尿细胞角蛋白19在膀胱移行细胞癌术后监测中的应用

目的　评价尿细胞角蛋白19片段(CK19,又称CYFRA2 1 1)在膀胱移行细胞癌(BTCC)术后监测中的作用。方法　对67例保留膀胱的BTCC术后患者定期行膀胱镜检查发现2 1例复发,采用电化学发光免疫分析(ECLIA)技术测定复发组(2 1例)、未复发组(4 6例)和正常对照组(2 4例)的尿CKl9含量。结果　复发组尿CKl9的平均值为(19.60±18.5 7) μg/L ,明显高于未复发组(2 .3 3±1.64 ) μg/L和正常对照组(1.82±0 .83 ) μg/L。复发组与未复发组及正常对照组比较,差异有统计学意义(P <0 .0 1)。尿CKl9对BTCC复发的敏感性为90 .5 % ,特异性为76.0 %。结论　尿CKl9是监测BTCC术后复发较为敏感、特异而且快速无创的指

Comparison of efficacy between mPCNL with holmium laser and EMS standard tract PCNL in the treatment of complex renal calculi under ultrasound guidance

目的比较b超引导下微通道经皮肾镜钬激光碎石术(MPCnl)与标准通道经皮肾镜气压弹道联合超声碎石术(标准通道PCnl)治疗复杂性肾结石的临床疗效。方法对78例复杂性肾结石患者分别行MPCnl(35例)和标准通道PCnl(43例)治疗,术后对2组患者的手术时间、一期结石清除率和手术并发症等指标进行比较分析。结果 2组患者分别成功建立16f和24f经皮肾通道并一期行碎石术。MPCnl组手术时间明显长于标准通道PCnl组;一期结石清除率MPCnl组低于标准通道PCnl组,差异均具有统计学意义(P均38.5℃1例。2组并发症差异无统计学意义(P>0.05)。结论 b超引导下MPCnl与标准通道PCnl治疗复杂性肾结石安全有效、并发症发生率低,标准通道PCnl联合应用EMS第4代气压弹道联合超声碎石清石系统碎石清石效率高,较MPCnl钬激光碎石明显有优势,值得推广。Objective To compare the outcomes of the surgical treatment of complex renal calculi with minimally invasive percutaneous nephrolithotomy(mPCNL) and EMS percutaneous nephrolithotomy(standard tract PCNL) under ultrasound guidance.Methods A total of 78 patients with complex renal calculi were allocated to either mPCNL treatment group(mPCNL group,n=35) or EMS(swiss,the fourth generation) standard tract PCNL treatment group(standard tract PCNL group,n=43).The operative time,primary stone-free rate and operative complications in the two groups were compared.Results 16F and 24F percutaneous renal accesses were successfully established in mPCNL group and standard tract PCNL group respectively,and then the first lithotrity-lithiasis cleaning procedure was performed.The operation time in mPCNL group was longer than that in the standard tract PCNL group 〔(102±31) min vs(67±22) min,P38.5 ℃ occurred in one case of mPCNL group.There was no significant difference in operative complications in two groups(P>0.05).Conclusions Both the treatments of complex renal calculi with mPCNL and EMS(the fourth generation) standard tract PCNL under ultrasound guidance are similarly safe,but the standard tract PCNL has the superiority of higher primary stone-free rate and shorter operation time over the holmium Laser mPCNL.Therefore the standard tract PCNL merits propagation for treating complex renal calculi

深度闭合性肾裂伤的非手术治疗

总结25例深度闭合性肾裂伤的救治经验。认为对深度闭合性肾裂伤,可根据具体情况,在严密监护下行非手术治疗,效果满意

新しい腫瘍マーカーCA19-9の臨床的検討

Article信州医学雑誌 32(3): 225-230(1984)journal articl