摘要
目的:评价经皮肾镜手术在高危麻醉风险病人中的安全性及有效性。方法:2008年1月至2010年1月回顾性分析178例患者行经皮肾镜手术189次,所有患者的术前情况均使用美国麻醉学学会评分标准进行评分,将患者分为2组,高危险组,评分为Ⅲ或Ⅳ,共39例,低危险组,评分为Ⅰ或Ⅱ,共139例。结果:高危组行经皮肾镜(Percutaneous nephrolithotomy,PCNL)手术42次,低危组共行147次。低危组患者年龄较高危组小(47.6岁与55.2岁)。2组在结石大小及位置上差异无统计学意义。高危组并发疾病平均为2.8种,低危组为0.6种,差异有统计学意义。在术中各种参数的比较中,高危组麻醉时间长于低危组,术中估计出血量差异无统计学意义。2组总的并发症发生率相当。高危组平均术后住院日为7.6 d,低危组为4.8 d,两者差异有统计学意义。高危组结石清除率为83%,低危组结石清除率为94%,两者差异有统计学意义。结论:对于高危的患者来说,PCNL是一种安全有效的治疗方法。
Objective：To discuss the safety and efficacy of percutaneous nephrolithotomy（PCNL） in high-risk patients.Methods： The records of 189 consecutive PCNL procedures performed on 178 patients from January 2008 to January 2010 were retrospective analyzed.The preoperative conditions of the patients were evaluated by American Society of Anesthesiologists（ASA） Scores.The patients were divided into a high-risk group（n=39）,which had an ASA score of III or IV,and a low-risk group（n=139） with scores of Ⅰ or Ⅱ.Results：42 procedures were performed in the high-risk group,and 147 procedures in the low-risk group.The low-risk group had a younger age than high-risk group（47.6 vs 55.2 y）（P0.05）.There was no difference observed in stone size and location.The mean number of comorbidities in high-risk group was 2.8,and 0.6 in low-risk group;the difference was significant（P0.05）.In the comparison of the intraoperative parameters,the general anesthesia time was longer in the high risk group（125.3 vs 102.4 min）;no significant difference was observed in the estimated blood loss（128 vs 160 ml）（P0.05）.The overall complication rate had no difference between the high-risk（13.2%） and low-risk（10.8%）（P0.05）.The mean postoperative hospital stay was 7.6 d in the high-risk group and 4.8 d in the low-risk group respectively;the difference was significant（P0.05）.The stone-free rate in the high-risk group was 83%,and 94% in the low-risk group;the difference was significant（P0.05）.Conclusion：For the patients with high-risk preoperative conditions,PCNL can be a safe and effective procedure.
出处
《重庆医科大学学报》
CAS
CSCD
北大核心
2011年第8期999-1001,共3页
Journal of Chongqing Medical University
关键词
经皮肾镜
肾结石
高危患者
percutaneous nephrolithotomy
renal stone
high-risk patients
