ABSTRACT
Objective To investigate the effects of the double J tube in treating drug -crystalline upper uri-nary tract obstruction.Methods There were 12 cases of drug -crystalline urinary tract obstruction,which were diag-nosed by CT for urinary tract obstruction.With the help of cystoscope,we retrograde placed the double -J tube in all the 12 patients who with persistently elevated serum creatinine in the next day of admission.Results Nine patients were successfully placed double J stent and serum creatinine of the patients decreased to normal rapidly.There were 2 patients with failed implantation and were with persistently elevated serum creatinine.1 patient with unilateral urina-ry tract obstruction was treated with conservative treatment and eventually cured.Conclusion Patients with drug -induced renal injury should have a routine bilateral ureteral CT scan,once they are clearly diagnosed as drug crystal upper urinary tract obstruction in them,timely placement of bilateral double J tube with the help of cystoscope,which was a simple and effective treatments.
ABSTRACT
Objective To explore the application value of thromboelastography(TEG)in perioperative evaluation of benign pros-tatic hyperplasia(BPH) patients treated with anticoagulants .Methods To retrospective analyze the intraoperative bleeding ,postop-erative bleeding and transfusion treatment of 120 patients with BPH surgery ,who were treated with anticoagulants .The results of TEG detection and coagulation function test were compared .Results There was no patients with significant intraoperative bleed-ing ,including 40 cases of bleeding after surgery ,80 cases of patients with no bleeding .In patients of bleeding ,there were 32 benign prostatic hyperplasia patients(80 .00% )with low coagulation function detected by TEG detection ,and 18(45 .00% ) with low coagu-lation function detected by routine coagulation function test .The difference of detection rates was statistical significant between the two methods(χ2 =12 .709 ,P=0 .002) .In patients of non-bleeding ,there were 76 benign prostatic hyperplasia patients(95 .00% ) with non-low coagulation function detected by TEG detection ,and 67(83 .75% )with non-low coagulation function detected by rou-tine coagulation function test .The difference in detection rate was significant between the two methods(χ2 =6 .679 ,P=0 .022) . Conclusion TEG could effectively evaluated postoperative bleeding in BPH patients ,guide postoperative transfusion therapy ,which is better than routine coagulation function test .
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Objective Analyzing risk factors for gastrointestinal bleeding(GIB) after coronary artery bypass grafting(CABG). Methods 582 cases undergoing CABG from August 2001 to May 2005 were divided into two groups (GIB group ,n=6 ;control group,n=576) . Preoperative , operative and postoperative clinic data were com-pared. Results The ratio of over-aging(age greater than 70), hypertension, cerebrovascular disease, myocardial in-fraction,heart function (NYHA) over Ⅲ and postoperative low output syndrome (LOS) in GIB group were signifi-cantly higher than that in control group;age, blood transfusion and hospitalized time were significantly higher and left ventricular ejective fraction was significantly lower in GIB group than that in control group. Age over 70,history of myocardial infraction and heart function (NYHA) over Ⅲ were selected as risk factors of GIB after CABG by step-wise logistic regression analysis. Conclusions It is very useful for precaution, early diagnosis and early therapy of GIB after CABG to evaluate if patients have the risk factors of GIB after CABG before operations.
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Objective: To summarize the experience of surgical treatment of subaortic stenosis. Methods: 70 patients with subaortic stenosis were treated surgically. The diagnosis was made by echocardiography, left ventricular catheterization and angiography. There were 46 males and 24 females. The mean age at operation was 11.8 years (range 3 to 46 years). 64 patients had discrete stenosis and 6 had tunnel stenosis. For the discrete stenosis cases, simply resection of stenosis membrane was done in 58 cases and plus myoctomy in 6 cases. For the tunnel stenosis cases, left ventricular muscle was resected to relieve obstruction. In 59 patients combined cardiovascular malformation were corrected at the same time. Results: There were two postoperative deaths. Mitral valve injury occurred in 1 patient. The mean systolic gradient of left ventricle to aorta was 7.5 mmHg with a range of 0-30 mmHg in 38 cases after operation. The 1-, 3-, 5-, 10-, 20-year follow-up rate was 83%, 77%, 68%, 45%, and 9%,respectively. All patients were asymptomatic postoperatively. No reoperation was required. Conclusion: Once subaortic stenosis was diagnosed, operation should be done. Preoperative echocardiography and routine exploration of the root of aorta should be done during operation are in diagnosing. The key point of the operation that left ventricular outflow tract should be thoroughly dredged, no injury should be made to the mitral valve, aortic valve and conduction bundle.