ABSTRACT
Objective To explore the risk factors ,prevention and treatment of the occurrence of perirenal hematoma after flexible lithotripsy. Methods We retrospectively analyzed the clinical data of 18 patients with symptomatic perirenal hematoma from 1259 who had undergone ureteral flexible lithotripsy in our hospital during the period of April 2007 to April 2016. Of the 18 patients,7 were complicated with diabetes mellitus,11 had urinary tract infection;15 were female,and 3 were male. Results Perirenal hematoma was confirmed by B ultrasound and CT,which situated on the Posterolateral side of the kidney in 8 patients,and on the lower pole and abdominal side in 10. Hematoma depth was 2.6-15.3 cm(average was 5.2 cm). The hematoma?related symptoms gradually disappeared in 11 patients 7 to 14 days after they received conservative treatment. 5 recovered gradually 15 days after undergoing hematoma puncture and drainage ,and 2 recovered 36 days after receiving open surgery for removal of hematoma. Conclusions Female,diabetes,urinary tract infection,bigger stone size,prolonged surgical duration,and infected stones were the risk factors for perinephric hematoma related to ureteroscopic lithotripsy. Full preoperative preparation ,effective anti?infection ,intraoperative improvement of calculus?breaking skills and use of large caliber semirigid through sheath,low pressure perfusion,shorter surgical duration,and staging surgery are effective ways to reduce the occurrence of perirenal hematoma.
ABSTRACT
Objective To investigate the association between Human Leukocyte Antigen DR (HLADR) gene polymorphisms and total IgE levels in children with asthma.Methods This study involved 84 unrelated children with asthma and 168 healthy controls without asthma.All participants had their serum total IgE levels measured with UniCAP Pharmacia system,and skin-prick test with ten kinds of inhalant allergens were taken among them.HLA oligonucleotide array was used to determine twenty-one gene frequencies of HLADR.Results ( 1 ) The frequencies of HLA-DRB1 * 070X allele and HLA-DRB1 * 11XX allele among the asthmatic were significantly higher than those in the healthy controls (HLA-DRB1 * 070X allele:2.98％vs.0.30％,x2 =6.915,P ＜ 0.05 ; HLA-DRB1 * 11XX allele:13.69％ vs.5.95％,x2 =9.478,P ＜ 0.01 ),Odds ratios( OR)for the two groups were 10.57(95％ CI:1.215 -91.986)and 2.79(95％ CI:1.429 -5.449)respectively.HLA-DRB3( 52 ) * 010X allele were significantly decreased in asthmatics compared to healthy controls(13.99％,x2 =5.854,P ＜0.05),OR was 0.429(95％ CI:0.214 -0.862).(2) Significant correlation between HLA-DRB1 * 160XX,HLA-DRB1 * 3 (17)alleles and the level of total IgE were found in asthmatic children(P ＜0.05).OR were 0.145(95％ CI:0.027 -0.781 )for HLA-DRB1 * 160XX allele and 1.667(95％CI:1.367-2.033)for HLA-DRB1 * 3(17)allele.Conclusion HLA-DRB1 *070X allele and HLA-DRB1 * 11XX allele were implicated in susceptibility to asthma,HLA-DRB3 (52) * 010X allele might conferring protection effects against asthma.There were association between HLA-DRB1 * 160XX,HLA-DRB1 * 3 ( 17 ) alleles and the level of total IgE in asthmatic children.Protective effects of HLA-DRB1 * 160XX allele against high level IgE response was noted,while HLA-DRB1 * 3(17)allele might be associated with high level of IgE in patients with asthma.