目的:探讨与高龄患者前列腺癌相关的危险因素,为前列腺癌的临床防治提供可靠依据.方法:回顾性选取 2016 年 1 月至 2021 年 6 月在河南中医药大学第一附属医院行前列腺组织病理检查的高龄患者病历资料 102例,其中前列腺癌患者 46 例为前列腺癌组,非前列腺癌患者 56 例为非前列腺癌组.前列腺癌组依据前列腺病理结果及Gleason评分又分为高危组(22 例)和非高危组(24)例.收集所有患者一般资料[年龄、体质量指数(BMI)、糖尿病、吸烟史等],经单因素、Logistic多因素分析高龄患者前列腺癌相关危险因素.结果:前列腺癌的发生可能与年龄、饮酒史、吸烟史、糖尿病史、高血压史无关(P＞0.05);但可能与 BMI、糖化血红蛋白(HbA1c)、前列腺特异性抗原(PSA)、游离前列腺特异性抗原(fPSA)/PSA、甘油三脂(TG)、总胆固醇(TC)水平有关(P＜0.05);经非条件Logistic回归分析结果得出,BMI、HbA1c、PSA、fPSA/PSA、TG、TC均是前列腺癌发生的危险因素(OR＞1,P＜0.05);经非条件Logistic回归分析结果得出,HbA1c、PSA、fPSA、fPSA/PSA、TG、TC、PI-RADS评分均是高危前列腺癌发生的危险因素(OR＞1,P＜0.05).结论:BMI、HbA1c、PSA、fPSA/PSA、TG、TC均是前列腺癌的独立危险因素;HbA1c、PSA、fPSA、fPSA/PSA、TG、TC、PI-RADS评分均是高危前列腺癌的独立危险因素.

Objective To retrospectively study the patients with benign prostatic hyperplasia（BPH） who still needed surgical treatment after taking α-receptor blocker, and analyze the risk factors. Methods A total of 209 cases of benign prostatic hyperplasia hospitalized in our hospital from January 2016 to July 2021 were retrospectively analyzed, patients who still needed surgical treatment after taking medicine were divided into the surgical group（n=95） and patients who continued oral drug therapy were divided into the drug group（n=114）, patients’ age, duration of continuous medication, history of hypertension, history of diabetes, history of smoking, history of urinary retention, history of alcohol consumption, BMI, total prostate volume（TPV）, intravesical prostatic protrusion（IPP）, international prostate symptom Score（I-PSS）, residual urine volume（PVR）, prostate specific antigen（PSA）,bladder detrusor muscle thickness（DWT）,maximum urine flow rate（Qamx） and other factors with statistical differences were first univariate analysis, followed by multivariate Logistic regression analysisand other factors. Results BMI, IPP, TPV, I-PSS, PVR, PSA, DWT and Qamx were statistically different between the two groups（P＜0.05）. Multivariate Logistic regression analysis showed that IPP, PVR and PSA were the main risk factors for BPH patients who still needed surgical treatment after taking α-receptor blocker. Conclusions IPP, PVR and PSA are the main risk factors for BPH patients who still need surgical treatment after taking α-receptor blocker, which is of great significance for predicting the efficacy of oral ɑ-receptor blocker in BPH patients.

Objective To explore the impact of preoperative CT urography（CTU） three-dimensional imaging on the effect and safety of flexible ureteroscopy in the treatment of lower calyceal calculus. Methods 64 patients with lower calyceal calculus were divided into CTU group（n = 26） and IVP group（n = 38） according to preoperative examination methods. CTU group received CTU three-dimensional imaging before operation, and IVP group received intravenous pyelography（IVP） before operation. The preoperative examination indicators,operation time, stone clearance rate, postoperative complications and laboratory indicators of the two groups were compared. Results No statistical difference was found in stone diameter, IPA and IW between the two groups（P ＞0.05）. The operation time of CTU group was shorter than that of IVP group, and the stone clearance rate was higher than that of IVP group（P ＜0.05）. No statistical difference was found in the incidence of postoperative complications between the two groups（P ＞0.05）. The leukocyte and CRP levels of CTU group were lower than those of IVP group（P ＜0.05）. Conclusions Preoperative CTU three-dimensional imaging for flexible ureteroscopy in the treatment of lower calyceal calculus has significant effect, which can shorten the operation time, improve the stone clearance rate and reduce the postoperative inflammatory reaction.

