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常规排泄式膀胱尿道造影术对新生儿单侧多囊性肾发育不良无诊断意义 被引量:1
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作者 Ismaili K. Avni F.E. +1 位作者 Alexander M. 郭战宏 《世界核心医学期刊文摘(儿科学分册)》 2006年第2期21-22,共2页
Objectives: To determine if two successive ultrasound examinations could rule out the presence of clinically significant contralateral anomalies in neonates with multicystic dysplastic kidney (MCDK), thereby avoiding ... Objectives: To determine if two successive ultrasound examinations could rule out the presence of clinically significant contralateral anomalies in neonates with multicystic dysplastic kidney (MCDK), thereby avoiding unnecessary voiding cystourethrography (VCUG). Study design: We followed 76 newborn infants with antenatally discovered MCDK. Two successive neonatal renal ultrasound examinations were performed, one within the first week and one at around 1 month of life. VCUG and isotopic studies were performed in all infants. Results: Urologic anomalies of the contralateral kidney were present in 19 of 76 children (25% ): vesicoureteral reflux (VUR) in 16 (21% ), ureteropelvic junction obstruction in 2 (3% ), and renal duplex kidney in 1 (1% ). Sixty-one infants (80% of total) had normal contralateral urinary tract on the 2 successive neonatal renal ultrasound scans. Among them, 4 of 61 (7% ) infants presented with low-grade VUR on VCUG that had resolved spontaneously before 2 years of age. The sensitivity, specificity, positive predictive value, and negative predictive value of two successive ultrasound scans in the neonatal period to predict contralateral urological anomalies on VCUG were 75% , 95% , 80% , and 93% , respectively. Conclusions: In infants with antenatally diagnosed MCDK, two successive normal neonatal renal ultrasound scans will rule out clinically significant contralateral anomalies, thereby rendering the need for a neonatal VCUG unnecessary. 展开更多
关键词 多囊性肾发育不良 膀胱尿道造影术 新生儿期 诊断意义 排泄 膀胱输尿管逆流 肾盂连接处梗阻 阴性预测值 出生前诊断 单侧
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改良膀胱尿道造影术诊断尿道狭窄 被引量:2
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作者 秦国强 罗欣 +3 位作者 叶旭莹 林宇峰 邹戈 李杰贤 《中华临床医师杂志(电子版)》 CAS 2017年第10期1799-1801,共3页
目的报道一种改良膀胱尿道造影术,并探讨其对尿道狭窄的诊断作用。方法造影前行膀胱穿刺造瘘术,造影时自膀胱造瘘管注入对比剂、使用纱条捆紧尿道龟头部,嘱患者排尿,X线透视下拍摄患者正位片及30°~45°侧位片,之后按照经典膀... 目的报道一种改良膀胱尿道造影术,并探讨其对尿道狭窄的诊断作用。方法造影前行膀胱穿刺造瘘术,造影时自膀胱造瘘管注入对比剂、使用纱条捆紧尿道龟头部,嘱患者排尿,X线透视下拍摄患者正位片及30°~45°侧位片,之后按照经典膀胱尿道造影术再次进行检查,术中进一步确定狭窄部位、长度及狭窄程度。结果共有11例患者参与研究,改良膀胱尿道造影术显示的狭窄长度与经典膀胱尿道造影术及术中确定的狭窄长度差异无统计学意义(P=0.897),但检查时间明显缩短(6 min vs.15.18 min,P<0.001)。结论改良膀胱尿道造影术可充分显示尿道狭窄部位及长度,同时有检查时间短、辐射量小等优点。 展开更多
关键词 改良膀胱尿道造影术 尿道狭窄 诊断
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盆底影像学技术及其价值 被引量:5
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作者 王毅 龚水根 张伟国 《临床放射学杂志》 CSCD 北大核心 2004年第5期441-443,共3页
关键词 盆底影像学技术 排粪造影术 腹膜腔造影术 排泄性膀胱尿道造影术
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小体积前列腺增生的诊断 被引量:1
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作者 张建春 张会清 余沁楠 《新乡医学院学报》 CAS 2003年第3期183-184,共2页
目的 提高小体积前列腺增生的诊断率。方法 对 7例患者的术前症状及尿道造影检查 ,结合术后病理结果进行总结分析。结果 术前诊断明确者 3例 ,术后病理证实者 4例。结论 对肛诊、B超检查前列腺体积不大的患者进行膀胱尿道造影。
关键词 前列腺增生症 诊断 膀胱尿道造影术
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催眠疗法可以减轻儿童创伤性医疗操作的痛苦并缩短操作时间 被引量:1
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作者 Butler L.D. Symons B.K. +1 位作者 Henderson S.L. 王一飞 《世界核心医学期刊文摘(儿科学分册)》 2006年第6期48-50,共3页
