摘要
目的:探讨微创经皮肾取石术基础上,适当增大通道口径的实用性和安全性。方法:分析三组采用F16、F18和F20三种不同通道进行经皮肾取石术治疗共312例上尿路结石患者的临床资料,就手术时间,出血情况,术中术后并发症,住院时间和结石清除率等几方面进行比较。结果:随着工作通道的增大,术中出血和患者的住院时间并未随之增加,结石的清除率无明显差异,但手术时间明显缩短,F16、F18和F20三组的平均手术时间分别为123、96和78min;黏膜损伤和肾组织被击穿的机会减少,三组发生率分别为8%,5.4%和0;术后高热的发生率和水外渗引起胸腹腔积液的发生率降低;前者的发生率分别为9.19%,4.65%和4.16%;水外渗引起胸腹腔积液仅见于F16组。结论:适当增大经皮肾取石的通道,不会造成肾盏颈部撕裂和肾血管损伤而引起的大出血,在保证较高取石率的情况下,可明显缩短手术时间,减少并发症的发生,安全有效。
Objective： To study the practicability and the security of properly increasing the caliber of passage way, which is basic on minimally invasive percutaneous nephrolithotomy. Methods： To analyze the clinical information of 312 cases of patients diagnosed as upper urinary stone disease. According to different calibers of passageway, the patients had been divided into three groups, such as group F16, group F18 and group F20, and treated by pereutaneous nephrolithotomy, compared the results by operation time, bleeding, complication in and after opera tion, length of stay, clearance of stone and so on. Results： With the increasing of working passageway, bleed dur ing operation and the patients＇ length of stay had not increased, while the clearance of stone had no apparent differ ence, however, the operation time had been shortened. The average operation time of the F16, FI, and F20 groups were respectively 123 minutes, 96 minutes and 78 minutes; the possibility of mucosa damage and kidney rupture had decreased, incidence rate were respectively 9.19%, 4.65% and 4.16% ; the incidence rate of hyperpyrexia after operation and thoracoabdominal effusion had decreased, the former were respectively 9.19%, 4.65% and 4. 16 %, the latter were only observed in group F16. Conclusions：The hemorrhea which is caused by neck of renal calices tearing or renal vessels injury will not occur, when we increase the caliber of passageway properly while ap plying percutaneous nephrolithotomy. What＇s more, while removing stones effectively, the operation time can be shortened apparently, the occurrence of complication can be reduced. It＇s not only safe, but also effective.
出处
《临床泌尿外科杂志》
2008年第11期844-845,848,共3页
Journal of Clinical Urology
关键词
经皮肾取石术
上尿路结石
Percutaneous nephrolithotomy
Upper urinary stone disease
