目的:探讨提高阴茎再植术的成功率的方法。方法: 回顾性分析本院3例运用显微外科技术行吻合血管神经的阴茎离断再植术的临床资料。结果: 3例病例采用大隐静脉自体移植修复阴茎背动脉并吻合阴茎静脉和神经,全部再植成功。3例均有勃起功能。结论:阴茎背动脉,阴茎背深静脉以及阴茎背神经的相继处理以及术中高度精细的无创操作技术是决定手术成败的关键之一。
【摘要】 目的 探讨微创经皮肾镜碎石术后并发感染性休克的原因和防治措施。 方法 回顾性分析2005年1月-2010年12月5例经皮肾镜术300例,其中术后并发感染性休克5例的临床资料。男1例,女4例,均表现为术后2~8 h内出现寒战、高热、烦燥不安,血压降至80/50 mm Hg(1 mm Hg=0.133 kPa)以下,心率超过120次/min。所有患者均行抗感染和抗休克治疗。 结果 所有患者均在72 h内停用升压药,1周内体温及血常规恢复正常,术后15 d治愈出院。 结论 感染性休克是微创经皮肾镜碎石术严重的并发症之一,术前有效抗感染、术中低压灌注、术后加强生命体征的监测、早期发现并合理处理,可有效防治感染性休克的发生。【Abstract】 Objective To explore the etiology and treatment of septic shock after percutaneous nephrolithotomy. Methods From Janurary 2005 to December 2010, the clinical data of five patients with septic shock after percutaneous nephrolithotomy in our hospital were retrospectively analyzed. The patients, including one male and four females, had chillness and high temperature after the nephrolithotomy. The blood pressure decreased to under 80/50 mm Hg (1 mm Hg=0.133 kPa), and the heart rate was more than 120 per minute. All patients underwent anti-shock and anti-infection therapies rapidly. Results Five patients were cured in the end, their temperature and blood routine tests returned to normal within one week. Conclusions Septic shock is one of the serious complications after percutaneous nephrolithotomy. Effective preoperative preparation, low pressure irrigation during operation, early diagnosis and treatment postoperatively are the effective ways to prevent the septic shock.