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目的:对比球囊扩张F24通道下经皮肾镜取石术中三种碎石器的碎石效果。方法:回顾分析2013年1月~2014年4月收治90例肾结石患者的临床资料,按术中碎石器的应用分为气压弹道组、钬激光组及超声组,每组30例。三组患者术中均采用腰肋悬空仰卧位,应用球囊扩张法扩张至F24通道。三组患者的性别、年龄、体质指数、结石位置和大小比较差异无统计学意义(P>0.05)。分别记录三组患者手术时间、术中出血量、结石清除率、术后并发症发生率及术后住院时间等指标。结果:三组术中出血量、结石清除率、发热率差异无统计学意义,气压弹道组碎石时间较超声组及钬激光组明显缩短(P<0.05),超声组与钬激光组碎石时间无明显差异(P>0.05)。所有患者术中、术后均无周围脏器损伤及集合系统穿孔等并发症发生。结论:F24通道下经皮肾镜取石术碎石器的选择更加自由,气压弹道碎石器设备便宜,手术时间短,碎石效果确切,配合球囊扩张手术效果良好,值得推广。
OBJECTIVE: To compare the gravel effect of three kinds of lithotripters in percutaneous nephrolithotomy under balloon dilatation F24. Methods: The clinical data of 90 patients with nephrolithiasis from January 2013 to April 2014 were retrospectively analyzed. According to the application of intraoperative lithotripsy, they were divided into pneumatic ballistic group, holmium laser group and ultrasound group, 30 cases in each group. Three groups of patients were lumbar lumbar surgery supine position, the use of balloon dilatation expansion to the F24 channel. There was no significant difference in gender, age, body mass index, stone location and size between the three groups (P> 0.05). Three groups of patients were recorded operation time, blood loss, stone removal rate, the incidence of postoperative complications and postoperative hospital stay and other indicators. Results: There were no significant differences in the amount of bleeding, the rate of stone removal and the rate of fever between the three groups. The lithotripsy time was significantly shorter in the pneumatic ballistic group than that in the ultrasound group and the holmium laser group (P <0.05) No significant difference in time (P> 0.05). All patients had no complications of peripheral organ injury and perforation of the collecting system after operation. Conclusion: The choice of percutaneous nephrolithotomy lithotripsy under F24 channel is more freedom. The pneumatic lithotripter device is cheap, the operation time is short, the lithotripsy effect is exact, and the effect of balloon dilatation surgery is good. It is worth to be popularized.