Objective: To explore the comparative observation on nursing effect of nursing intervention and routine nursing in patients with renal calculi and gastric ulcer and the impacts on epidermal growth factor. Methods: A t...Objective: To explore the comparative observation on nursing effect of nursing intervention and routine nursing in patients with renal calculi and gastric ulcer and the impacts on epidermal growth factor. Methods: A total of 72 patients with renal calculi and gastric ulcer were selected and treated in our hospital from January 2018 to December 2018. They were divided into the observation group and the control group, 36 for each. Comprehensive nursing intervention was implemented in the observation group, whereas routine nursing was implemented in the control group. The level of epidermal growth factor, nursing satisfaction, renal calculi recurrence rate, average hospital stay and postoperative blood loss were compared between the two groups after nursing. Results: There was no significant difference in the level of epidermal growth factor between the two groups before nursing (P > 0.05), while after nursing, the level in the observation group was higher compared with the control group, and the difference between the two groups was significant (P Conclusion: With regard to patients with renal calculi and gastric ulcer, comprehensive nursing intervention can improve nursing satisfaction and quality of patients’ lives, reduce calculi recurrence rate, and increase the level of epidermal growth factor, which has clinical application value.展开更多
Complex renal calculi remain to be a challenge for the treating urologist due to sheer bulk and the technicalities involved.Percutaneous nephrolithotomy(PCNL)remains the treatment modality of choice in dealing with th...Complex renal calculi remain to be a challenge for the treating urologist due to sheer bulk and the technicalities involved.Percutaneous nephrolithotomy(PCNL)remains the treatment modality of choice in dealing with these large and complex stones.The limiting factor in their treatment continues to be the need for using additional tracts or the use of flexible nephroscopy for complete stone clearance.This systematic review focuses on the need for multi-tract PCNL for complex renal calculi.The literature review was performed using PubMed database using the keywords“multiple tract PCNL”or“multiperc”.We identified original articles published on the usage of multiple tracts for stone clearance in renal calculi between January 2000 to October 2018,and the search was restricted to available literature in English language only.Ten studies with n>20 were included for the final analysis.We analyzed the technical efficacy with respect to the number of tracts and stages that were required for stone clearance,outcomes and complications,especially,procedural bleeding and post-procedure infective complications of multiple-tract PCNL for large burden renal stones.Multiperc is found to be safe,feasible and effective for the management of large burden complex renal calculi with respect to stone clearance and morbidity associated with the procedure.It is cost effective and complete stone clearance as a single procedure is higher in comparison to flexible ureteroscopy and shockwave lithotripsy.展开更多
INTRODUCTION The presentation of cardiogenic shock （CS） is usually straightforward, and includes hypotension, absence of hypovolemia, and clinical signs of poor tissue perfusion such as oliguria, cyanosis, cool ext...INTRODUCTION The presentation of cardiogenic shock （CS） is usually straightforward, and includes hypotension, absence of hypovolemia, and clinical signs of poor tissue perfusion such as oliguria, cyanosis, cool extremities and altered mentation. The most common etiology of CS is acute myocardial infarction, Here, we report a case of a 42-year-old male who presented with right flank pain, nausea and vomiting initially thought to be nephrolithiasis, which he had a history of but was ultimately diagnosed with CS due to a type II myocardial infarction. This case illustrates the importance of having a broad differential diagnosis especially when a patient＇s vital signs take a drastic turn since this patient initially resembled someone with nephrolithiasis.展开更多
