摘要
目的探究12肋尖上2cm区域经皮肾镜取石术(PCNL)治疗鹿角型肾结石的临床疗效及安全性。方法分析该科2016年8月—2018年3月入院行PCNL术的鹿角形肾结石患者120例,观察组60例,经皮肾通道穿刺点选择12肋尖上2 cm区域(简称肋尖上通道),对照组60例,经皮肾通道(简称肋下通道)穿刺点选择12肋下范围,比较两组手术患者一期结石清除率、手术时间、术中出血量、术后住院时间、术后肾出血需要介入栓塞例数。结果观察组的结石清除率(88.3%)高于对照组(75.0%),两组比较差异有统计学意义(χ~2=5.13,P<0.05);但相对于对照组的手术时间(99.77±19.68)min、术中出血量(319.51±43.2)mL、术后住院时间(8.17±2.01)d及术后肾出血需要介入栓塞的例数(7例),观察组的手术时间(90.12±17.21)min、术中出血量(251.50±31.37)mL、术后住院时间(5.57±1.63)d及术后肾出血需要介入栓塞的例数(1例)均明显低于对照组,两组差异有统计学意义(t=2.857、9.867,7.77,χ~2=4.82,P<0.05)。结论 12肋尖上2 cm区域行经皮肾镜取石术是安全的。与肋下通道相比,具有结石清除效率高、手术时间短、术中出血少及术后恢复快等优点。
Objective To investigate the clinical efficacy and safety of percutaneous nephrolithotomy （PCNL） in the treatment of staghorn type kidney stones in the 2 cm region. Methods A total of 120 patients with staghorn kidney stones admitted to the hospital from August 2016 to March 2018, and 60 patients in the observation group were select- ed. The percutaneous renal channel puncture site was selected from the 12 rib tip 2 cm area （referred to as the rib tip channel）. 60 cases in the control group, the percutaneous renal channel （referred to as the subcostal channel） puncture point was selected under the 12-ribbed range, comparing the first-stage stone removal rate, operation time, intraopera- tire blood loss, postoperative hospital stay, surge^7 postoperative renal hemorrhage requires interventional embolization. Results The stone clearance rate （88.3%） in the observation group was higher than that in the control group （75.0%）. The difference between the two groups was statistically significant （X2=5.13, P〈0.05）. However, the operation time was compared with the control group （99.77±lg.68）min, intraoperative blood loss （319.51±43.2）mL, postoperative hospital stay （8.17e2.01）d and postoperative renal hemorrhage requiring interventional embolization （7 cases）, observation group operation time （90.12±17.21）min, the number of intraoperative blood loss （251.50±31.37）mL, postoperative hospital stay （5.57±1.63）d and postoperative renal hemorrhage requiring interventional embolization （1 case） were significantly lower than the control group. Academic significance （t=2.857, 9.867, 7.77, X2=4.82, P〈0.05）. Conclusion Percutaneous nephrolithotomy is safe in the 2 cm area of the rib. Compared with the subcostal channel, it has the advantages of high stone removal efficiency, short operation time, less intraoperative blood loss and quick postoperative recovery.
作者
徐浩
韩献成
栾志敏
XU Hao;HA N Xian-cheng;L UA N Zhi-min(Department of Urology,Affiliated Hospital of Weifang Medical College,Weifang,Shandong 261000,China)
出处
《系统医学》
2018年第20期72-74,共3页
Systems Medicine
关键词
经皮肾镜取石术
经皮肾通道
鹿角形肾结石
Percutaneous nephrolithotomy
Percuta-neous renal access
Staghorn kidney stones
