目的 比较腹腔镜前列腺癌根治术(laparoscopic radical prostatectomy,LRP)后发生尿失禁(postprostatectomy incontinence,PPI)与没有发生PPI的患者在尿动力学上的差异,为临床诊疗提供尿动力学依据。方法 对87例LRP术后的患者按术后是否并发PPI分成两组,行尿动力学检查后进行比较分析。结果 PPI组患者术中保留一侧或双侧神经血管束的比例少于非PPI组,且最大尿道闭合压(maximum urethral closure pressure,MUCP)、最大膀胱容量(maximum cystometric capacity,MCC)、排尿时膀胱开口压力和最大逼尿肌压均较非PPI组低。而腹压漏尿点压试验阳性与临床上是否漏尿并不完全相符。多变量回归分析表明,术中保留神经血管束、MUCP和MCC是PPI的相关因素。结论 PPI与LRP术中保留神经血管束、MUCP和MCC独立相关。尿动力学检查能为更精准有效指导临床治疗提供依据。

Objective To compare the urodynamic parameters in men with and without postprostatectomy incontinence(PPI) after laparoscopic radical prostatectomy(LRP). Methods 87 patients of prostatic carcinoma after LRP were divided into two groups according to have PPI or not. After urodynamic study, the data were collected to find the difference. Results Overall, the proportion of preservation of unilateral or bilateral neurovascular bundles(NVBs) during LRP was lower in PPI group than that in non-PPI group. Besides, the patients in PPI group had lower maximum urethral closure pressure (P=0.04), maximum cystometric capacity (P=0.04), detrusor pressure during opening (P=0.02)and maximum detrusor pressure (P<0.001), as compared with those in non-PPI group. In the multivariate logistic regression, the preservation of unilateral or bilateral NVBs, MUCP and MCC were identified as the related factor with PPI. Conclusion PPI is significantly associated with the preservation of unilateral or bilateral NVBs, MUCP and MCC. Urodynamic test can be used to make the treatment for PPI. It will be more accurate and effective in clinical practice.

目的 探讨雷公藤甲素防治大鼠青光眼术后滤过泡纤维化的可行性。方法 选取Wistar大鼠100只分为两组,对照组和观察组各50例。采用房水释放联合激光房角光凝法建立青光眼大鼠模型,然后所有大鼠均进行青光眼手术。手术后,观察组大鼠使用雷公藤甲素预防治疗青光眼术后滤过泡纤维化,对照组大鼠使用5-氟尿嘧啶预防治疗青光眼术后滤过泡纤维化。观察比较防治滤过泡纤维化效果。结果 观察组大鼠的眼压在手术后第1天与对照组相比无差异(P＞0.05),在第6天、14天低于对照组(P＜0.05),观察组大鼠滤过泡面积在手术后第1天、6天、14天均小于对照组大鼠(P＜0.05);观察组大鼠的治疗后滤过泡分型Ⅰ型和Ⅱ型均优于对照组,Ⅲ型和Ⅳ型均低于对照组(P＜0.05);观察组术后不良反应发生率为12.16%,低于对照组22.86%(P＞0.05)。结论 雷公藤甲素防治大鼠青光眼术后滤过泡纤维化效果明显,且安全性较高,值得临床广泛运用推广。

Objective To investigate the feasibility of triptolide in prevention and cure rats glaucoma surgery fibrosis. Methods 100 cases of Wistar rats were divided into two groups, with 50 cases in the control group and the observation group.Glaucoma rat model were built by aqueous release combined with laser photocoagulation, and all rats underwent glaucoma surgery. After surgery, the rats in the observation group were observed their triptolide preventive treatment in glaucoma surgery fibrosis, the control rats were observed their 5-fluorouracil preventive treatment in glaucoma surgery fibrosis.The effects of prevention and treatment of bleb fibrosis were compared. Results The intraocular pressure of rats in observation group in the first day after surgery compared with the control group has no significant difference (P>0.05), on the 6th、 14th day it was lower than the control group rats(P<0.05). Filtration area in the observation group on first, 6th day, 14th days after surgery, was less than the control rats(P<0.05); In the observation group, the type Ⅰ and type Ⅱ of filtering bleb were better than those of the control group, the type Ⅲ and type Ⅳ were lower than those of the control group (P<0.05);The adverse reaction rate was 12.16% in observation group, it was lower than the control group 22.86% (P<0.05). Conclusion Triptolide in prevention and cure of rats glaucoma surgery fibrosis is obvious, and high security. It is worthy of promotion.

