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无管化PCNL治疗上尿路结石的可行性 预览 被引量:1

Feasibility Study of Tubeless PCNL in the Treatment of Upper Urinary Tract Calculi
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摘要 目的探讨无管化(Tubeless)经皮肾镜(PCNL)碎石取石术治疗上尿路结石的疗效及可行性.方法 2010年5月至2017年4月,选取160例上尿路结石患者行无管化PCNL术(Tubeless PCNL组).在同时期内以相同通道数及结石大小为条件,随机选择160例上尿路结患者行标准PCNL术(有管化PCNL组).探讨两组病例在手术时间、血红蛋白下降情况、术后疼痛评分(visual analogue scale,VAS)、术后住院天数及术后发热感染方面的差异.结果 2组患者性别(P=0.574)、年龄(P=0.056)、手术部位(P=0.502)、结石位置(P=0.582)及结石大小(P=0.337)差异均无统计学意义.所有病例均经超声定位穿刺成功、手术顺利.Tubeless PCNL组患者VAS评分及术后住院天数比有管化PCNL组低,其差异具有统计学意义(P〈0.05).而2组患者的手术时间、血红蛋白下降情况及发热感染几率相比较并无统计学差异(P〉0.05).结论无管化PCNL能够显著减轻患者术后疼痛、缩短住院天数,且并未增加术后出血、感染及其他严重并发症的风险.因此,无管化PCNL在选择合适的病例的基础上是安全、有效、可行的,其具有非常肯定的临床价值,值得进一步推广应用. Objective To investigate the efficacy and feasibility of tubeless percutaneous nephrolithotomy(PCNL) lithotripsy in the treatment of upper urinary tract calculi. Methods From May 2010 to April 2017, 160 patients with upper urinary tract calculi underwent tubeless PCNL. In the meantime, 160 patients with upper urinary tract calculi were randomly assigned to standard PCNL(standardized PCNL group) under the same number of passages and stone size so as to investigate the difference of operation time, hemoglobin drop, visual analogue scale(VAS), postoperative hospital stay and postoperative fever and infection between the two groups.Results There were no significant differences between the two groups in gender(P = 0.574), age(P = 0.056),surgical site(P = 0.502), stone location(P = 0.582) and stone size(P = 0.337). All cases were punctured by ultrasound and operated successfully. The VAS score and postoperative hospital stay in patients with Tubeless PCNL were significantly lower than those in patients with standardized PCNL(P 〈 0.05). There was no significant difference between the two groups in the operation time, hemoglobin drop and the incidence of fever and infection(P 〉 0.05). Conclusions Tubeless PCNL can significantly reduce the postoperative pain and shorten the length of stay in hospital without increasing the risk of postoperative bleeding, infection and other serious complications. Therefore, the tubeless PCNL is safe, effective and feasible based on the selection of suitable cases, which has very positive clinical value and is worthy of further promotion and application.
作者 段先忠 黄应龙 朱晓瑞 董学丽 马东升 王剑松 DUAN Xian-zhon, HUANG Ying-long, ZHU Xiao-rui, DONG Xue-li, MA Dong-sheng, WANG Jian-song (1.Dept. of Urinary Surgery, The 2nd People's Hospital of Baoshan City, Baoshan Yunnan 678000; 2. Dept. of Urinary Surgery, The 2nd Affiliated Hospital of Kunming Medical University, Kunming Yunnan 650101, China)
出处 《昆明医科大学学报》 CAS 2018年第9期82-86,共5页 Journal of Kunming Medical University
基金 云南省首批基层专家工作站资助项目(2014-300-28) 保山市第四批技术创新人才资助项目[2015(52)]
关键词 无管化 经皮肾镜 上尿路结石 Tubeless Percutaneous nephrolithotomy Calculi
作者简介 段先忠(1975~),男,云南保山人,医学学士,副主任医师,主要从事泌尿外科临床工作.;[通信作者]王剑松.E-mail:iiansongwang@126.com
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