Objective: To evaluate the safety and effectiveness of ultrasound-guided percutaneous nephrolithotomy (PCNL) accessed by SVOF-principle and two-step puncture techniques. Methods: A total of 838 cases with upper urinary stones underwent percutaneous nephrolithotomy successfully accessed by ultrasound-guided between June 2007 and December 2015 at Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology. Of all cases were divided in two groups: hydronephrosis calyces puncture group include 425 cases and SVOF-principle puncture group include 413 cases. The access establishment time, operation time, stone free rate (SFR), postoperative complications, and postoperative hospitalization time between the two groups we compared by t test or χ2 test. Results: Statistically significant differences were observed between hydronephrosis calyces puncture group and SVOF-principle puncturegroup in the first access establishment time ((16.5±8.4) minutes vs. (11.2±5.9) minutes, t=3.931, P=0.013), one-stage SFR (74.3% vs. 85.7%, χ2=16.868, P=0.000), postoperative hospitalization time ((6.4±2.1) days vs. (4.8±1.8)days, t=4.574, P=0.000), transfusion rate (7.1% vs. 2.9%, χ2=8.027, P=0.006), and embolization rate (3.3% vs. 1.0%, χ2=5.390, P=0.020). There were no statistically significant differences in operation time, total SFR, postoperative fever and sever infection between these two groups (all P>0.05). In both two groups, no serious complications such as peripheral organ injury and death occurred. Conclusions: PCNL accessed guided by ultrasound with SVOF-principle and two-step puncture techniques has advantages of quick puncture location, high stone free rate, fewer complications and fast recovery. This technique is an effective and safe treatment option for upper urinary stones and deserved promotion and application in clinic.

癫性发作在肾功能衰竭患者中时有发生,是肾功能衰竭患者死亡的重要原因之一.电解质代谢紊乱、酸碱平衡失调、高血压、氮质血症和药代动力学的改变是肾功能衰竭患者更易于出现癫性发作的主要原因.认识并纠正肾功能衰竭患者的病理生理状态是防治癫性发作的有效方式.

膀胱排尿功能障碍的病人在临床很常见,保守治疗效果甚微,本文主要介绍国外一些新的电刺激治疗方法,为临床泌尿外科医生提供新的治疗思路。

Objective:To analyse the complications and management of tension-free vaginal tape(TVT) procedure.Methods:Fifty-eight women(mean age(53.3)±(9.9) years;range 35~79) with stress urinary incontinence(SUI) were assigned to TVT procedure between June 2002 and May 2005.They suffered SUI between 6 months and 30 years(mean 10.2±13.8 years) by asked symptoms and received related examining.Results:All patients were followed-up 1 to 32 months.The rates of cure,improvement,and failure were(89.7)%(52/58),(6.9)%(4/58),(3.4)%(2/58).The rate of complication was(17.2)%(10/58),including that bladder perforation in 3 patients((5.2)%),postoperative dysuria or retention in 6 patients((10.3)%) and hematomas of the retropubic space in one patient((1.7)%).Conclusions:TVT procedure is safe and effective for female SUI with an enduring,high success rate.The key point of operation was the degree of tension of tape.Intraoperative complications do not cause further problems when identified and treated during surgery.It also does not influence the continence rate in most cases.