目的:研究温肾益气止遗方在前列腺增生(Benign Prostate Hyperplasia,BPH)术后尿失禁患者中的应用效果.方法:采用随机数字表法将 2021 年 3 月至 2022 年 12 月医院收治的 82 例BPH术后尿失禁患者分为常规组和中医组,各 41 例.常规组采用常规西药+盆底功能锻炼治疗,中医组在常规组基础上加用温肾益气止遗方治疗.比较两组临床疗效、中医证候积分、国际前列腺症状量表(IPSS)评分、尿失禁生活质量量表(I-QOL)评分、尿失禁问卷表简表(ICI-Q-SF)评分、尿动力学[膀胱顺应性(BC)、残余尿量(RUV)、最大尿流速(Qmax)、最大逼尿肌压力(PQmax)]和不良反应.结果:中医组临床治疗总有效率为 87.80%,高于常规组的 68.29%,差异有统计学意义(P＜0.05);治疗后,中医组中医证候积分、IPSS评分低于常规组,I-QOL评分高于常规组(P＜0.05);治疗后,中医组漏尿量、对日常生活影响、漏尿频率、ICI-Q-SF总分降低幅度大于常规组,差异有统计学意义(P＜0.05);治疗后,中医组PQmax、RUV低于常规组,BC、Qmax高于常规组(P＜0.05);两组不良反应总发生率比较无明显差异(P＞0.05).结论:温肾益气止遗方治疗BPH术后尿失禁疗效确切,可显著缓解患者临床症状,改善尿动力学状态,提高生活质量,且安全性高.

目的:观察当归六黄汤联合单纯去势治疗气阴两虚型晚期前列腺癌的疗效及对免疫功能的影响.方法:将108 例气阴两虚型晚期前列腺癌患者随机分为两组.对照组 54 例采用单纯去势治疗,用醋酸戈舍瑞林缓释植入剂,10.8 mg/次,皮下注射 1 次;治疗组 54 例在对照组治疗基础上联合当归六黄汤(生地黄、熟地黄、当归、黄芪、黄芩、黄柏、黄连)治疗,每日 1 剂,浓煎为 2 袋,100 mL/袋,早晚 2 次温服,连续治疗 3 个月.对比两组临床疗效,治疗前后卡氏功能状态评分(KPS)、生活质量(QOL)评分、中医症状积分(TCMSS)、前列腺特异性抗原(PSA)水平、焦虑自评量表(SAS)评分、抑郁自评量表(SDS)评分,以及 CD3+、CD4+、CD4+/CD8+水平.结果:治疗组显效 22 例,有效 28 例,无效 4 例,有效率 92.59％(50/54);对照组显效 15 例,有效 24 例,无效 15 例,有效率 72.22％(39/54).两组疗效对比,差异有统计学意义(P＜0.05).治疗后两组 KPS评分、QOL 评分、TCMSS、SAS 评分、SDS 评分、PSA 水平、不良反应发生率对比,差异均有统计学意义(P＜0.05);治疗后,两组 CD3+、CD4+及 CD4+/CD8+水平均较治疗前提高,且治疗组高于对照组(P＜0.05).结论:当归六黄汤联合单纯去势治疗气阴两虚型晚期前列腺癌可有效缓解临床症状,提高生活质量和免疫功能,且不良反应少.

目的:评价超细肾镜治疗1～2 cm肾下盏结石的有效性和安全性.方法:纳入2018年3月-2021年6月于河南中医药大学第一附属医院住院治疗的67例1～2 cm肾下盏结石患者,根据不同手术方式分成超细肾镜组37例和输尿管软镜组30例.比较两组术后3 d结石清除率、术后并发症发生率、手术时间、术后住院时间、术后1 h血红蛋白下降量和术后12 h不同疼痛程度例数.结果:超细肾镜组和输尿管软镜组术后3 d结石清除率分别为91.9％和70.0％,差异有统计学意义(P＜0.05);超细肾镜组和输尿管软镜组术后并发症发生率分别为16.2％和26.7％,手术时间分别为(54.43±12.02)min和(59.23±12.00)min,术后住院时间分别为(6.51±1.26)d和(6.30±1.53)d,术后1 h血红蛋白下降量分别为(10.95±3.64)mL和(11.40±3.31)mL,术后不同程度疼痛例数比较,差异无统计学意义(P＞0.05).结论:超细肾镜治疗1～2 cm肾下盏结石是安全、高效的.