Objective:To design a device to increase the accuracy of the targeting process and reduce the radiation exposure to both the patients and the medical staff.Methods:We analyzed the inherent problem and designed the Ext...Objective:To design a device to increase the accuracy of the targeting process and reduce the radiation exposure to both the patients and the medical staff.Methods:We analyzed the inherent problem and designed the External Assist Targeting Device(EATD)to assist in the alignment of needle targeting on the desired renal calyx under fluoroscopic guidance.The EATD was designed to allow rapid and precise access to calyces at all angles,with a simple two-step puncture protocol developed for puncturing a target renal calyx.We then tested the device in a pilot human trial with four patients.Results:In experiments with phantom models,the time for successful targeting was reduced by 31%using the device.The mean fluoroscopic time was reduced by 40%.In initial human trial,the puncture time was shortened by 66%and the radiation dose was decreased by 65%compared to free-hand technique.No complication was observed during the trial.Conclusion:The EATD was found to be cost effective,portable,simple to set up,and safe to operate for assisting in the percutaneous nephrolithotomy procedures.Our preliminary tests showed high degree of accuracy in gaining precise access to a targeted renal calyx with much shorter time and lesser radiation dose.The EATD also has the potential to be used to access other organs with precision under fluoroscopic guidance.展开更多
<strong>Aim: </strong>To evaluate the efficacy of extracorporeal lithotripsy in the management of renal and ureteric calculi in a urology center in Douala, Cameroon. <strong>Materials and Methods:<...<strong>Aim: </strong>To evaluate the efficacy of extracorporeal lithotripsy in the management of renal and ureteric calculi in a urology center in Douala, Cameroon. <strong>Materials and Methods:</strong> This is a retrospective study carried out over six years, between January 2014 and December 2020. All the patients were treated using a Direx Integra lithotripter, with the number of shockwaves ranging from 1200 to 3500, without anaesthesia and were discharged a few hours after the procedure on the same day. In a majority (63.75%) of the cases, the calculi were incidental findings. A Double-J stent was indicated in two patients and preceded extracorporeal lithotripsy because of renal colic and signs of urinary tract infection. <strong>Results:</strong> We recruited a total of 122 patients with a mean age of 42.19 ± 13.08. We had 65 (53.3%) males and all patients had at least one calculus confirmed by CT scan with a mean size of 13.84 ± 4.17 mm, 85 (69.7%) patients became completely stone-free after a maximum of four sessions of extracorporeal lithotripsy (ESWL). 21 (17.2%) patients had intermediate results, being asymptomatic and/or having less than three residual fragments that measured less than 4 mm. The failure rate was 13.9%, with 17 patients still having more than three fragments measuring more than 4 mm after 4 ESWL sessions. 1 (0.8%) had septic shock as a post ESWL complication while 6 (4.9%) benefitted from a complimentary medical and/or surgical treatment (double J stent placement). <strong>Conclusion:</strong> The management of renal and ureteral calculi through extracorporeal lithotripsy in adults seems to be particularly effective for renal calculi measuring less than 20 mm and ureteral calculi measuring less than 15 mm. Extracorporeal lithotripsy, which can be performed on an outpatient basis (and without anaesthesia) is associated with minimal complications, and remains the option of choice for most upper urinary tract calculi.展开更多
目的分析经皮肾镜联合输尿管软镜取石术(RIRS)治疗输尿管结石合并同侧肾结石的应用优势。方法选取2020年1月—2023年1月150例输尿管结石合并同侧肾结石患者,随机分为2组各75例,肾镜组行经皮肾镜取石术(PCNL),双镜组采用PCNL联合RIRS。比...目的分析经皮肾镜联合输尿管软镜取石术(RIRS)治疗输尿管结石合并同侧肾结石的应用优势。方法选取2020年1月—2023年1月150例输尿管结石合并同侧肾结石患者,随机分为2组各75例,肾镜组行经皮肾镜取石术(PCNL),双镜组采用PCNL联合RIRS。比较2组围术期指标、术后并发症发生率、术后视觉模拟评分法(VAS)评分及尿液代谢异常发生率,术前及术后神经源炎症反应指标[神经生长因子(NGF)、前列腺素E_(2)(PGE_(2))、C反应蛋白(CRP)、P物质(SP)]、肾功能指标[血清肌酐(Cr)、尿素(UREA)、肾损伤分子-1(KIM-1)、中性粒细胞明胶酶相关载脂蛋白(NGAL)]。结果双镜组手术时间、住院天数短于肾镜组,术中出血量低于肾镜组,术后3 d、术后1个月结石清除率高于肾镜组(P<0.01)。双镜组术后并发症发生率为2.67%(2/75)低于肾镜组的12.00%(9/75)(P<0.05)。双镜组术后6、12、24、48 h VAS评分低于肾镜组(P<0.05)。双镜组术后24、48 h NGF、PGE_(2)、CRP及SP均低于肾镜组(P<0.05)。术后1周、2周双镜组Cr、UREA、KIM-1及NGAL低于肾镜组(P<0.05)。双镜组术后2周高尿酸尿症、高草酸尿症、低枸橼酸尿症、高钙尿症及低镁尿症发生率均较肾镜组低(P<0.05)。结论PCNL联合RIRS治疗输尿管结石合并同侧肾结石患者可优化手术操作,抑制神经源炎症反应,减轻术后疼痛与肾功能损伤,且能提高结石清除率,降低并发症风险,改善尿液代谢状态。展开更多
