目的 比较超声引导下经皮肾镜取石术标准通道与多通道的效果。方法 回顾分析2020-06至2022-06于武警安徽总队医院接受超声引导下经皮肾镜取石术治疗的100例肾结石患者的临床资料,其中50例行标准通道经皮肾镜取石术(标准组),50例行多通道经皮肾镜取石术(多通道组)。比较两组手术时长、碎石时长、出血量、住院时长、术后第1天视觉模拟评分(VAS)、结石清除率,以及术后并发症发生情况。结果 多通道组手术时长、碎石时长及术中出血量低于标准组(P＜0.05);多通道组术后第1天VAS低于标准组[(4.41±1.14)分 vs.(5.03±1.22)分],结石清除率高于标准组(96.0% vs. 82.0%),差异均有统计学意义(P＜0.05);多通道组术后并发症总发生率为2.0%,低于标准组的14.0%,差异有统计学意义(P＜0.05)。结论 与超声引导下标准通道相比较,应用超声引导下多通道经皮肾镜取石术治疗肾结石有助于节省手术时间,减轻手术损伤,提高结石清除效果,且可降低术后并发症发生风险。
Abstract
Objective To compare the effect of ultrasound-guided standard and multi-channel percutaneous nephrolithotomy in the treatment of renal calculi. Methods Retrospective analysis was made on the clinical data of 100 patients with renal calculi who received ultrasound-guided percutaneous nephrolithotomy in Anhui Provincial Corps Hospital from June 2020 to June 2022. Among them, 50 patients underwent standard channel percutaneous nephrolithotomy (standard group) and 50 patients underwent multi-channel percutaneous nephrolithotomy (multi-channel group). Operation duration, lithotomy duration, blood loss, length of hospital stay, visual analogue score (VAS) on the first day after surgery, stone clearance rate, and postoperative complications were compared between the two groups. Results The operation time, lithotripsy time and intraoperative blood loss in the multi-channel group were lower than those in the standard group (P<0.05). The visual analogue scale (VAS) score of the multi-tract group was lower than that of the standard group on the first day after operation (4.41±1.14 vs. 5.03±1.22), and the stone clearance rate was higher than that of the standard group(96.0% vs. 82.0%), with statistically significant difference (P<0.05). The total incidence of postoperative complications in the multi-tract group was 2.0%, which was lower than 14.0% in the standard group, whose difference was statistically significant (P<0.05). Conclusions Compared with ultrasound-guided standard percutaneous nephrolithotomy, the application of ultrasound-guided multi-channel percutaneous nephrolithotomy in the treatment of renal calculi is helpful to save operation time, reduce surgical injury, improve stone clearance effect, and reduce the risk of postoperative complications.
关键词
标准通道 /
多通道 /
经皮肾镜取石术 /
肾结石
Key words
standard channel /
multi-channel /
percutaneous nephrolithotomy /
renal calculi
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参考文献
[1] 曹石金, 张新明, 叶宗岳,等. 输尿管软镜与微通道经皮肾镜碎石术治疗肾结石疗效比较[J]. 海南医学, 2019, 30(3):297-300.
[2] 高新梅, 戚微岩, 徐寒梅. 肾结石形成机制及治疗方法研究进展[J]. 药物生物技术, 2019, 26(6):558-561.
[3] 卞少华, 李颖毅, 张 辉,等. 超声引导下经皮肾镜取石术与可视超微通道经皮肾镜取石术治疗儿童肾结石的效果比较[J]. 现代泌尿外科杂志, 2020,27(3):222-241.
[4] 周 凯, 陈珍霖, 杨 旭,等. 输尿管软镜碎石术与经皮肾镜碎石术治疗肾结石的临床效果及对患者炎症反应,应激反应的影响[J]. 现代生物医学进展, 2020, 20(15): 2896-2899,2938.
[5] 刘 军, 何 炜, 项立波,等. 直径2~3 cm肾结石患者经输尿管软镜钬激光碎石术与经皮肾镜取石术的临床效果比较[J].广西医科大学学报, 2020, 37(3): 501-506.
[6] 黄裕棱, 李卓航, 刘 成,等. 斜跨位多通道经皮肾镜碎石术与单通道经皮肾镜联合输尿管软镜碎石术治疗鹿角形肾结石的疗效对比[J]. 中华医学杂志, 2021, 101(38):3121-3126.
[7] 李 峰, 陈胜龙, 谢 喜,等. 微通道与标准通道经皮肾镜碎石术对上尿路结石患者肾功能及机体氧化应激反应的影响[J]. 现代生物医学进展, 2019, 19(13):2511-2514.
[8] 张宝勋, 蒋胜利, 吴文弼,等. 经皮肾镜联合输尿管软镜治疗复杂肾结石[J]. 中国微创外科杂志, 2021, 21(10):875-878.
[9] 席俊华, 张艳斌, 吴 畏,等. 同期与分期单通道经皮肾镜取石术联合输尿管软镜钬激光碎石术治疗复杂性肾结石的对比研究[J]. 国际泌尿系统杂志, 2020, 40(1): 72-75.
[10] 刘光伟, 向 彬, 雷光辉,等. 经皮肾镜碎石术后二期逆行输尿管软镜结合原通道经皮肾镜碎石在复杂性肾结石治疗中的应用[J]. 陕西医学杂志, 2020, 49(10):4.
[11] 刘创明, 廖伟强, 陈志权. 超声引导下多通道经皮肾镜取石术治疗复杂性结石的疗效观察[J]. 国际泌尿系统杂志, 2018, 38(4):565-567.
[12] 王 慧, 余育晖. 超声引导下微通道和标准通道下经皮肾镜取石术治疗肾结石效果比较[J]. 重庆医学, 2020, 49(20):3412-3415.
[13] 冯战启, 王云玲, 陈轶杰,等. 超声引导下针状肾镜联合标准通道与多通道PCNL治疗肾结石的效果比较[J]. 临床泌尿外科杂志, 2022, 37(3):163-167.
[14] 潘东山, 杨水法, 李 康,等. 一期双通道经皮肾镜取石术治疗重复肾双输尿管畸形合并肾结石的体会(附21例报告)[J]. 中国内镜杂志, 2022, 28(5):64-68.
[15] 席俊华, 张艳斌, 吴 畏,等. 微通道经皮肾镜联合输尿管软镜钬激光碎石术与双通道经皮肾镜取石术治疗复杂性肾结石的疗效比较[J]. 临床泌尿外科杂志, 2019, 34(10): 820-822.
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