RESUMO
Objective To compare the treatment effects of different dosage of tamsulosin for patients with type Ⅲ prostatitis.Methods 150 patients with type Ⅲ prostatitis were selected as study objects.They were divided into control group and research group according to the digital table,each group in 75cases.The research group was treated with tamsulosin 2 tablets (0.4mg),1 time a day.The control group was treated with tamsulosin 1 tablet (0.2mg) + starch tablet 1 tablet,1 time a day.After treatment for 12 weeks,the clinical effects,NIH-CPSI score,white blood cell count and pH value,and adverse reaction between the two groups were compared.Results The total effective rate of the research group was higher than that of the control group(93.33％ vs.81.33％),the difference was statistically significant (x2 =4.881,P ＜ 0.05).After treatment,the pain,voiding symptoms,quality of life and NIH-CPSI scores in the research group were (5.13 ± 4.02) points,(2.52 ± 1.07) points,(3.64 ± 3.25) points,(9.19 ± 0.63) points,respectively,which were lower than those in the control group [(8.25 ± 3.54) points,(3.28 ± 1.87) points,(5.57 ± 3.62) points,(16.47 ± 0.38) points],the differences were statistically significant (t =5.044,3.055,3.436,85.693,all P ＜0.05).The white blood cell and pH value of the research group were (12.65 ± 5.88) x 109/L,(6.29 ±0.20),respectively,which were lower than those in the control group [(16.58 ±6.24) x 109/L,(6.73 ± 0.16)],the differences were statistically significant (t =3.970,14.878,all P ＜ 0.05).The single occurrence rate and total occurrence rate between the two groups had no statistically significant differences (x2 =0.340,0.207,0.000,0.000,0.362,all P ＞ 0.05).Conclusion The effect of tamsulosin in dose of 0.4 mg is better than 0.2 mg,and had no significant impact on safety.
RESUMO
Objective To report the primary experience of open placement of triple-branched stent graft for acute Stanford type A aortic dissection. Methods Between June 2008 and September 2009, 20 well-selected patients with acute Stanford type A aortic dissection underwent open placement of triple-branched stent graft for total arch reconstruction. When core cooling to a 20℃ nasophageal temperature, perfusion to the lower body was discontinued and the ascending aorta was transected at the base of the innominate artery. Through a transverse incision, the triple-branched stent graft was inserted into the true lumen of the arch and descending aorta, and each side arm of the stent graft was positioned one by one into the arch branches.The transected stump of the ascending aorta was reconstructed by inner proximal stent-free dacron tube of the main graft and outer teflon felt, and subsequently continuous anastomosis to the 1-branched dacron tube graft was made. Results Open placement of triple-branched stent graft was technically successful in all patients. The mean cardiopulmonary bypass time, aortic cross-clamp time and lower body arrest time were (163.2 ±19.2) min, (89.4 ±10.0) min and (32. 7 ±6. 6)min, respectively. Transient postoperative neurological dysfunction was observed in 1 patient and acute renal failure in 1 patient. All patients were discharged from the hospital. Their computed tomographic scans at 3 months postoperatively showed that all stent grafts were fully opened without distortion. In the vascular stent implantation site the dissected false lumen was eliminated. The false lumen of the descending aorta distal to the stent graft was closed with thrombus in 16 cases. Conclusion Open placement of triple-branched stent graft is a new effective technique for total arch reconstruction in acute type A aortic dissection. Patients have the indications of the extensive primary repair of the thoracic aorta without primary intimal tears in the arch may be the best candidates for this new technique. The size of the stent graft, the distances between two neighboring side arm grafts and the prevention of the intimal trauma during the placement are crucial for successful open placement of triple-branched stent graft.