急性胰腺炎患者应用三腔营养管与螺旋胃管给予肠内营养的效果观察
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Preliminary experience of transurethral enucleation with 1 470 nm diode laser for benign prostatic hyperplastia (56 cases)
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    目的   探讨经尿道1 470 nm半导体激光前列腺剜除术(DiLEP)治疗良性前列腺增生症(BPH)的方法和疗效。方法  对2015年4月-2015年10月1 470 nm DiLEP剜除的56例BPH患者临床资料进行回顾性分析。在精阜外上方5点或7点于外括约肌近侧处用镜鞘逆推侧叶增生腺体或用激光点切加镜鞘逆推的方式找到外科包膜平面,用激光进行汽化和止血,剜除中叶、左侧叶、右侧叶,并推入膀胱腔,组织粉碎器粉碎剜除腺体。结果   剜除腺体时间15~65 min,组织粉碎时间5~37min,切除腺体组织29~152 g。术中无电切综合征、直肠穿孔和膀胱穿孔病例,无输血病例。短期尿失禁5例。术后3个月,国际前列腺症状评分(IPSS)、生活质量评分(QOL)、最大尿流率(Qmax)均较术前明显改善(P <0.01)。结论  1 470 nm半导体激光具有良好的组织汽化和止血效果,1 470 nm DiLEP+组织粉碎,最大限度地切净了增生腺体,止血更加彻底,还节省了手术时间。

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    Objective To evaluate the surgical effects and methods of transurethral enucleation with 1470 nm diode laser for treatment of benign prostatic hyperplastia (BPH). Methods Clinical data of 56 cases with benign prostatic hyperplastia treated by transurethral enucleation with 1 470 nm diode laser from April 2015 to October 2015 were analyzed retrospectively. The surgical capsule was searched by way of endoscopic sheath (or adding vaporisation with 1 470 nm laser) pushing off the lateral lobe at 5 or 7 o'clock above the verumontanum. The adhesive prostatic tissue between gland and surgical capsule or between each lobe was ablated and stanched by 1 470 nm diode laser, then the middle lobe, left lateral lobe, and right lateral lobe were enucleated and pushed into bladder. The gland enucleated was performed by the morcellator system. Results The 56 cases underwent the procedure uneventfully. Enucleating gland time was 15~65 min with, morcellating tissue time 5~37 min, the weight of resected tissue was 29~152 g. There were no cases of transurethral resection syndrome, intestinal perforation, bladder perforation or transfusion. 5 cases had short term (≤4 w) urinary incontinence. There was significant difference of IPSS, QOL, Qmax before and after treatment (P < 0.01) in 3 months postoperatively. Conclusions 1 470 nm diode laser has the benefits of tissue ablation haemostasis, 1 470 nm DiLEP+tissue morcellating can not only resect the hyperplastic gland as complete as possible, stop bleeding much more thorough, but also save the operation time.

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李娜,赵春光,张桂香.急性胰腺炎患者应用三腔营养管与螺旋胃管给予肠内营养的效果观察[J].中国内镜杂志,2016,22(5):30-34

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  • 收稿日期:2016-01-11
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  • 在线发布日期: 2016-05-31
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