目的 探讨输尿管镜钬激光碎石术(FURL)联合猪苓排石汤与FURL治疗输尿管结石的效果.方法 前瞻性纳入2020-01-2022-01 于宜阳县人民医院泌尿外科行FURL术的输尿管结石患者,根据治疗方案分为FURL联合猪苓排石汤组(联合组)和单纯FURL组(对照组).比较2 组术后临床指标.检测治疗前后患者的血肌酐(Scr)、尿素氮(BUN)、半胱氨酸蛋白酶抑制剂(CysC)、中性粒细胞明胶酶相关脂质运载蛋白(NGAL)肾功能指标水平;尿 N-乙酰-β-氨基葡萄糖苷酶(NAG)、β2 微球蛋白(β2-MG)尿液相关因子水平.统计随访 1 个月期间的并发症发生率和随访 1a期间的复发率.结果 共纳入96 例患者,每组48 例.2 组患者的基线资料差异无统计学意义(P＞0.05).联合组患者的结石排净率高于对照组、止痛药使用率低于对照组、治疗后的血尿改善时间和住院时间均短于对照组,差异均有统计学意义(P＜0.05).联合组患者的CysC、Scr、BUN、NGAL水平和β2-MG、NAG水平低于对照组;随访 1 个月期间的并发症总发生率及 1 a期间的复发率均低于对照组.差异均有统计学意义(P＜0.05).结论 与单纯FURL术比较,FURL联合猪苓排石汤治疗输尿管结石患者,可优化术后临床指标,改善肾功能和尿液相关因子水平,并利于降低并发症发生率及复发率.但仍需进行大样本量的前瞻性随机对照研究予以证实.

目的 评价在经尿道等离子前列腺剜除术(TUKEP)手术过程中采用保留前列腺尖部的手术方式治疗良性前列腺增生的临床疗效.方法 通过回顾性分析,选择2017年01月至2021年06月于我院收治的良性前列腺增生124例患者,将其中行保留前列腺尖部的TUKEP的患者60例纳入观察组,而接受传统前列腺电切术的患者64例归于对照组;比较两组年龄、前列腺体积、术前I-PSS评分、术后第3个月I-PSS评分、最大自由尿流率(Qmax)、残余尿量(PVR)、手术时长、导尿管留置时长、术后住院总天数(HOD)、手术并发症、术后血红蛋白(HGB)下降量、短期(术后一周)及长期(术后3个月)尿失禁(UI)发生率.结果 两组年龄、前列腺体积、术前I-PSS评分、手术时长、手术并发症、术后HGB下降量,第3个月UI发生率的差异无统计学意义(P>0.05),但观察组导尿管留置时长、术后HOD、短期UI发生率、术后第3个月I-PSS、PVR等均低于对照组,差异有统计学意义(P<0.05),Qmax高于对照组,差异有统计学意义(P<0.05).结论 保留前列腺尖部的TUKEP较传统前列腺电切术治疗BPH的效果更加明显,能降低UI发生率,改善患者术后生活质量.

Objective:To investigate the clinical effect of early cluster therapy on septic shock after minimally invasive urological surgery.Methods:A total of 40 patients with septic shock after minimally invasive surgery in the Department of Urology of the First Affiliated Hospital of Henan University of Traditional Chinese Medicine from July 2017 to April 2022 were selected as the research objects. The patients were divided into control group (hospitalized from July 2017 to August 2019) and observation group (hospitalized from September 2019 to April 2022) according to the length of hospital stay, with 20 cases in each group. The control group treated by the conventional plan, the observation group treated by the bundled strategy in the early stage, and the related treatment was completed within 6 hours of the onset. The vital signs, inflammatory indexes and shock disease-related scales of patients in the two groups at different time points were evaluated.Results:After 6 hours of treatment, the vital signs including heart rate, mean arterial pressure (MAP), central venous pressure (CVP) and blood oxygen saturation (SaO 2) were significantly improved in both groups, and the MAP, CVP and SaO 2 of the observation group were higher than those of the control group, and the differences were significant ( t=3.74, 8.79, 5.83; all P<0.05). After 24 hours of treatment, the inflammatory indexes including neutrophils and procalcitonin of the two groups were significantly improved, and the procalcitonin of the observation group was lower than that of the control group, and the difference was significant ( Z=2.24, P<0.05). After 6 and 24 hours of treatment, the Apache II and sequential organ failure assessment scores in the two groups showed a downward trend, and the above scores of the observation group were lower than those of the control group, and the differences were significant ( F=550.85, 417.58; all P<0.05). Conclusions:The early bundle strategy has a significant effect on the treatment of septic shock after urological surgery, which can stabilize the patient’s vital signs as soon as possible, relieve the symptoms of infection, and effectively avoid further damage to the organ function.

