目的：总结采用自体肾移植术治疗长段输尿管缺损的临床疗效和体会。方法对10例输尿管中上段结石患者，在经输尿管硬镜钬激光碎石时出现长段输尿管黏膜袖套状剥脱或全层撕脱，内镜下放置双 J 管失败，无法行输尿管端端吻合或再植，于损...目的：总结采用自体肾移植术治疗长段输尿管缺损的临床疗效和体会。方法对10例输尿管中上段结石患者，在经输尿管硬镜钬激光碎石时出现长段输尿管黏膜袖套状剥脱或全层撕脱，内镜下放置双 J 管失败，无法行输尿管端端吻合或再植，于损伤发生2 h 至9 d 后行自体肾移植术。结果1例术前肾功能严重减退患者术后7 d 出现移植肾栓塞，其余9例随访5～75个月，移植肾血流灌注良好，肾功能维持正常水平；1例术后4个月出现膀胱吻合口狭窄致自体移植肾中度积水，给予微创经皮肾穿刺造瘘引流；尿路感染1例，经抗感染治疗后好转，未见复发。结论针对医源性长段输尿管撕脱伤患者，及时施行自体肾移植可以有效恢复尿路完整性并保持肾功能，且并发症发生率低。展开更多
Recent developments in synthetic bone grafting materials and adjuvant therapeutic agents have opened the door to the regenerative reconstruction of critical-size long bone segmental defects resulting from trauma,osteo...Recent developments in synthetic bone grafting materials and adjuvant therapeutic agents have opened the door to the regenerative reconstruction of critical-size long bone segmental defects resulting from trauma,osteoporotic fractures or tumour resections.Polymeric scaffolds with controlled macroporosities,degradability,useful surgical handling characteristics,and the ability to deliver biotherapeutics to promote new bone ingrowth have been developed for this challenging orthopaedic application.This review highlights major classes of degradable synthetic polymers and their biomineral composites,including conventional and amphiphilic polyesters,polyanhydrides,polycarbonates,and polyethylene glycol-based hydrogels,that have been explored for the regenerative reconstruction of critical-size long bone segmental defects over the past two decades.The pros and cons of these synthetic scaffold materials are presented in the context of enabling or impeding the functional(mechanical and radiographic)repair of a long bone segmental defect,with the long bone regeneration outcomes compared with healthy long bone controls or results achieved with current grafting standards.展开更多
文摘目的：总结采用自体肾移植术治疗长段输尿管缺损的临床疗效和体会。方法对10例输尿管中上段结石患者，在经输尿管硬镜钬激光碎石时出现长段输尿管黏膜袖套状剥脱或全层撕脱，内镜下放置双 J 管失败，无法行输尿管端端吻合或再植，于损伤发生2 h 至9 d 后行自体肾移植术。结果1例术前肾功能严重减退患者术后7 d 出现移植肾栓塞，其余9例随访5～75个月，移植肾血流灌注良好，肾功能维持正常水平；1例术后4个月出现膀胱吻合口狭窄致自体移植肾中度积水，给予微创经皮肾穿刺造瘘引流；尿路感染1例，经抗感染治疗后好转，未见复发。结论针对医源性长段输尿管撕脱伤患者，及时施行自体肾移植可以有效恢复尿路完整性并保持肾功能，且并发症发生率低。
基金This work is supported by an Alex Lemonade Stand Foundation Innovation Grant and a BRIDGE Award from the University of Massachusetts Medical School.
文摘Recent developments in synthetic bone grafting materials and adjuvant therapeutic agents have opened the door to the regenerative reconstruction of critical-size long bone segmental defects resulting from trauma,osteoporotic fractures or tumour resections.Polymeric scaffolds with controlled macroporosities,degradability,useful surgical handling characteristics,and the ability to deliver biotherapeutics to promote new bone ingrowth have been developed for this challenging orthopaedic application.This review highlights major classes of degradable synthetic polymers and their biomineral composites,including conventional and amphiphilic polyesters,polyanhydrides,polycarbonates,and polyethylene glycol-based hydrogels,that have been explored for the regenerative reconstruction of critical-size long bone segmental defects over the past two decades.The pros and cons of these synthetic scaffold materials are presented in the context of enabling or impeding the functional(mechanical and radiographic)repair of a long bone segmental defect,with the long bone regeneration outcomes compared with healthy long bone controls or results achieved with current grafting standards.
