目的分析逆行输尿管软镜手术(retrograde intrarenal stone surgery,RIRS)治疗输尿管上段结石或肾结石后出现残留结石患者放置输尿管排石支架辅助排石的效果。方法选取2020年12月—2021年12月连云港市东方医院接收的RIRS治疗输尿管上段...目的分析逆行输尿管软镜手术(retrograde intrarenal stone surgery,RIRS)治疗输尿管上段结石或肾结石后出现残留结石患者放置输尿管排石支架辅助排石的效果。方法选取2020年12月—2021年12月连云港市东方医院接收的RIRS治疗输尿管上段结石或肾结石后出现残留结石患者50例展开研究,按照电脑随机分配方式分组,参比组25例患者应用普通双J管辅助排石治疗,研究组25例患者应用输尿管排石支架留置辅助排石术治疗。分析两组患者治疗后的疼痛水平、结石排尽时间、止痛时间、住院时间、结石排出率、并发症发生率。结果研究组患者疼痛水平轻于参比组,差异有统计学意义(P<0.05);研究组患者结石排尽时间、止痛时间、住院时间均短于参比组,差异有统计学意义(P<0.05);研究组结石排出率为96.00%,高于参比组的68.00%,差异有统计学意义(χ^(2)=4.878,P<0.05);研究组并发症发生率为4.00%,低于参比组的32.00%,差异有统计学意义(χ^(2)=4.878,P<0.05)。结论在对RIRS治疗输尿管上段结石或肾结石后出现残留结石患者进行治疗时,应用输尿管排石支架留置辅助排石术治疗能够减轻患者疼痛水平,加快结石排出,缩短住院时间,减少并发症发生风险。展开更多
Objective: to investigate the lithotripsy, blood loss and safety of patients with upper urinary calculi by MPCNL and RIRS. Methods: 80 clinical trial participants were counted. From June 2020, they were treated accord...Objective: to investigate the lithotripsy, blood loss and safety of patients with upper urinary calculi by MPCNL and RIRS. Methods: 80 clinical trial participants were counted. From June 2020, they were treated according to the protocol provided by the hospital. By December 2021, they were treated according to their own treatment procedures. The number of each patient was limited to 40. After the completion of the control group and the study group, statistics and sorting were carried out. MPCNL, RIRS and MPCNL were used for comparison in the control group, and the gravel situation, blood loss, safety mental state and quality of life. Results: after comparison, the stone treatment results of the two cases were compared. The success rate of one-time treatment was 92.50%, and the treatment effect of the treatment group was 70.00%;Comparing the bleeding rates of the two groups, the bleeding rate of the control group was significantly lower than that of the control group;The incidence of comorbidities in the two groups was 5.00% and 22.50%, and the incidence of comorbidities in the experimental group was lower. In this study, individual cases were used for psychological and emotional comparison. Among them, the anxiety level was (38.59 ± 3.54) and (42.86 ± 3.73), the emotional fluctuation in the control group was more obvious, the depression status was (35.86 ± 3.26) and (38.64 ± 3.18), and the improvement in the research group was more excellent;In this trial, the survival quality of cases was used as control, and the results showed that the quality of life of control patients was relatively poor. Conclusion: MPCNL and RIRS can significantly improve the clinical effect of patients with urinary system symptoms. It can reduce intraoperative bleeding and complications, make full use of a variety of bad emotions in patients, improve their daily quality of life, and comprehensively protect patients lives and physical health. It has very obvious clinical application value and is worth widely recommended.展开更多
Introduction:Surgeons typically prefer 270μm and 272μm laser probes in retrograde intrarenal surgery(RIRS)due to the reduced deflection capacity of flexible ureterorenoscopes when using larger probe diameters.This s...Introduction:Surgeons typically prefer 270μm and 272μm laser probes in retrograde intrarenal surgery(RIRS)due to the reduced deflection capacity of flexible ureterorenoscopes when using larger probe diameters.This study aims to investigate the effects of 272 and 365μm holmium laser probes on operative time,clinical efficacy,and complication rates in RIRS.Materials and Methods:A total of 285 patients with proximal ureteral or kidney stones who met the inclusion criteria were enrolled in the study.Patients were divided into two groups based on laser probe thickness:272μm and 365μm.Stone-free rates,operative time,and complication rates were compared between the groups.Factors affecting stone-free rates were analyzed using multivariate logistic regression analysis.Results:Patient and stone characteristics were similar between the two groups.No significant differences were found in stone-free or complication rates.However,operative time was significantly shorter in the 365μm probe group.In univariate analysis,risk factors for postoperative residual stones included multi-calyceal stones,lower pole stones,high Hounsfield unit(HU)values on noncontrast computed tomography,and larger stone size.In multivariate analysis,independent prognostic factors for residual stones were identified as multi-calycal stones,lower pole stones,and high HU values.Conclusion:Compared to 272μm laser probes,operative time was shorter in surgeries performed with 365μm laser probes.The 365μm holmium laser can be effectively and safely used in the treatment of proximal ureteral and renal stones,demonstrating high clinical efficacy and safety.