目的 探讨不同数量经皮肾镜通道对肾结石患者术后早期肾功能的影响.方法 选取2017年7月至2021年8月河南中医药大学第一附属医院接收的60例复杂肾结石患者作为研究对象,按照经皮肾镜碎石取石术(PCNL)通道数量分为3组,分别为A组(单通道PCNL组)、B组(双通道PCNL组)及C组(多通道PCNL组),比较术后第2天3组肾功能指标变化情况.结果 3组手术时间、住院时间比较,差异无统计学意义(P>0.05).A组术中出血量最少,随着通道的增加,出血量增多,差异有统计学意义(P<0.05).B组与C组血肌酐(SCr)水平变化高于A组,差异有统计学意义(P<0.05),B组与C组SCr水平比较,差异无统计学意义(P>0.05).3组血中尿素氮(BUN)水平变化比较,差异无统计学意义(P>0.05).结论 复杂肾结石患者应用经皮肾镜单通道、双通道及多通道治疗后均会损伤早期肾功能,与单通道相比双通道术后早期肾功能下降明显,双通道与多通道对肾功能损害无明显差异.因此,对于复杂肾结石患者,临床可根据其具体病情选择合适的治疗方案.

Objective:To compare the efficacy of transurethral resection of the prostate and holmium laser enucleation of the prostate in the treatment of benign prostatic hyperplasia.Methods:The clinical data of patients with benign prostatic hyperplasia treated in the First Affiliated Hospital of Henan University of Traditional Chinese Medicine from January 2018 to January 2022 were retrospectively. According to surgical methods, patients were divided into control group and study group, with 50 cases in each group. The control group was treated by transurethral resection of the prostate, and the study group was treated by holmium laser enucleation of the prostate. The perioperative operation indexes, urodynamic indicators, prostate symptoms score, quality of life score, sexual function and complications were compared between the two groups.Results:The intraoperative blood loss, bladder flushing time, indwelling time of the catheter, and hospital stay in the study group were less than those in the control group (all P<0.05). Before operation, there was no significant difference in urodynamic indexes, prostate symptom scores, and quality of life scores between the two groups ( P>0.05). The maximum urinary flow in the study group was higher than that in the control group, while the residual urine volume, prostate symptom score, quality of life score were lower than those in the control group ( P<0.05). The erectile function index score in the study group was higher than that in the control group, while erectile dysfunction score and incidence of retrograde ejaculation were lower than those in the control group ( P<0.05); the incidence of complications in the study group (28.00%, 14/50) was higher than that in the control group (8.00%, 4/50), P<0.05. Conclusions:Holmium laser enucleation of the prostate has more prominent effects in the treament of benign prostatic hyperplasia, which can shorten the hospital stay, facilitate the recovery of postoperative sexual function, and have a lower complication rate.

目的:研究中药治疗去势抵抗性前列腺癌的作用,探讨其临床疗效.方法:通过检索PubMed、万方、维普(VIP)、知网(CNKI)及相关博、硕士论文,收集有关中药治疗去势抵抗性前列腺癌的随机对照试验,时间为建库至2020年6月,采用Stata 14.0软件绘制证据图,并进行Meta分析.结果:最终纳入10个随机对照试验,均为中文文献,共553例患者,Meta分析结果显示,中药参与治疗去势抵抗性前列腺癌患者的生活质量在生理状况[MD=-2.20,95％CI(-3.02,-1.38),P＜0.05]、社会/家庭状况[MD=1.37,95％C]1(0.30,2.44),P＜0.05]、情感状况[MD=-1.40,95％CI(-2.19,-0.60),P＜0.05]、功能状况[MD=2.45,95％CI(1.48,3.43),P＜0.05]、附加关注[MD=-2.33,95％CI(-3.26,-1.40),P＜0.05]等方面均优于单纯西医方案治疗的对照组;总有效率[OR=3.31,95％CI(1.85,5.92),P＜0.05]、中医证候评分[MD=-2.85,95％CI(-4.05,-1.64),P＜0.05]、卡氏评分[MD=8.67,95％CI(3.32,14.03),P＜0.05]、前列腺特异性抗原(PSA)水平[MD=-7.60,95％CI(-14.22,-0.97),P＜0.05]、不良反应[OR=0.43,95％CI(0.20,0.90),P＜0.05]等方面与单纯西医方案治疗的对照组比较,差异均有统计学意义.结论:中药治疗去势抵抗性前列腺癌能够减轻患者临床症状,增强体力,提高总有效率,改善生活质量,减少不良反应的发生率;但对PSA的影响因异质性强,仍需要进一步研究证实.