Objective. Voiding cystourethrography (VCUG) is a commonly performed radiologic procedure in children that can be both painful and frightening. Given the distress that some children experience during the VCUG and the ... Objective. Voiding cystourethrography (VCUG) is a commonly performed radiologic procedure in children that can be both painful and frightening. Given the distress that some children experience during the VCUG and the need for children to be alert and cooperative during the procedure, finding a psychological intervention that helps children to manage anxiety, distress, and pain is clearly desirable. This study was designed to examine whether relaxation and analgesia facilitated with hypnosis could reduce distress and procedure time for children who undergo this procedure. Methods. Forty-four children who were scheduled for an upcoming VCUG were randomized to receive hypnosis (n = 21) or routine care (n = 23) while undergoing the procedure. The sample consisted of 29 (66%) girls and 15 (34%) boys with a mean age of 7.6 years (SD: 2.5; range: 4-15 years). Ethnicracial backgrounds were 72.7%white, 18.2%Asian, 4.5%Latino, 2.3%black, and 2.3%Filipino. The mean number of previous VCUGs was 2.95 (SD: 2.51; mode: 2; range: 1-15). Potential participants were identified through computerized hospital records of upcoming VCUGs. Parents were contacted by telephone and invited to participate if their child was eligible. To be eligible for the study, the child must have underg one at least 1 previous VCUG, been at least 4 years of age at that time, and experienced distress during that procedure, and both the child and the participating parent had to be English speaking. Each eligible child and parent met with the research assistant (RA) before the day of the scheduled procedure for an initial assessment. Children were queried regarding the degree of crying, fear, and pain that they had experienced during their most recent VCUG. Parents completed a series of parallel questions. Immediately after this assessment, those who were randomized to the hypnosis condition were given a 1-hour training session in self-hypnotic visual imagery by a trained therapist. Parents and children were instructed to practice using the imaginative self-hypnosis procedure several times a day in preparation for the upcoming procedure. The therapist was also present during the procedure to conduct similar exercises with the child. The majority (83%) of those who were randomized to the routine care control group chose to participate in a hospital-provided recreation therapy program (offered as part of routine care). The program includes demonstration of the procedure with dolls, relaxation and breath work training, and assistance during the procedure. On the day of the VCUG, the RA met the family at the clinic before the procedure, and both the child and the parent rated the child’s present level of fearfulness. During the procedure, the RA recorded observational ratings of the child’s emotional tone and behavior and timed the overall procedure and its phases. Immediately after the VCUG, the child was asked how much crying, fear, and pain he or she had experienced during the procedure; the parent rated the child’s experience on the same dimensions and also how traumatic the procedure had been (both generally and compared with their previous one), and the medical staff rated the degree of procedural difficulty. Outcomes included child reports of distress during the procedure, parent reports of how traumatic the present VCUG was compared with the previous one, observer ratings of distress during the procedure, medical staff reports of the difficulty of the procedure overall, and total procedural time. Results. Results indicate significant benefits for the hypnosis group compared with the routine care group in the following 4 areas: (1) parents of children in the hypnosis group compared with those in the routine care group reported that the procedure was significantly less traumatic for their children compared with their previous VCUG procedure; (2) observational ratings of typical distress levels during the procedure were significantly lower for children in the hypnosis condition compared with those in the routine care condition; (3) medical staff reported a significant difference between groups in the overall difficulty of conducting the procedure, with less difficulty reported for the hypnosis