论文部分内容阅读
目的:探讨微小针道在辅助单通道微创经皮肾镜取石术(minimally invasive percutaneous nephrolithotomy,MPCNL)中处理复杂性肾结石的临床价值。方法:我院2013年3月~2014年3月行多通道MPCNL手术79例(A组),2014年3月~2015年3月行微小针道辅助单通道MPCNL手术57例(B组)。回顾性分析两组的手术时间、标准通道建立时间、术中出血量、一期结石清除率以及术后肾造瘘管出血时间、并发症发生率、术后血红蛋白下降值、术后输血例数和术后住院时间,比较两组不同术式治疗肾结石患者的疗效和安全性。结果:两组136例手术均获得成功。其中A、B两组一期结石清除率分别为95%和96%;与A组相比,B组建立通道和总手术时间更短(P<0.001),术中出血量较小(P=0.038),并发症发生率较低(7.0%vs 15.2%),血红蛋白值下降更少(P=0.024),术后住院时间明显缩短(P=0.003)。结论:微小针道辅助单通道MPCNL在治疗和处理肾结石方面弥补了单一通道经皮肾穿刺取石的不足,避免了多通道的创伤,安全高效。
Objective: To investigate the clinical value of microneedles in the treatment of complicated renal calculi in minimally invasive percutaneous nephrolithotomy (MPCNL). Methods: From March 2013 to March 2014, 79 patients underwent multi-channel MPCNL (group A), 57 patients underwent micro-needle assisted single-channel MPCNL (group B) from March 2014 to March 2015, respectively. Retrospective analysis of the two groups of operation time, the establishment of standard channel time, blood loss, a stone clearance rate and postoperative renal fistula bleeding time, the incidence of complications, postoperative hemoglobin decline, blood transfusion and Postoperative hospital stay, the efficacy and safety of two groups of different surgical treatment of kidney stones were compared. Results: 136 cases were successful in both groups. Among them, the stone clearance rates of stage I and group B were 95% and 96% respectively. Compared with group A, the channel and the total operation time of group B were shorter (P <0.001) and the amount of bleeding during operation was smaller (P = 0.038). The complication rate was lower (7.0% vs 15.2%), the hemoglobin value decreased less (P = 0.024) and the postoperative hospitalization time was significantly shorter (P = 0.003). Conclusion: The tiny needle-assisted single-channel MPCNL can make up for the lack of single-channel percutaneous nephrolithotomy in the treatment and treatment of kidney stones, and avoid the multi-channel trauma, which is safe and efficient.