文摘Objective: To explore the comparative observation on nursing effect of nursing intervention and routine nursing in patients with renal calculi and gastric ulcer and the impacts on epidermal growth factor. Methods: A total of 72 patients with renal calculi and gastric ulcer were selected and treated in our hospital from January 2018 to December 2018. They were divided into the observation group and the control group, 36 for each. Comprehensive nursing intervention was implemented in the observation group, whereas routine nursing was implemented in the control group. The level of epidermal growth factor, nursing satisfaction, renal calculi recurrence rate, average hospital stay and postoperative blood loss were compared between the two groups after nursing. Results: There was no significant difference in the level of epidermal growth factor between the two groups before nursing (P > 0.05), while after nursing, the level in the observation group was higher compared with the control group, and the difference between the two groups was significant (P Conclusion: With regard to patients with renal calculi and gastric ulcer, comprehensive nursing intervention can improve nursing satisfaction and quality of patients’ lives, reduce calculi recurrence rate, and increase the level of epidermal growth factor, which has clinical application value.
文摘Complex renal calculi remain to be a challenge for the treating urologist due to sheer bulk and the technicalities involved.Percutaneous nephrolithotomy(PCNL)remains the treatment modality of choice in dealing with these large and complex stones.The limiting factor in their treatment continues to be the need for using additional tracts or the use of flexible nephroscopy for complete stone clearance.This systematic review focuses on the need for multi-tract PCNL for complex renal calculi.The literature review was performed using PubMed database using the keywords“multiple tract PCNL”or“multiperc”.We identified original articles published on the usage of multiple tracts for stone clearance in renal calculi between January 2000 to October 2018,and the search was restricted to available literature in English language only.Ten studies with n>20 were included for the final analysis.We analyzed the technical efficacy with respect to the number of tracts and stages that were required for stone clearance,outcomes and complications,especially,procedural bleeding and post-procedure infective complications of multiple-tract PCNL for large burden renal stones.Multiperc is found to be safe,feasible and effective for the management of large burden complex renal calculi with respect to stone clearance and morbidity associated with the procedure.It is cost effective and complete stone clearance as a single procedure is higher in comparison to flexible ureteroscopy and shockwave lithotripsy.
文摘INTRODUCTION The presentation of cardiogenic shock （CS） is usually straightforward, and includes hypotension, absence of hypovolemia, and clinical signs of poor tissue perfusion such as oliguria, cyanosis, cool extremities and altered mentation. The most common etiology of CS is acute myocardial infarction, Here, we report a case of a 42-year-old male who presented with right flank pain, nausea and vomiting initially thought to be nephrolithiasis, which he had a history of but was ultimately diagnosed with CS due to a type II myocardial infarction. This case illustrates the importance of having a broad differential diagnosis especially when a patient＇s vital signs take a drastic turn since this patient initially resembled someone with nephrolithiasis.
文摘Objective:To design a device to increase the accuracy of the targeting process and reduce the radiation exposure to both the patients and the medical staff.Methods:We analyzed the inherent problem and designed the External Assist Targeting Device(EATD)to assist in the alignment of needle targeting on the desired renal calyx under fluoroscopic guidance.The EATD was designed to allow rapid and precise access to calyces at all angles,with a simple two-step puncture protocol developed for puncturing a target renal calyx.We then tested the device in a pilot human trial with four patients.Results:In experiments with phantom models,the time for successful targeting was reduced by 31%using the device.The mean fluoroscopic time was reduced by 40%.In initial human trial,the puncture time was shortened by 66%and the radiation dose was decreased by 65%compared to free-hand technique.No complication was observed during the trial.Conclusion:The EATD was found to be cost effective,portable,simple to set up,and safe to operate for assisting in the percutaneous nephrolithotomy procedures.Our preliminary tests showed high degree of accuracy in gaining precise access to a targeted renal calyx with much shorter time and lesser radiation dose.The EATD also has the potential to be used to access other organs with precision under fluoroscopic guidance.
