who were famous in the literary world, Hemingway was not a person who always followed the trend but a sharp observer. At the same time, he was a tragedy maestro, he paid great attention on existence, fate and end-result. The dramatis personae's tragedy of his works was an extreme limit by all means tragedy on the meaning of fearless challenge that failed. The beauty of tragedy was not produced on the destruction of life, but now this kind of value was in the impact activity. They performed for the reader about the tragedy on challenging for the limit and the death.  相似文献   

18.
Being the primary media of geographical information and the elementary objects manipulated, almost all of maps adopt the layer-based model to represent geographic information in the existent GIS. However, it is difficult to extend the map represented in layer-based model. Furthermore, in Web-Based GIS, It is slow to transmit the spatial data for map viewing. In this paper, for solving the questions above, we have proposed a new method for representing the spatial data. That is scale-based model. In this model we represent maps in three levels: scale-view, block, and spatial object, and organize the maps in a set of map layers, named Scale-View, which associates some given scales.Lastly, a prototype Web-Based GIS using the proposed spatial data representation is described briefly.  相似文献   

19.
为了有助于提高英文爱好者的个人情操、文化素养和学习兴趣,以及专业人员对英语学习和研究进行多途径的探索,本文通过一些精选诗歌的引证和分析,着重论述了喻类修辞法在英文诗歌中的运用其及效果。  相似文献   

20.
Tennessee Williams is considered as one of the most important American playwrights since World War II.The Glass Menagerie is his first successful drama,which describes a tragic situation of family and means to say that Man is unable to change the miserable life,no matter whatever means he try,This essay focuses on the analysis of the arrangement of the four main characters:Laura.Amanda,Jim and Tom to reveal the theme.Laura is fragile.Amanda is brave.Jim is vital.Tom is sensible.And all of them develop and try the different means to struggle against life,but fail tragically.With the evidence,the paper comes to conclusion naturally that Man is unable to change the miserable life,and he dooms to fail.  相似文献   

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