ABSTRACT
Objective:To probe into the influence of adhesive tape and string fixation on postoperative catheter-associated urinary tract infection(CAUTI) and comfort degree of patients undergoing percutaneous nephrolithotomy.Methods:A total of 106 cases of male urinary tract calculi patients undergoing percutaneous nephrolithotomy in Urology Department of First Affiliated Hospital of Zhengzhou University from January 2018 to April 2019 were selected. They were divided into the experimental group (55 cases) and the control group (51 cases) by random digits tbale method. The control group received platform fixation method, the experimental group implemented adhesive tape and string fixation method for catheter fixation. The incidence of CAUTI were compared between two groups, the catheter exposed length changes and catheter-related discomfort changes was also compared.Results:The incidence of CAUTI were 3.9%(2/51) in the experimental group, significantly lower than 16.7%(8/48) in the control group, the difference was statistically significant ( χ2=4.42, P<0.05). After 3 days, 5 days and 7 days of indwelling catheter, the catheter exposed length were (17.76 ± 1.41), (17.12 ± 1.28), (16.49 ± 1.63) cm, significantly longer than those in the control group (16.04 ± 1.96), (15.81 ± 1.78), (15.29 ± 1.96) cm ( t=5.00, 4.17, 3.32, all P<0.05); the catheter-related discomfort symptom scores at above mentioned time were 0.82 ± 0.09, 0.53 ± 0.07, 0.49 ± 0.08, significantly lower than those in the control group (1.17 ± 0.23, 0.92 ± 0.09, 0.77 ± 0.11), the differences were statistically significant ( t=2.10, 2.88, 2.46, all P<0.05). Conclusions:Adhesive tape and string fixation method for catheter fixation can reduce the incidence of CAUTI of patients with urinary tract calculi, improve the catheter fixed state as well as reduce the patient′s catheter-related discomfort.
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Objective To evaluate the efficacy and complications of flexible ureteroscopy for the treatment of upper urinary tract calculi in children.Methods The clinical data of upper urinary tract calculi in 20 children including 16 male and 4 female,treated by using flexible ureteroscopy,were collected from January 2014 to May 2015 in the First Affiliated Hospital of Zhengzhou University.The mean age was 6.4 years (ranging from 2.7-15.0 years old).Among them,6 cases had upper ureteral calculi and 14 cases had renal calculi.All the calculi was found unilaterally with on the left side in 12 cases and on the right side in 8 cases.Ipsilateral mild to moderate hydronephrosis were found in all of the cases.The mean stone size was 1.2 cm (ranging from 0.5-1.8 cm).All the cases were treated through retrograde flexible ureteroscopy holmium laser lithotripsy after the invalid conservative through conservative treatment.Double J tube was left routinely in the sick side 1 week before operation to expand the internal diameter of the ureter.A double J stent was left in place for 1 month after operation as a routine.Results The flexible ureteral access sheath failed to insert into the upper ureter in 2 cases because of the narrow ureter,then the flexible ureteroscopy was inserted into ureter through wire directly.The flexible ureteral access sheath was successfully inserted into the ureter for the others and flexible ureteroscopy were inserted through flexible sheath.The mean operative time was 38 min (ranging from 20-60 min).The patients were discharged from hospital after a mean of 4.5 days (ranging from 3-7 days).The rate of stone-free in one-stage was more than 90％.There were residual small stones in the lower calices of kidney in 2 cases.The perfusion liquid volume during the operation was 500 mL(ranging from 200-1 000 mL).There was no major perioperative complication,while transient macroscopic hematuria and fever were common complications after operation.The stone search was performed successfully in the whole 14 cases.NO residual stone could be found through ultrasound and kidney ureter bladder plain and Double-J stent was removed 1 month after operation.Conclusions Flexible ureteroscopy produces high stone-free rate and clinical safety for upper urinary calculi in children.However,the complications of flexible ureteroscopy lithotripsy cannot be ignored and sufficient preoperative preparation and careful perioperative safety control should be required.
ABSTRACT
To investigate the clinical applications of robot-assisted radical cystectomy with orthotopic ileal neobladder [RARC-INB] and make a preliminary summary. Retrospective analysis the clinical data of 12 patients underwent robotic bladder cancer [da vinci surgical system] assisted laparoscopic cystectomy with ileal orthotopic neobladder from March 2015 to April 2015. 12 cases were successful, with no surgical intervention, and organ damage occurred. The operation time was 330470 min, which average [390.0 +/- 61.5] min; blood loss was 90870 ml, which average [185.0 +/- 88.3] ml. One case of intraoperative blood transfusion was 400 ml. The enjoin eating time of postoperative intestinal ventilation was 36 d, and the average time was [4.0 +/- 1.5] d. Removal of ureteral stents time was 1428 d and the average time was [21 +/- 7] d. Removal of the catheter time was 1828 d and the average time was [23 +/- 5] d. Postoperative hospital stay 1929 d and the average time was [24 +/- 5] dRARC-INB make the surgical tends to simplify, which was conducive to surgeon intraoperative control and assurance. RARC-INB make the surgical tends to use less trauma, less bleeding, complete lymphadenectomy, quick recovery, etc. It is a safe, effective and reliablethe method in the treatment of invasive bladder cancer. So the method should be widely applied