1.Analysis of Mini-incision approach for urological surgery on 43 patients
Wensheng WANG ; Jian XUE ; Xiaoming YU ; Baoguo LI ; Xin LI ; Gang ZHANG ; Kewei TANG ; Yishu LIN ; Xiaohu TANG
Clinical Medicine of China 2011;27(4):436-437
Objective To summarize the clinical experiences of mini-incision urological surgery.Methods The clinical data of 43 patients who received mini-incision surgery were reviewed retrospectively.The subjects included 5 adrenal tumor excisions,9 nephrectomy,13 unroofing of solitary renal cyst,4 pyeloplasty.12 pyelolithotomy and ureterolithotomy.Results All surgical procedures were successful in the 43 cases.The length of the incision ranged from 3 to 8 cm.The average operation time was 80 minutes and average blood loss was 100 ml. No patients needed blood transfusion during the operation.No serious complications such as the surrounding organ damage happened.The postoperative hospitalization was 5-7 d. Conclusion Mini-incision approach for urological operation has the advantages of minimal invasion,safety,rapid recovery and no requirement for special equipments.Its easy to be popularized in the primary hospital.
2.The predictive value of estimated renal perfusion pressure in acute kidney injury of severe multiple trauma patients
Jing QI ; Chuanzheng SUN ; Huaizheng LIU ; Kefu ZHOU ; Zheren DAI ; Yishu TANG
Chinese Journal of Emergency Medicine 2021;30(8):968-972
Objective:To investigate the predictive value of estimated renal perfusion pressure (eRPP) for acute kidney injury (AKI) in severe multiple trauma patients.Methods:Severe multiple trauma patients were collected based on the inclusion criteria and exclusion criteria from the Trauma Center, the Third Xiangya Hospital, Central South University. Subsequently, patients were divided into the AKI group and non-AKI group according to the occurrence of AKI during 72 h admission to hospital. Further clinical information, ISS score, SOFA score, APACHE Ⅱ score, mean arterial pressure (MAP), central venous pressure (CVP) and intra-abdominal pressure (IAP) were collected, and eRPP were calculated. Additionally, the differences of parameters in the AKI group and non-AKI group were analyzed and logistic regression analysis was performed to identify the independent predicted risk factors for AKI. Finally, ROC curve was conducted to identify specificity, sensibility and best cut-off point.Results:A total of 173 severe multiple trauma patients were finally analyzed. Compared with the non-AKI group, the serum albumin [(32.21±5.20)g/L vs. (34.83±4.20)g/L, P =0.001] and 24 h urine output [(711.90±241.38)mL vs. (1 101.21±509.86)mL, P =0.001] were significantly lower and serum lactate [(2.80±0.96)mmol/L vs. (1.89±0.63)mmol/L, P<0.001], ISS score [(29.05±5.91) vs. (22.17±4.02), P <0.001], APACHEⅡ score [(38.84±21.47) vs. (31.45±18.24), P <0.001] and SOFA score [(5.26±2.08) vs. (3.14±1.34), P <0.001], in-hospital mortality (9.52% vs. 2.29%, P=0.038), and ICU stay [(8.43±6.46)d vs. (6.42±3.78) d, P =0.01) were significantly higher in the AKI group. Moreover, 6, 12 and 24 h of CVP and eRPP after admission were associated with the incidence of AKI. Logistic regression analysis showed that 24 h urine output, CVP and eRPP were the independent predictive factors (P <0.05) and 24 h of eRPP after admission applied a better predictive value of the incidence in AKI. Conclusions:24 h of eRPP might be the most suitable independent predictive factor for AKI in severe multiple trauma patients.