展开更多
湖泊沉积物作为重要的环境演化记录载体,其矿物组合特征蕴含了丰富的古环境信息。然而,由于沉积物中晶质和非晶质组分的复杂共存关系,以及多相矿物体系的相互干扰效应,其精确定量分析一直是沉积学研究中的技术难点。该研究以西藏中部封...湖泊沉积物作为重要的环境演化记录载体,其矿物组合特征蕴含了丰富的古环境信息。然而,由于沉积物中晶质和非晶质组分的复杂共存关系,以及多相矿物体系的相互干扰效应,其精确定量分析一直是沉积学研究中的技术难点。该研究以西藏中部封闭咸水湖泊巴木错沉积物为研究对象,系统分析、评估了参比强度比(RIR)法和Rietveld全谱拟合法在复杂沉积物矿物定量分析中的可靠性和应用效果。文章采用高纯度刚玉作为内标物质,设计了1∶1、3∶7和1∶9三组不同配比的混合样品,通过X射线衍射(XRD)分析获取了完整的衍射数据。基于COD晶体结构数据库,分别采用RIR值法和Rietveld全谱拟合法进行定量计算,并结合非晶含量测定方法,构建了完整的矿物定量分析体系。研究结果表明,Rietveld全谱拟合法表现出优异的分析精度和稳定性:对于含量大于20%的主量相,相对标准偏差(RSD,Relative Standard Deviation)控制在3%以内;含量在5%~20%之间的次量相,RSD值保持在5%~10%范围内;即使对于含量低于5%的微量相,其定量结果也显著优于RIR值法。特别是在处理非均质样品时,Rietveld法表现出良好的适应性,各矿物相含量与混合比例呈现显著的线性相关性(R^(2)>0.95)。相比之下,RIR值法在高含量内标条件下(50%和30%)表现出显著的不稳定性,定量结果的相对偏差超出了SY/T5163-2018标准规定的允许范围。这种局限性主要源于其对单个衍射峰强度比值的过度依赖,易受样品基体效应和优势相干扰的影响。此外,通过非晶含量计算,获得了原始沉积物样品中约31%的非晶态物质含量,三组混合样品计算结果的高度一致性(RSD<3%)进一步验证了Rietveld法的可靠性。该研究不仅系统评估了两种定量方法的适用性,而且在复杂湖泊沉积物分析中首次实现了晶质矿物和非晶质组分的协同定量。研究结果对完善湖泊沉积物矿物定量分析方法,提高环境重建的准确性具有重要意义和应用价值。展开更多
文摘目的分析逆行输尿管软镜手术(retrograde intrarenal stone surgery,RIRS)治疗输尿管上段结石或肾结石后出现残留结石患者放置输尿管排石支架辅助排石的效果。方法选取2020年12月—2021年12月连云港市东方医院接收的RIRS治疗输尿管上段结石或肾结石后出现残留结石患者50例展开研究,按照电脑随机分配方式分组,参比组25例患者应用普通双J管辅助排石治疗,研究组25例患者应用输尿管排石支架留置辅助排石术治疗。分析两组患者治疗后的疼痛水平、结石排尽时间、止痛时间、住院时间、结石排出率、并发症发生率。结果研究组患者疼痛水平轻于参比组,差异有统计学意义(P<0.05);研究组患者结石排尽时间、止痛时间、住院时间均短于参比组,差异有统计学意义(P<0.05);研究组结石排出率为96.00%,高于参比组的68.00%,差异有统计学意义(χ^(2)=4.878,P<0.05);研究组并发症发生率为4.00%,低于参比组的32.00%,差异有统计学意义(χ^(2)=4.878,P<0.05)。结论在对RIRS治疗输尿管上段结石或肾结石后出现残留结石患者进行治疗时,应用输尿管排石支架留置辅助排石术治疗能够减轻患者疼痛水平,加快结石排出,缩短住院时间,减少并发症发生风险。
文摘Objective: to investigate the lithotripsy, blood loss and safety of patients with upper urinary calculi by MPCNL and RIRS. Methods: 80 clinical trial participants were counted. From June 2020, they were treated according to the protocol provided by the hospital. By December 2021, they were treated according to their own treatment procedures. The number of each patient was limited to 40. After the completion of the control group and the study group, statistics and sorting were carried out. MPCNL, RIRS and MPCNL were used for comparison in the control group, and the gravel situation, blood loss, safety mental state and quality of life. Results: after comparison, the stone treatment results of the two cases were compared. The success rate of one-time treatment was 92.50%, and the treatment effect of the treatment group was 70.00%;Comparing the bleeding rates of the two groups, the bleeding rate of the control group was significantly lower than that of the control group;The incidence of comorbidities in the two groups was 5.00% and 22.50%, and the incidence of comorbidities in the experimental group was lower. In this study, individual cases were used for psychological and emotional comparison. Among them, the anxiety level was (38.59 ± 3.54) and (42.86 ± 3.73), the emotional fluctuation in the control group was more obvious, the depression status was (35.86 ± 3.26) and (38.64 ± 3.18), and the improvement in the research group was more excellent;In this trial, the survival quality of cases was used as control, and the results showed that the quality of life of control patients was relatively poor. Conclusion: MPCNL and RIRS can significantly improve the clinical effect of patients with urinary system symptoms. It can reduce intraoperative bleeding and complications, make full use of a variety of bad emotions in patients, improve their daily quality of life, and comprehensively protect patients lives and physical health. It has very obvious clinical application value and is worth widely recommended.
