摘要
目的:探讨微创经皮肾镜取石术(MPCNL)治疗肥胖患者上尿路结石的安全性和可行性。方法:选择本院2007年11月至2011年9月间实施的、符合病例入选标准及排除标准的439例MPCNL患者。肥胖组(体重指数BMI≥24)78例,正常体重组(18.5<BMI<24)391例。研究组MPCNL术由同一个医疗组医师完成。分别记录两组患者的术前-术毕血红蛋白和红细胞压积的差值,输血率以及手术时间、结石清除率、术后平均住院天数、并发症发生率等。结果:所有的手术均取得成功,无一例中转开放,术中未发生损伤胸膜和肠管手术并发症。两组间比较,术前-术毕血红蛋白和红细胞压积差值、术后住院时间、结石清除率和手术并发症发生率、输血率等均无统计学差异(P﹥0.05),肥胖患者组手术时间较正常体重组手术时间长,差异有统计学意义(P<0.05)。结论:MPCNL治疗肥胖和正常体重患者上尿路结石同样安全、有效,但一定程度上肥胖体质增加了MPCNL治疗上尿路结石的手术时间;肥胖患者上尿路结石MPCNL应由熟练的、有经验的医师完成。
Objective： To Analyze the security and feasibility of treating upper urinary tract calculi for obese patients by the use of minimally invasive percutaneous nephrolithotomy （MPCNL）. Methods：The research objects were 439 MPCNL pa- tients selected in the hospital from November, 2007 to September ,2011 in accordance with the criteria of case selection. There were 78 members in the obesity group （ body mass index, BMI≥24） and 391 in normal weight group （ 18.5 〈 BMI 〈24）. All the surgeries are finished by surgeons from one medical group. Take note of the following data of the two groups： difference between hemoglobin and hematocrit before and after the surgery, blood transfusion rate, length of the surgery, the rate of stone clearance, average hospitalization length after the surgery and incidence rate of surgical complications. Results：All the surgeries were successful with no Conversion to open. No injury of pleura or bowel surgery compli- cation happened during the surgeries. No statistical difference （P 〉 0.05 ） of the two groups was observed in difference between hemoglobin and hematocrit before and after the surgery, hospitalization length after the surgery, the rate of stone clearance, incidence rate of surgical complications and blood transfusion rate. There was statistical significance （P 〈 0.05） of surgery length between obesity group and normal weight group. Conclusion： MPCNL treatment of upper urinary tract calculus of obese patients is as safe and effective as that of patients with normal weight. However,to a certain extent, obese physique lengthens the treating time, so MPCNL of upper urinary tract calculus of obese patients should be operated by experienced surgeons.
出处
《赣南医学院学报》
2014年第1期37-39,共3页
JOURNAL OF GANNAN MEDICAL UNIVERSITY