目的 总结分析青光眼术后前房形成延缓的原因与处理措施。方法 选取2010年12月—2013年12月在我院行青光眼滤过术的84例患者(112眼),回顾性分析术后发生浅前房的原因及相应处理措施。结果 术后出现浅前房为26眼,占23.2%;其中高滤过泡引流过畅18眼(69.2%),结膜伤口渗漏5眼(19.2%),脉络膜脱离2眼(7.6%),恶性青光眼1眼(3.8%),大多数浅前房均经保守治疗恢复,1例需行再次手术。结论 青光眼术后前房延缓形成发生率较高,主要原因是脉络膜脱离、滤过作用强、结膜伤口渗漏、恶性青光眼等,及时发现并采取相应处理是浅前房恢复正常的关键。

目的 探讨综合中医护理措施在无痛人工流产术后调复中的效果。方法 将100例无痛人流病人随机分为观察组和对照组各50例,对照组手术前后予常规护理。观察组在对照组的基础上,采取综合中医护理措施。结果 观察组术后阴道出血量、出血时间、腹痛持续时间等少于对照组,月经按时复潮率高于对照组(P<0.05)。结论 综合中医护理干预对无痛人工流产病人具有良好的调复作用,可以有效地提高患者术后舒适度,促进患者早日康复,值得临床推广应用。

目的 对比观察海桐皮汤熏洗应用于膝骨性关节炎关节镜清理术后的临床疗效。方法 于2012年1月—2014年1月,从我院骨科住院患者中选取因膝骨性关节炎行关节镜清理术病例60例,随机分为两组,对照组术后给予常规康复治疗措施,治疗组在常规康复治疗的基础上于术后2周拆线后配合海桐皮汤熏洗治疗,治疗周期4周。对比两组患者治疗前后的WOMAC评分,分析其疗效差异。结果 两组患者WOMAC评分术后2周比较无差异P＞0.5;治疗4周后,两组患者较术后2周有所降低(P＜0.5),但治疗组疗效优于对照组(P＜0.5)。结论 海桐皮汤熏洗疗法可改善膝骨性关节炎关节镜清理术后膝关节功能,操作简便,成本低廉,无副作用,值得临床推广应用。

目的 通过分析6例阴茎折断患者术后主要护理的要点,以提高阴茎折断患者术后的护理水平。方法 回顾性分析阴茎折断患者术后护理。对6例术后患者进行心理辅导,病情观察,正确体位的摆放,出院指导等护理干预。结果 6例患者在明确诊断后均急诊行阴茎血肿清除加白膜修补术,其中1例另外行尿道修补术。住院时间10~15天,平均9天,住院期间伤口愈合良好,无出现术后并发症。术后随访2~12个月,平均8个月。5例患者阴茎外观正常,性生活满意,无阴茎弯曲、痛性勃起、尿道狭窄等并发症。1例阴茎外观有轻度弯曲,但不影响性生活。结论 目前阴茎折断治疗的方法主要是手术治疗,护理人员帮助患者消除手术顾虑保持良好心态积极面对手术是手术成功的关键, 重视术后局部的护理以及病情观察,预防并发症的发生;指导患者积极进行功能锻炼和配合治疗,促进患者恢复。

Objective To summarize the experience of nursing intervention in diagnosis and treatment of penile fracture, and to improve the level of nursing of penile fracture. Methods The clinical data of 6 cases with penile fracture were retrospectively analyzed, the nursing intervention mode and significance in diagnosis and treatment were evaluated. 6 patients have emergency surgery after the diagnosis, and one patient urethra accepted surgical repair. Results The hospitalized period varied from 10 to15 days(average 9 days), and the patients were followed up for 2~12 months(average 8 months). 5 patients showed a very good outcome without complications, such as the penile deviation, pain, ED and urethral stricture, and 1 patient with penile deviation did not impede sexual activity. Conclusion Prompt surgical intervention of penile fracture showed a satisfied long-term outcome and get better therapeutic effects. Nursing intervention is important to improve the success rate of surgical, and targeted nursing after surgical can reduce complications.

目的 调查I-IIa期宫颈鳞状细胞癌患者术后随诊和复发情况,并探索随诊和复发的相关因素。方法 分析2011年1月—2012年6月中山市妇幼保健院收治的128例宫颈鳞状细胞癌患者的临床资料,分析他们的术后随诊情况及其影响因素。将有液基薄层细胞学(TCT)及盆腔检查者视为有效随诊的患者,分析肿瘤复发情况及其影响因素。结果 128例患者中,有效随诊104例(占总人数的81.25%)。年龄组越小,随诊率越高(P=0.034);城市患者较农村患者,随诊率高(P=0.028);文化程度越高,随诊率越高(P=0.028);职业为公务员、教师、公司职员或自由职业、个体,随诊率比职业为家庭妇女和工人更高(P=0.030)。在104例随诊者中,2年复发8例(占7.7%)。临床分期较晚,肿瘤直径>4cm,病理类型,脉管内瘤栓阳性,淋巴结转移阳性是影响患者2年复发的危险因素(P<0.05)。结论 临床分期,肿瘤直径,脉管内瘤栓阳性,淋巴结转移等临床病理特征与患者复发密切相关。应针对宫颈癌患者社会人口学特点制定措施,提高随诊率。