文摘Introduction:Surgeons typically prefer 270μm and 272μm laser probes in retrograde intrarenal surgery(RIRS)due to the reduced deflection capacity of flexible ureterorenoscopes when using larger probe diameters.This study aims to investigate the effects of 272 and 365μm holmium laser probes on operative time,clinical efficacy,and complication rates in RIRS.Materials and Methods:A total of 285 patients with proximal ureteral or kidney stones who met the inclusion criteria were enrolled in the study.Patients were divided into two groups based on laser probe thickness:272μm and 365μm.Stone-free rates,operative time,and complication rates were compared between the groups.Factors affecting stone-free rates were analyzed using multivariate logistic regression analysis.Results:Patient and stone characteristics were similar between the two groups.No significant differences were found in stone-free or complication rates.However,operative time was significantly shorter in the 365μm probe group.In univariate analysis,risk factors for postoperative residual stones included multi-calyceal stones,lower pole stones,high Hounsfield unit(HU)values on noncontrast computed tomography,and larger stone size.In multivariate analysis,independent prognostic factors for residual stones were identified as multi-calycal stones,lower pole stones,and high HU values.Conclusion:Compared to 272μm laser probes,operative time was shorter in surgeries performed with 365μm laser probes.The 365μm holmium laser can be effectively and safely used in the treatment of proximal ureteral and renal stones,demonstrating high clinical efficacy and safety.
文摘湖泊沉积物作为重要的环境演化记录载体,其矿物组合特征蕴含了丰富的古环境信息。然而,由于沉积物中晶质和非晶质组分的复杂共存关系,以及多相矿物体系的相互干扰效应,其精确定量分析一直是沉积学研究中的技术难点。该研究以西藏中部封闭咸水湖泊巴木错沉积物为研究对象,系统分析、评估了参比强度比(RIR)法和Rietveld全谱拟合法在复杂沉积物矿物定量分析中的可靠性和应用效果。文章采用高纯度刚玉作为内标物质,设计了1∶1、3∶7和1∶9三组不同配比的混合样品,通过X射线衍射(XRD)分析获取了完整的衍射数据。基于COD晶体结构数据库,分别采用RIR值法和Rietveld全谱拟合法进行定量计算,并结合非晶含量测定方法,构建了完整的矿物定量分析体系。研究结果表明,Rietveld全谱拟合法表现出优异的分析精度和稳定性:对于含量大于20%的主量相,相对标准偏差(RSD,Relative Standard Deviation)控制在3%以内;含量在5%~20%之间的次量相,RSD值保持在5%~10%范围内;即使对于含量低于5%的微量相,其定量结果也显著优于RIR值法。特别是在处理非均质样品时,Rietveld法表现出良好的适应性,各矿物相含量与混合比例呈现显著的线性相关性(R^(2)>0.95)。相比之下,RIR值法在高含量内标条件下(50%和30%)表现出显著的不稳定性,定量结果的相对偏差超出了SY/T5163-2018标准规定的允许范围。这种局限性主要源于其对单个衍射峰强度比值的过度依赖,易受样品基体效应和优势相干扰的影响。此外,通过非晶含量计算,获得了原始沉积物样品中约31%的非晶态物质含量,三组混合样品计算结果的高度一致性(RSD<3%)进一步验证了Rietveld法的可靠性。该研究不仅系统评估了两种定量方法的适用性,而且在复杂湖泊沉积物分析中首次实现了晶质矿物和非晶质组分的协同定量。研究结果对完善湖泊沉积物矿物定量分析方法,提高环境重建的准确性具有重要意义和应用价值。
