ABSTRACT
Objective To investigate the efficacy of ureteroscopic pneumatic lithotripsy and percutaneous renal holmium laser lithotripsy in the treatment of upper ureteral calculi. Methods A total of 132 patients with upper ureteral calculi admitted to our hospital from December 2016 to December 2017 were randomly divided into observation group and control group, 66 cases in each group. The control group underwent ureteroscopic pneumatic lithotripsy, and the observation group used percutaneous nephrolithotomy holmium laser lithotripsy. The clinical efficacy, surgical index and complication rate between two groups were compared. Results The clinical efficacy of the observation group (90. 91％) was higher than that of the control group(75. 76％),and the difference was statistically significant(P ＜ 0. 05). The operation time of the observation group was (27. 53 ± 3. 97) minutes,which was shorter than (42. 59 ± 4. 34) minutes of the control group,and the postoperative blood loss was (18. 59 ± 5. 21) mL,which was less than (31. 68 ± 4. 72) mL of the control group, the difference was statistically significant(P ＜ 0. 05). There was no significant difference in postoperative hospital stay between observation group[(5. 31 ± 1. 62) days]and control group[(5. 28 ± 1. 48) days](P ＞ 0. 05). There was no significant difference in the incidence of complications between two groups (P ＞ 0. 05). Conclusion Percutaneous nephrolithotomy with holmium laser lithotripsy is more effective than pneumatic lithotripsy in the treatment of upper ureteral calculi. It can shorten the operation time, reduce the amount of bleeding, and has higher safety.
ABSTRACT
Objective To explore the feasibility and effectiveness of external ureteral clipping and insertion of double J tube in laparoscopic ureterobladder reimplantation. Methods The clinical data of 21 patients with lower ureteral stricture undergoing laparoscopic ureterobladder reimplantation from Mar. 2014 to Mar. 2016 were retrospectively analyzed. Twelve patients receiving conventional laparoscopic ureterobladder reimplantation were assigned to control group, and 9 patients receiving laparoscopy-assisted external ureterobladder reimplantation were assigned to improvement group. The ureter of the patients in the improvement group was separated under laparoscopy, the narrow ureter was severed, and the proximal ureter was taken out from the 12-mm Trocar. Then, the broken end of ureter was clipped under euthyphoria, and the double J tubes were inserted and fixed on the ureteral mucosa with 4-0 absorbable sutures and then sent back to the pelvis. The bladder was mobilized under laparoscopy, and the bladder and ureter were anastomosed. Results The surgery was successfully completed in all the 21 patients without transferring to open surgery or urine leakage after operation. The operation time was significantly shorter in the improvement group versus the control group ([77±17] min vs [104±20] min, P<0.05). All patients were followed up for at least 6 months after operation. Both ultrasonography and intravenous pyelography showed no ureteral anastomotic stricture. The hydronephrosis was alleviated to some extent. Cystography showed that 2 patients had reflux, with 1 case in each group. Conclusion In laparoscopic ureteral reimplantation, external ureteral clipping and insertion of double J tube are minimally invasive, and can shorten operation time and make the surgery less complex.
ABSTRACT
@#Falling in the elderly is a major health problem and may cause severe consequences. Fall risk assessment is important for preventing and intervening fall incidence. Inertial Measurement Unit (IMU) has been introduced to evaluate motion/balance function and fall risk among the older people. Some researches indicated that it might have advantages over the usual tools, and can be used in the hospitals, communities, nursing homes, etc. IMU is a good way to measure gait variability, which may be strongly related with the risk of falls.