Objective To investigate the follow-up rate after surgical treatment and the recurrence rate among patients with cervical squamous cell carcinoma in I-IIa stage, and identify associated factors. Methods The clinical data of 128 cases of cervical squamous cell carcinoma from January 2011 to June 2012 in Zhongshan maternal and child health hospital was collected. Follow up record of these cases was analyzed and factors associated with follow up were identified. Patients having taken thinprep liquid-based cytology test (TCT) and pelvioscopy were treated as cases being followed effectively, and their recurrence and associated factors were analyzed. Results Among the 128 patients, 104(81.25%) were effectively followed. Patients with younger age(P=0.034), living in city (P=0.028), with higher education level(P=0.028) had higher follow-up rate. Civil servants, teachers and freelancers had higher follow-up rate than housewives and workers (P=0.030).Eight of the 104 effectively followed cases recurred within two years after surgery, accounting for 7.7%. The associated factors of recurrence included clinical stage, tumor diameter, larger than 4cm, the depth of myometrial invasion, deeper than 2/3, vascular tumor thrombus positive, and lymph node metastasis positive (P<0.05). Conclusion Clinical stage, tumor size, vascular tumor thrombus positive, lymph node metastasis positive were associated with recurrence. Tailored strategies should be developed to improve the follow up rate based on the social and demographic characteristics of patients.

目的 探讨优质护理对于提高白内障手术患者术后恢复的影响。方法 选取本院自2014年1月—2014年6月收治的56例实施白内障手术的患者,将患者平均分配为对照组和实验组,对照组实行常规护理服务,观察组实施优质护理服务,建立完善的护理人员工作机制,提高护理人员素质;加强对患者的健康教育和心理护理,及时给患者进行检查。统计两组患者的治疗效果,分析优质护理服务的效果。结果 在术后接受优质护理服务的实验组患者的恢复效果好于对照组患者,术后的不良事件发生率较对照组低,患者的疼痛程度低,二组数据差异具有统计学意义。结论 给白内障术后的患者以优质护理服务能提高护理质量,缩短患者恢复时间,提高患者恢复效果。

目的 通过对比观察常规西药和当归芍药散加减治疗哺乳期子宫上环术后子宫异常出血的临床效果,探讨其安全有效的治疗方法。方法 选取在哺乳期行子宫上环术的妇女96例,随机分为两组,西药组采用常规西药治疗,中药组采用当归芍药散加减方剂治疗。观察术前、术后及治疗后月经量的变化,并对实验结果进行分析和评价。结果 所有96例患者在行子宫上环术后均出现月经量较术前增多(P<0.05),在经过药物治疗后,所有患者月经量较治疗前减少(P<0.05),并治疗后月经量与术前月经量相比波动较小,差异无统计学意义(P>0.05)。中药组与西药组比较,治疗后月经量稍增多,差异无统计学意义(P>0.05)。西药组有5例患者出现头痛、头晕、恶心、呕吐等不适,对症处理或减量后好转,中药组无不良反应病例。结论 西药及中药治疗哺乳期子宫上环术后子宫异常出血效果相当,当归芍药散加减方剂副作用小,具有较高的可靠性和安全性,值得借鉴与推广。

目的 探讨群组管理对老年前列腺术后患者下肢活动依从性的效果。方法 将60例患者分为干预组和对照组,对照组按常规护理,干预组实施1周的群组管理活动。结果 干预后干预组患者对预防DVT发生的知晓度、进行下肢主动活动的依从性高于对照组,双下肢皮肤温度、颜色、胀痛等改变显著小于对照组,比较差异均有统计学意义(P＜ 0. 01)。结论 群组管理是一种有效的管理模式,可增强患者的自我效能,提高患者下肢活动的依从性,达到预防DVT发生的作用。

Objective To explore the influence of group management on compliance of lower extremities of elderly patients who underwent prostatectomy. Methods 60 patients were divided into the intervention group and the control group. While the control group was accepted normal nursing, the intervention group was accepted one-week group management. Results The intervention group performed better than the control group in awareness on the prevention of DVT and compliance of activities of lower extremities, and experienced less changes than the control group in skin temperatures, colors and ache of both lower extremities. These changes had statistical significant (P＜0.01). Conclusion Group management is an effective management mode, and improves parents' self-efficacy and compliance of lower extremities, is helping prevent DVT.