目的 探讨超细肾镜治疗肾结石的临床疗效.方法 选取2018年1月至2021年4月于河南中医药大学第一附属医院泌尿外科住院治疗的68例肾结石患者,依照手术方式不同分为超细肾镜组(肾镜组)32例,输尿管软镜组(软镜组)36例.比较两组患者的结石清除率、手术时间、术后住院时间、并发症发生率、术中出血量(术后1 h血红蛋白下降量)、术后C反应蛋白(C-reaction protein,CRP)及降钙素原(procalcitonin,PCT)水平.结果 肾镜组较软镜组清石率明显增高,差异有统计学意义(P<0.05);肾镜组术后CRP及PCT水平较软镜组明显降低,差异有统计学意义(P<0.05);两组术中出血量、手术时间、术后住院时间、并发症发生率比较,差异无统计学意义(P>0.05).结论 超细肾镜治疗肾结石的效果显著优于输尿管软镜,炎性反应较输尿管软镜轻,与输尿管软镜比,未增加手术出血量及住院时间和手术时间、并发症.

目的 探讨3D打印技术在双镜联合治疗复杂性上尿路结石手术中的临床应用.方法 选取2018年7月至2020年7月河南中医药大学第一附属医院应用经皮肾镜联合输尿管软镜治疗的复杂性上尿路结石患者56例,分为3D打印组和对照组,其中3D打印组20例,对照组36例.56例患者均为单侧肾结石,两组间年龄、体重指数、结石负荷无显著性差异.3D打印组术前应用3D打印技术打印出肾结石相关3D打印模型,术前由手术医师参照3D打印模型模拟手术操作,后进行经皮肾镜联合输尿管软镜碎石取石治疗.对照组由同一医师采用同样方式完成手术.两组间手术时间、术中通道数、术中冲洗液用量、手术出血量、术后平均住院时间、并发症及术前谈话满意度评分等数据进行统计分析.结果 两组间术中建立通道数、术后平均住院时间、并发症出现率、术后CRP之间差异无统计学意义(P＞0.05).平均手术时间、术中冲洗液用量、手术出血量(以术前术后血红蛋白下降记)及术后结石清除率均有显著性差异(P＜0.05).术前谈话满意度评分量表调查显示,差异有统计学意义.结论 3D打印泌尿系模型应用于双镜联合治疗复杂性上尿路结石具有缩短手术时间、减少术中出血、提高清石率等优势,同时可以作用术前沟通的有效工具,便于进行医患沟通,减少医患矛盾.

目的 观察五淋散加减联合索利那新治疗输尿管上段结石术后留置输尿管支架管(D-J)OAB患者的临床疗效.方法 收集60例在河南中医药大学第一附属医院泌尿外科住院的输尿管上段结石术后留置D-J管出现OAB相关症状的患者,按随机数字表分两组,试验组30例,对照组30例.对照组给予常规索利那新治疗;治疗组在对照组基础上给予五淋散加减口服治疗.两组均于治疗前及治疗后2周观察记录膀胱过度活动症状评分(OABSS),生活质量指数(QoL)以及服药2周后复查泌尿系彩超观察结石排净率判断疗效.结果 两组的夜间排尿次数、尿急、急迫性尿失禁次数和结石排净率均有不同程度的减轻,差异均具有显著性意义(P<0.05).结论 五淋散加减配合琥珀酸索利那新片治疗输尿管上段结石术后留置输尿管支架管OAB患者有较好的疗效,同时具有溶石排石的作用.

