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目的:探讨血小板凝胶在经皮肾镜取石术治疗肾、输尿管上段结石中的应用疗效。方法:选取2012-01-2014-12行经皮肾镜取石术的上尿路结石患者124例,随机分为试验组和对照组各62例,试验组患者在手术结束时使用血小板凝胶封闭创面,对照组患者采用常规止血和手术创面缝合,对比2组患者手术时间、术后并发症的发生率、术后出血率等。结果:试验组手术时间为(2.65±0.60)h,对照组为(3.15±0.70)h,试验组比对照组手术用时更短;试验组术后尿培养阳性者2例(3.2%),对照组尿培养阳性者16例(25.8%);试验组术后血肌酐值较对照组有明显降低;试验组无一例术后出血,对照组出血者1例(1.6%),2组比较差异有统计学意义(P<0.05)。结论:在经皮肾镜取石术治疗肾盂、肾盏和输尿管上段结石中,应用血小板凝胶有效缩短了手术时间,降低了并发症的发生率,促进了肾脏功能恢复,减轻了患者的痛苦,具有较高的临床实用价值。
Objective: To investigate the effect of platelet gel in percutaneous nephrolithotomy for the treatment of renal and upper ureteral calculi. Methods: A total of 124 patients with upper urinary tract calculi underwent percutaneous nephrolithotomy from January 2012 to December 2014 were randomly divided into two groups: trial group (62 cases) and control group (62 cases). Patients in the test group were treated with platelet gel at the end of surgery The patients in the control group received conventional hemostasis and surgical wound suture. The operation time, postoperative complications and postoperative bleeding rate were compared between the two groups. Results: The operation time was (2.65 ± 0.60) h in the test group and (3.15 ± 0.70) h in the control group, and the operation time in the test group was shorter than that in the control group. In the test group, urine culture was positive in 2 patients (3.2%), There were 16 cases (25.8%) with positive urinary culture in the experimental group. The postoperative serum creatinine in the experimental group was significantly lower than that in the control group. There was no postoperative bleeding in the experimental group and 1 case (1.6%) in the control group. Statistical significance (P <0.05). Conclusion: Percutaneous nephrolithotomy for the treatment of renal pelvis, calyx and upper ureteral calculi, the use of platelet gel shorten the operative time, reduce the incidence of complications, promote renal function recovery, reduce the patient’s pain, Has a high clinical value.