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  elderly patient
The medical management of primary open-angle glaucoma in the elderly patient
      
Predictors for the use of physical restraints are poor mobility, impaired cognitive status and high dependency of the elderly patient and the risk of falls in the nurses' opinion.
      
???The occurrence of extreme cardiac enlargement in an elderly patient associated with multiple coronary bypasses has been not described so far.
      
Since AAA is a disease of the elderly patient with generalized atherosclerosis, there is a high coincidence with other vascular morbidities.
      
The dominant factor in a fracture is therefore the fall of the elderly patient.
      
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Social functioning was significantly better in older patients and in those with no alcohol abuse or personality disorder.
      
Early hemicraniectomy lowers mortality below 40% but functional outcome is frequently unsatisfactory, especially in older patients.
      
In addition levothyroxine 300-500 μg (50 μg in older patients with known cardiovascular disease) has to be administered intravenously 12-24 hours later.
      
Patients in severe pain and older patients were more likely to prefer injections.
      
Ventricular arrhythmias (couplets, ventricular tachycardia) were found in 3% of the younger and 17% of the older patients.
      
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The clinical presentations and spectrum of renal histo- pathology were studied in 120 patients,over 50 years of age,with renal diseases,Renal biopsy revealed primary glomerulonephritis in 88 cases (73.3%)and secondary glomerular lesions in the others.Persistent urinary abnormalities were the most important clinical features in our group.The percutaneous renal biopsy is recommended to be valuable in the diagnosis of glomerular diseases in the aged.

本文回顾性分析讨论了1980年1月~1990年10月间,因肾脏疾病行经皮肾穿刺活检的120例老年及老年前期患者肾脏病理分类及临床特点。结果发现,在我国肾功能异常、血尿、蛋白尿的主要原因仍为肾小球肾炎,其中以膜性肾病最多见,占高龄患者肾活检的25%,占原发性肾炎的34.1%。无症状性尿检异常是最常见的临床表现;其次是肾病综合征。提出尿液检查在这一年龄组是十分必要的观点。作者认为,依靠目前非创伤性检查难以得到正确的组织学诊断,建议对老年及老年前期肾脏疾病患者,争取做肾穿刺活检明确诊新,以采取正确的治疗方法。

45 elderly patients have undergone cadaveric renal transplantation that account for 30.2 percent of 149 patients grafted from Feb, 1988 to Feb, 1992 in our hospital. 37 of the elderly patients were 50~60 years and 8 over 60 years. The average heart/chest ratio was 0.56 with 10 patients more than 0.6. Coronary insufficient perfusion was found in 7 patients and cardiac arrhythmia in 4 patients. Titanium nails were used in 29 patients for the anastomosis of donor renal artery with recipient internal lilac artery...

45 elderly patients have undergone cadaveric renal transplantation that account for 30.2 percent of 149 patients grafted from Feb, 1988 to Feb, 1992 in our hospital. 37 of the elderly patients were 50~60 years and 8 over 60 years. The average heart/chest ratio was 0.56 with 10 patients more than 0.6. Coronary insufficient perfusion was found in 7 patients and cardiac arrhythmia in 4 patients. Titanium nails were used in 29 patients for the anastomosis of donor renal artery with recipient internal lilac artery and in 9 patients for the anastomosis of donor and recipient ureters. The application of titanium nails in renal transplantation can solve the problem of arterial suture in elderly patients and at the same time prevent postoperative stenosis of renal artery, stenosis of the ureterovcsical anastomosis and vesicouretcral reflux, arid urine linkage. One year patient/graft survival rate was 77.3%/68.2%. In author's opinion, the age of recipients is not a decisive factor influencing the final graft survival. For most patients, however, renal transplantation is still an optional effective treatment. The authors have also proposed some important measures and management in the transplantation of elderly patients.

本文报道45例高龄肾移植患者,其中29例采用钛轮钉作髂内动脉与肾动脉吻合术,9例用于输尿管对端吻合。作者认为采用钛轮钉解决了高龄移植者动脉缝合技术的难度,并可防止术后肾动脉狭窄、避免输尿管膀胱吻合口的狭窄与逆流,以及预防尿瘘的发生。认为受者年龄不是肾移植成功与否的绝对因素,并提出高龄患者行肾移植应加强的环节和措施。

223 patients, aged 50~71 years, were biopsied because of a history of renal disease. All of these patients, the incidence of primary glomerulonephritis is about 65.5%, secondary renal disease is 34.5%. In a comparison with patients of younger age groups, it appeared that membranous nephropathy was the most commonly primary glomerulonephritis, the diabetes, amyloidosis had a significantly higher incidence in secondary glomerulonephritis in the elderly. Main clinical features were nephrotic syndrome (37.7%) and...

223 patients, aged 50~71 years, were biopsied because of a history of renal disease. All of these patients, the incidence of primary glomerulonephritis is about 65.5%, secondary renal disease is 34.5%. In a comparison with patients of younger age groups, it appeared that membranous nephropathy was the most commonly primary glomerulonephritis, the diabetes, amyloidosis had a significantly higher incidence in secondary glomerulonephritis in the elderly. Main clinical features were nephrotic syndrome (37.7%) and persistent proteinuria and hematuria (36.8%). In conclusion, we feel renal biopsy in the elderly is essential for the diagnosis and management of some clinical situations,such as acute renal failure and nephrotic syndrome.

本文回顾性分析223例高龄肾脏病患者肾脏病变的病理分型及临床特点。其中原发性肾炎占65.5%;各类继发性肾脏病占34.5%,且随着年龄增长,继发性肾脏病的发病率逐渐增加。原发性肾炎中,以膜性肾病最常见;继发性者则以糖尿病、肾淀粉样变性多见。近年来,高龄患者中急性间质性肾炎及坏死性血管炎有所增多.肾病综合征及持续性尿检异常是最常见的初发临床表现,ARF的发病率有所升高。与青年人相比,高龄患者存在明显的肾小管-间质受损害的实验室及病理改变证据。

 
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