目的:探讨经皮肾通道顺行输尿管软镜治疗输尿管中下段结石合并远端输尿管狭窄、扭曲患者的有效性及安全性.方法:回顾性分析2014年6月～2018年11月在我院行输尿管硬镜碎石术(URL)的27例输尿管中下段结石的临床资料,术中发现输尿管狭窄及扭曲严重,输尿管镜难以上行至结石处,改行俯卧位建立F24皮肾镜通道后,顺行置入输尿管导引鞘及输尿管软镜,处理结石.结果:手术时间46～139 min,平均(67±15) min,26例采用顺行输尿管软镜将输尿管结石全部清除(残石颗粒冲入膀胱),术后1～3 d拔除尿管,后自行排出,均未出现气胸、肠道损伤、严重出血及输尿管脱套等严重并发症.1例改行开放取石.结论:顺行输尿管软镜在URL治疗失败的输尿管中下段结石合并远端输尿管狭窄、扭曲的治疗中,具有安全、有效、并发症少等优点.

Objective: To investigate the relationships of bladder mucosal inflammatory factors, interleukin-1 (IL-1), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) with the occurrence and development of cystitis glandularis (CG), and their effects on the prognosis. Methods: A total of 61 patients with CG from January 2010 to 2014 were randomly selected. Tissue specimens of postoperative patients were collected. 16 cases of normal bladder mucosa during the same period were collected as a control group. Blood specimens and fresh tissue specimens were collected from 6 patients with CG. The messenger ribonucleic acid (mRNA) levels of IL-1, IL-6 and TNF-α were detected via reverse transcription polymerase chain reaction (RT-PCR). The protein levels of IL-1, IL-6 and TNF-α in serum of patients with GC and normal controls were detected via an enzyme-linked immunosorbent assay (ELISA). The protein expressions of IL-1, IL-6 and TNF-α were detected via immunohistochemistry (IHC), and their relationships with the clinical features and prognosis of GC were analyzed. A Cox proportional hazard regression model was used for multivariate analysis on the prognostic factors of CG, and all the tests were performed with 95% confidence interval (CI). Results: The protein expressions of IL-1, IL-6 and TNF-α in patients with CG were obviously higher than those in normal group. The mRNA levels of IL-1, IL-6 and TNF-α in the serum of patients with CG were also significantly higher than those in normal group (P<0.05). The expressions of IL-1, IL-6 and TNF-α in CG were positively correlated. TNF-α is an independent prognostic factor of CG. Conclusion: IL-1, IL-6 and TNF-α are associated with the occurrence and development of CG. TNF-α presents as an independent prognostic factor of CG that can be used for the diagnosis of cystitis glandularis.

目的 :探讨大株红景天注射液配合中药灌肠治疗湿热下注型前列腺炎的临床疗效及对肿瘤坏死因子(TNF)-α、白细胞介素(IL)-1β 和IL-10水平的影响.方法 :选取2017年3月—2018年3月我院收治的慢性前列腺炎患者84例为研究对象,按随机数字表法分为对照组和观察组,各42例.对照组给予普乐安片(2 g,tid,po)治疗,观察组给予中药灌肠联合大株红景天注射液(10 mL加入250 mL 5％ 葡萄糖注射液中,ivgtt,qd)治疗.比较两组临床疗效及治疗前后TNF-α、IL-1β 和IL-10水平.结果 :观察组治疗总有效率高于对照组,差异有统计学意义(P<0.05).治疗后,两组TNF-α、IL-1β 水平均低于治疗前,IL-10水平均高于治疗前,且观察组TNF-α、IL-1β 水平低于对照组,IL-10水平高于对照组,差异均有统计学意义(P<0.05).结论 :大株红景天注射液联合中药灌肠治疗湿热下注型前列腺炎疗效显著,且可下调TNF-α 与IL-1β 水平,提高IL-10水平.

无菌术是临床医学的一个基本操作规范.作为一名医务工作者,正确的无菌观念及准确的无菌操作技术是其必备的基本素质.对于中医院校而言,培养学生的无菌观念,是外科临床教学的一个重点.本文通过总结中医院校学生在无菌术教学方面存在的问题及体会,提出相应的方法及对策,为完善中医人才无菌术教学改革提供有益的借鉴.

目的 探讨皮肤软组织扩张术在烧伤后瘢痕整形中的应用效果.方法 将76例烧伤后瘢痕患者分为两组:对照组行复合皮移植术,观察组行皮肤软组织扩张术,对比两组疗效.结果 与对照组相比,观察组治疗总有效率更高,术后并发症发生率更低,两组比较差异有统计学意义(P<0.05).结论 将皮肤软组织扩张术用于烧伤后瘢痕整形是一种理想选择.