摘要
目的 探讨F18/F16微通道经皮肾镜取石术与标准通道手术治疗肾铸形结石的疗效.方法 选取2017年1月~2018年12月在我院经F18/F16微通道经皮肾镜取石术的66例肾铸形结石患者作为观察组,选取同时期在我院进行标准通道手术的62例肾铸形结石患者为对照组.对两组临床指标、肾盂内压、结石清除率、肾功能指标及并发症发生率进行对比分析.?结果观察组手术时间(125.43±12.74)min长于对照组(103.32±6.73)min,差异有统计学意义(P<0.05),但其术中出血量(113.76±14.94)mL、输液量(1274.34±219.35)mL明显少于对照组(155.54±11.43)mL、(1543.43±284.94)mL,此外其住院时间(11.43±2.54)d明显的短于对照组(17.34±3.54)d,差异有统计学意义(P<0.05).观察组碎石前、中、后肾盂内压(10.37±1.25)、(28.84±4.95)、(20.74±3.84)mm Hg均明显的高于对照组(7.43±1.34)、(20.65±4.32)、(14.94±2.85)mm Hg,差异有统计学意义(P<0.05).两组一期手术的结石清除率分别为93.93%和74.19%,差异有统计学意义(P<0.05).手术前后,两组血白细胞值、尿白细胞值、降钙素原、及血肌酐(Scr)、血尿素氮(BUN)等肾功能指标,差异无统计学意义(P>0.05).两组患者发热、感染、延迟性出血及脓毒血症等并发症发生率比较,差异无统计学意义(P>0.05).结论 F18/F16微通道经皮肾镜取石术具有减少术中出血量、输液量,提高结石清除率等优势,对患者肾功能无不良影响,且并发症无明显提高,具有较高的安全性.
Objective To explore curative effects of F18/F16 microchannel percutaneous nephrolithotomy and standard channel surgery in treatment of kidney staghorn calculi.Methods 66 patients with kidney staghorn calculi who underwent F18/F16 microchannel percutaneous nephrolithotomy in our hospital from January 2017 to December 2018 were selected as the observation group.62 patients with kidney staghorn calculi who underwent standard channel surgery in our hospital at the same time were selected as the control group.The clinical indexes,intrapelvic pressure,stone clearance rate,renal function index and complication rate of two groups were compared and analyzed.Results The operation time of the observation group was(125.43±12.74)min,longer than that of the control group(103.32±6.73)min.The difference was statistically significant(P<0.05).The intraoperative bleeding volume and infusion volume were respectively(113.76±14.94)mL and(1274.34±219.35)mL,significantly less than(155.54±11.43)mL and(1543.43±284.94)mL in the control group.In addition,the hospital stay of the observation group was(11.43±2.54)D,significantly shorter than that of the control group(17.34±3.54)D,and the difference was statistically significant(P<0.05).The intrapelvic pressures before,during and after lithotripsy in the observation group were respectively(10.37±1.25),(28.84±4.95)and(20.74±3.84)mm Hg,significantly higher than those in the control group(7.43±1.34),(20.65±4.32)and(14.94±2.85)mm Hg.The difference was statistically significant(P<0.05).The stone clearance rates of one-stage operation in the two groups were respectively 93.93%and 74.19%,and the difference was statistically significant(P<0.05).Before and after surgery,there was no statistically significant difference in leukocyte values,urinary white blood cell values,procalitonin,serum creatinine(Scr),blood urea nitrogen(BUN)and other renal function indexes(P>0.05).There was no statistically significant difference in the incidence of complications such as fever,infection,delayed bleeding and sepsis between the two groups(P>0.05).Conclusion F18/F16 microchannel percutaneous nephrolithotomy has the advantages of reducing intraoperative blood loss and infusion volume and improving stone clearance rate,which has no adverse effects on renal function.And the complications are not significantly improved,and it has higher safety.
作者
陈咏佳
冯能贵
许华强
陈光耀
黄秋宝
谭健秋
许敏妹
CHEN Yongjia;FENG Nenggui;XU Huaqiang;CHEN Guangyao;HUANG Qiubao;TAN Jianqiu;XU Minmei(First Department of Urology Surgery,Yangjiang Hospital Affiliated to Guangdong Medical University,Yangjiang People’s Hospital,Yangjiang 529500,China)
出处
《中国医药科学》
2020年第6期13-16,46,共5页
China Medicine And Pharmacy
关键词
微通道经皮肾镜取石术
标准通道经皮肾镜取石术
肾铸形结石
肾盂内压
结石清除率
Microchannel percutaneous nephrolithotomy
Standard channel percutaneous nephrolithotomy
Kidney staghorn calculi
Intrapelvic pressure
Stone clearance rate
