逆行性肾盂造影联合输尿管软镜在诊断小肾盏癌中的价值

探讨逆行性肾盂造影联合输尿管软镜在诊断小肾盏癌中的价值。回顾分析5例小肾盏癌临床资料,术后病理检查结果均提示尿路上皮癌I级（Ta-G1）,术后定期行膀胱内灌注化疗药物,且均未出现肿瘤其他部位转移等并发症发生。对5例患者均进行随访,1年期间每3个月行尿常规及B超检查均正常,1年生存率达100％。患者出现血尿症状,虽然常规检查（尿常规、B超、IVU、CT或MRI等）诊断不明确者,都可行逆行性肾盂造影检查。一旦逆行性肾盂造影检查提示异常图像,均可提示肾盏癌,使误诊率及漏诊率降至最低程度,尽可能阻断早期肿瘤的发展。故逆行性肾孟造影联合输尿管软镜可提高早期小肾盏癌的术前诊断率。     

Determination of problems in patients with post‐laryngectomy

The purpose of this study is the determination of the physical and psychosocial problems of total and partial laryngectomies. A total of 25 patients, who were operated with the diagnosis of larynx carcinoma in 2010 at Gazi University Faculty of Medicine Otolaryngology Department, were included in the study. They were evaluated with the help of the Personal Information Form (PIF) and the Determination Form of Post Laryngectomy Problem (DFPLP) for the problems they encountered after the operation. Total laryngectomy (TL) was performed on 76% of patients. It was determined that patients undergoing total laryngectomy experienced some physical and psycho‐social problems such as problems in sleep (31.6%), smell (52.6%), taste (36.8%), and difficulty in swallowing solid foods (36.8%). Furthermore in patients with TL surgery whilst 47.4% of them think that their sexual lives were affected rather negatively, this rate was determined as 33.3% in patients with partial laryngectomy surgery (PL). The psychosocial score averages of the patients who had smell and taste disorders were significantly lower (p < 0.05). The patients, who underwent a laryngectomy operation, experienced many physical, social, and psychological problems. Thus, medical personnel also need to pay attention to these concomitant problems that occur during the treatment of the primary disease and the application of necessary supplementary treatments such as voice prosthesis, pre‐op and post‐op counseling, and anti‐depressants seems significant in terms of increasing the life quality of the patients.     

乳腺癌保乳手术的哲学思考

保乳手术基于乳腺癌是一种全身疾病的认识,符合医学发展的方向并最大程度地满足了患者对形体美的追求,保乳手术是早期乳腺癌手术的发展趋势,保乳治疗是多种疗法序贯应用的综合治疗。乳腺外科医师应及时转变治疗观念,以更大的责任心给予乳腺癌患者最好的治疗和更多的人文关爱。     

早期宫颈癌术式选择的比较研究

根治性子宫切除术与保留生育功能的根治性宫颈切除术均可用于早期宫颈癌患者的手术治疗。根据生物-心理-社会医学模式的要求,本文采用比较治疗学的方法,对这两种手术方式,从适应证、手术方式、并发症、疗效等方面进行比较,为宫颈癌临床科学决策提供借鉴。     

低位直肠癌保肛手术循证医学证据

低位直肠癌是否行保肛手术的主要依据是病人的全身条件、肿瘤的分化程度、浸润转移的范围以及距齿状线的距离而个体化对待。对于低位直肠癌是否行保肛手术、低位直肠癌保肛手术后是否行结肠贮袋吻合术、直肠癌术前是否新辅助治疗以及是否行腹腔镜低位直肠癌保肛手术,这些方面都需要依据循证医学证据,不能凭个人主观意愿,这样才有助于进一步提高直肠癌的治疗效果。     

食管癌切除术后颈部不同方法食管胃吻合比较分析

比较食管癌切除术后应用非一次性沪产吻合器和手工缝合在颈部行食管胃吻合的经验体会。我科1998年11月~2010年12月,食管癌切除术后应用沪产吻合器在颈部通过＂反插法＂进行食管胃吻合126例;手工缝合100例。结果全部病例均治愈出院,手工缝合组发生吻合口瘘5例,吻合口狭窄9例,食物返流18例,吻合口出血1例;吻合器组未...     

乙酰肝素酶剪接变体T5mRNA在肾癌中的表达

探讨乙酰肝素酶（Hpa）剪接变体T5mRNA在肾癌（RCC）组织中的表达,分析其与RCC发生发展及预后的关系。采用逆转录-聚合酶链反应（半定量RT—PCR）方法检测RCC组织标本及癌旁正常组织标本中T5mRNA的表达。结果RCC组织中T5mRNA阳性率高于癌旁正常组织（P〈0．05）;T5mRNA阳性表达率与RCC病理...     

肝癌基础研究如何向临床转化

肝癌基础研究在过去数十年取得了长足的进步,而肝癌临床研究则相对滞后,二者间存在巨大的反差。如何将基因组时代发现的大量有重要意义的基础研究成果及时有效地转化为临床可用的技术方法,以进一步提高肝癌治疗效果是亟待解决的难题。转化医学研究为其搭建了一条重要桥梁。     

低位直肠癌保肛手术的哲学思辨

回顾直肠癌手术的发展史,追求根治与功能相互对立统一的发展过程。低位直肠癌保肛手术经历了长时间的对立、演化、发展,如今已经不再是手术技巧的问题,而是如何掌握保肛原则的问题。只有树立辩证唯物主义的世界观和方法论并用于实践,才能有助于进一步提高直肠癌的手术疗效。     

甲状腺癌的诊治原则

甲状腺癌是内分泌系统最常见的恶性肿瘤,它的发病率正逐年增加,其诊断方法包括体格检查、超声检查、细针穿刺、影像学检查及实验室检查等,甲状腺癌的治疗以外科手术为主,对较晚期或远处转移的患者可行综合治疗(I131,放疗,化疗)。总之,甲状腺癌经合理治疗,可获得较好的预后。