group; and (4) total procedural time was significantly shorter by almost 14 minutes for the hypnosis group compared with the routine care group. Moderate to large effect sizes were obtained on each of these 4 outcomes. Conclusions. Hypnotic relaxation may provide a systematic method for improving the overall medical care of childrenwith urinary tract abnormalities and may be beneficial for children who undergo other invasive medical procedures. Because the VCUG is an essential part of the evaluation of urinary tract infections and vesicoureteral reflux in children, lower distress during the procedure may improve patient and family compliance with initial as well as follow-up evaluations. These findings augment the accumulating literature demonstrating the benefits of using hypnosis to reduce distress in the pediatric setting. The present findings are noteworthy in that this study was a controlled, randomized trial conducted in a naturalistic medical setting. In this context, we achieved a convergence of subjective and objective outcomes with moderate to large effect sizes, including those that may have an impact on patient care and procedure cost, that were consistently supportive of the beneficial effects of hypnosis-a noninvasive intervention with minimal risk. The findings, therefore, have immediate implications for pediatric care. Limitations of this study include the lack of participant and staff blindness to the child’s condition assignment, which could have introduced bias into reports. However, the objective procedural time differences between groups were consistent with the other, more subjective outcome findings. The sample was also small and primarily white in ethnicracial makeup, which may have restricted our ability to detect some differences and may limit the generalizability of findings to more representative samples. In addition, the sample comprised children who had already undergone at least 1 VCUG during which they had had difficulty. Consequently, additional research is needed to determine whether hypnosis would be helpful to those who are undergoing their first VCUG. Additional limitations, clinical observations, and directions for future research are also discussed. 展开更多
关键词 儿童疼痛 催眠疗法 痛苦 操作时间 医疗操作 缩短 减轻 放射学检查方法 创伤性 膀胱尿道造影术
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肾脏、输尿管重复畸形的影像学诊断进展 被引量:5
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作者 李占华 王振锋 《医学综述》 2018年第21期4281-4285,共5页
肾脏重复畸形是一种常见的由于胚胎期后肾发育异常、2个输尿管芽进入一个后肾胚基所形成的肾脏畸形改变。输尿管重复畸形亦由相同原因所致,是输尿管先天发育异常中最常见的一种畸形改变。输尿管重复畸形的形成与肾脏重复畸形密切相关且... 肾脏重复畸形是一种常见的由于胚胎期后肾发育异常、2个输尿管芽进入一个后肾胚基所形成的肾脏畸形改变。输尿管重复畸形亦由相同原因所致,是输尿管先天发育异常中最常见的一种畸形改变。输尿管重复畸形的形成与肾脏重复畸形密切相关且多同时发生。随着现代医学影像学技术的发展与进步,对肾脏、输尿管重复畸形复杂形态和结构的认识趋于精准化和立体化,诊断肾脏、输尿管重复畸形的方法呈现多样化,不仅局限于传统的影像学方法,新兴的影像学方法也可以诊断,并各具优劣势。 展开更多
关键词 肾脏重复畸形 输尿管重复畸形 静脉肾盂造影 排泄性膀胱尿道X线造影术 超声检查 计算机断层扫描尿路成像技术 磁共振水成像技术
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经水柱法简易膀胱容量-压力测定技术测定的膀胱安全容量与脊髓损伤合并神经源性膀胱患者输尿管反流的关系研究 被引量:7
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作者 蒋晓敏 纪婕 +4 位作者 钱雪 杨玲 张艳 汤燕 周莉 《实用心脑肺血管病杂志》 2020年第12期104-108,共5页
背景脊髓损伤(SCI)患者易并发神经源性膀胱,而简易膀胱容量-压力测定技术因操作简便、易行、经济实用及可重复性等优势而广泛用于评估SCI患者膀胱功能。目的分析经水柱法简易膀胱容量-压力测定技术测定的膀胱安全容量与SCI合并神经源性... 背景脊髓损伤(SCI)患者易并发神经源性膀胱,而简易膀胱容量-压力测定技术因操作简便、易行、经济实用及可重复性等优势而广泛用于评估SCI患者膀胱功能。目的分析经水柱法简易膀胱容量-压力测定技术测定的膀胱安全容量与SCI合并神经源性膀胱患者输尿管反流的关系。方法选取2018年5月—2019年7月江苏省人民医院康复医学科、常州市德安医院康复中心收治的SCI合并神经源性膀胱患者46例,采用水柱法简易膀胱容量-压力测定技术测定患者膀胱安全容量,并进一步通过膀胱尿道造影术观察患者是否发生输尿管反流。收集患者的性别、年龄、损伤平面、美国脊髓损伤协会(ASIA)分级、最大膀胱压力、灌注方式、膀胱安全容量及漏尿/自排发生情况,并采用单因素及多因素Logistic回归分析探讨SCI合并神经源性膀胱患者发生输尿管反流的影响因素。结果膀胱尿道造影术检查结果显示,在46例患者中,发生输尿管反流13例(28.3%)。多因素Logistic回归分析结果显示,ASIA分级A级(完全性脊髓损伤)〔OR=32.753,95%CI(1.332,805.642)〕、膀胱安全容量<300 ml〔OR=15.943,95%CI(1.707,148.919)〕是SCI合并神经源性膀胱患者发生输尿管反流的独立危险因素(P<0.05)。结论ASIA分级A级(完全性脊髓损伤)、膀胱安全容量<300 ml是SCI合并神经源性膀胱患者发生输尿管反流的独立危险因素。 展开更多
关键词 脊髓损伤 膀胱 神经源性 膀胱尿道造影术 膀胱容量-压力测定技术
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