双通道经皮肾镜碎石治疗复杂性肾结石的疗效观察-东南大学学报医学版

双通道经皮肾镜碎石治疗复杂性肾结石的疗效观察

单位：广西医科大学第四附属医院泌尿外科, 广西柳州 545005

分类号：R737

出版年·卷·期（页码）：2014·33·第三期（342-346）

摘要：

目的：探讨标准通道联合微通道经皮肾镜取石术（micro channel percutaneous nephrolithotomy，MPCNL）治疗复杂性肾结石的临床疗效。方法：选择2012年1月至2012年12月我院收治的复杂性肾结石患者76例，随机分为大通道组38例，采用传统大通道经皮肾镜取石术（percutaneous nephrolithotomy，PCNL）治疗，双通道组38例，采用标准通道联合MPCNL治疗，比较两组的手术时间、术中出血量、一期结石取净率、术中并发症、下床活动时间、住院时间、伤口愈合时间、肾功能恢复时间。结果：双通道组手术时间、术中出血量明显少于单通道组（P<0.05）；双通道组一期结石取净率明显高于单通道组（P<0.05），且并发症明显少于单通道组（P<0.05）；双通道组患者下床活动时间、住院时间、伤口愈合时间、肾功能恢复时间均明显短于单通道组（P<0.05）。结论：标准通道PCNL联合MPCNL治疗复杂性肾结石效果良好，可有效地处理残留结石，减少了手术创伤，降低了并发症发生风险，提高了结石取净率和手术安全性，值得临床推广。

Objective:To investigate the clinical efficacy of treating complex renal calculus by standard channel combined with micro channel percutaneous nephrolithotomy (MPCNL). Methods:Seventy-six patients with complex renal calculus in our hospital between January, 2012 to December,2012 were selected and randomly divided into big-tract group and double-tract group. There were 38 cases in big-tract group, they were treated with traditional big channel percutaneous nephrolithotomy percutaneous nephrolithotomy (PCNL). There were 38 cases in double-tract group, they were treated with standard tract combined with MPCNL. Operation time, bleeding during operation,stone clearance rate I phase,complications, ambulation time,hospitalization time, wound healing time, time of renal function recovery of two groups were compared. Results:The operation time,bleeding during operation of double-tract group were significantly less than those of big-tract group (P<0.05); the stone clearance rate I phase of double-tract group was significantly higher than that of big-tract group (P<0.05), and the complications were significantly less than big-tract group (P<0.05); the ambulation time, hospitalization time, wound healing time, time of renal function recovery of double-tract group were significantly shorter than those of big-tract group (P<0.05). Conclusion:Treating complex renal calculus by standard-tract PCNL combined with MPCNL has good effect, it can effectively reduce the residual stones and operation trauma, reduce complication risk, improve stone clearance rate and operation safety, it is worth to be spreading.

参考文献：

[1] 龚云辉,刘武,刘泽辉,等.开放手术联合B超、弹道碎石治疗复杂肾结石38例分析[J].临床外科杂志,2011,19(7):505-506.
[2] 杨德峰,霍勇,苏翼,等.B超引导下经皮肾镜治疗复杂肾结石106例报告[J].腹腔镜外科杂志,2010,15(8):619-620.
[3] 徐林锋,兰厚金,朱伟东.微创经皮肾镜钬激光碎石术治疗重复肾肾结石11例[J].现代医学,2012,40(2):229-230.
[4] 李龙,汤华章,龙益军.开放手术与微创经皮肾镜穿刺取石治疗复杂肾结石的临床分析[J].国际泌尿系统杂志,2011,31(3):318-319.
[5] 纳宁,胡成,司徒杰.微创经皮肾镜和大通道经皮肾镜治疗肾结石的疗效比较[J].实用医学杂志,2011,27(17):3169-3171.
[6] 周大庆,王坚.标准通道在经皮肾镜取石术中、术后对出血的影响[J].南方医科大学学报,2010,30(12):2768-2769.
[7] FALAHATKAR S,NEIROOMAND H,AKBARPOUR M,et al.One-shotversus metal telescopic dilation technique for tract creation in percutaneous nephrolithotomy:comparison of safety and efficacy[J].J Endourol,2009,23(4):615-618.

服务与反馈：

【文章下载】【发表评论】【查看评论】【加入收藏】

提示：您还未登录，请登录！点此登录