文摘<strong>Aim: </strong>To evaluate the efficacy of extracorporeal lithotripsy in the management of renal and ureteric calculi in a urology center in Douala, Cameroon. <strong>Materials and Methods:</strong> This is a retrospective study carried out over six years, between January 2014 and December 2020. All the patients were treated using a Direx Integra lithotripter, with the number of shockwaves ranging from 1200 to 3500, without anaesthesia and were discharged a few hours after the procedure on the same day. In a majority (63.75%) of the cases, the calculi were incidental findings. A Double-J stent was indicated in two patients and preceded extracorporeal lithotripsy because of renal colic and signs of urinary tract infection. <strong>Results:</strong> We recruited a total of 122 patients with a mean age of 42.19 ± 13.08. We had 65 (53.3%) males and all patients had at least one calculus confirmed by CT scan with a mean size of 13.84 ± 4.17 mm, 85 (69.7%) patients became completely stone-free after a maximum of four sessions of extracorporeal lithotripsy (ESWL). 21 (17.2%) patients had intermediate results, being asymptomatic and/or having less than three residual fragments that measured less than 4 mm. The failure rate was 13.9%, with 17 patients still having more than three fragments measuring more than 4 mm after 4 ESWL sessions. 1 (0.8%) had septic shock as a post ESWL complication while 6 (4.9%) benefitted from a complimentary medical and/or surgical treatment (double J stent placement). <strong>Conclusion:</strong> The management of renal and ureteral calculi through extracorporeal lithotripsy in adults seems to be particularly effective for renal calculi measuring less than 20 mm and ureteral calculi measuring less than 15 mm. Extracorporeal lithotripsy, which can be performed on an outpatient basis (and without anaesthesia) is associated with minimal complications, and remains the option of choice for most upper urinary tract calculi.
文摘目的分析经皮肾镜联合输尿管软镜取石术(RIRS)治疗输尿管结石合并同侧肾结石的应用优势。方法选取2020年1月—2023年1月150例输尿管结石合并同侧肾结石患者,随机分为2组各75例,肾镜组行经皮肾镜取石术(PCNL),双镜组采用PCNL联合RIRS。比较2组围术期指标、术后并发症发生率、术后视觉模拟评分法(VAS)评分及尿液代谢异常发生率,术前及术后神经源炎症反应指标[神经生长因子(NGF)、前列腺素E_(2)(PGE_(2))、C反应蛋白(CRP)、P物质(SP)]、肾功能指标[血清肌酐(Cr)、尿素(UREA)、肾损伤分子-1(KIM-1)、中性粒细胞明胶酶相关载脂蛋白(NGAL)]。结果双镜组手术时间、住院天数短于肾镜组,术中出血量低于肾镜组,术后3 d、术后1个月结石清除率高于肾镜组(P<0.01)。双镜组术后并发症发生率为2.67%(2/75)低于肾镜组的12.00%(9/75)(P<0.05)。双镜组术后6、12、24、48 h VAS评分低于肾镜组(P<0.05)。双镜组术后24、48 h NGF、PGE_(2)、CRP及SP均低于肾镜组(P<0.05)。术后1周、2周双镜组Cr、UREA、KIM-1及NGAL低于肾镜组(P<0.05)。双镜组术后2周高尿酸尿症、高草酸尿症、低枸橼酸尿症、高钙尿症及低镁尿症发生率均较肾镜组低(P<0.05)。结论PCNL联合RIRS治疗输尿管结石合并同侧肾结石患者可优化手术操作,抑制神经源炎症反应,减轻术后疼痛与肾功能损伤,且能提高结石清除率,降低并发症风险,改善尿液代谢状态。
