Comparison of clinical parameters between micro-channel and standard-channel percutaneous nephrolithotomy in the treatment of upper urinary calculi
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摘要: 目的：比较微通道与标准通道经皮肾镜取石术（PCNL）治疗上尿路结石的临床手术参数。方法：回顾性分析2017年1~12月在洪湖市人民医院行单通道PCNL患者，根据所建立取石通道大小不同分为微通道PCNL组和标准通道PCNL组。其中微通道PCNL 43例，标准通道PCNL 74例。比较两组患者的总手术时间、术前术后血红蛋白下降值、血清肌酐变化值、术后发热发生率、一期手术清石率、术后住院日及其他并发症发生率等指标。所有术中数据均现场采集并记录。结果：微通道PCNL组和标准通道PCNL组的平均手术时间分别为（58.6±11.2） min和（35.4±7.9） min，两组比较差异有统计学意义（P<0.05）；术前术后血红蛋白下降值分别为（6.8±6.3） g/L和（9.2±7.1） g/L，两组比较差异有统计学意义（P<0.05）；两组术前术后血清肌酐变化值、术后发热发生率、一期手术清石率及术后住院日比较差异均无统计学意义。结论：微通道PCNL与标准通道PCNL比较，手术时间明显更长，但手术出血量更少，2种手术方式各有优劣。Abstract: Objective: To compare the clinical parameters between micro-channel and standard-channel percutaneous nephrolithotomy(PCNL) in treatment of upper urinary calculi. Method: The patients with upper urinary tract calculi who accepted single-channel PCNL surgeries in our hospital from January 2017 to December 2017 were included in this retrospective clinical research. The number of patients who underwent micro-channel and standard-channel PCNL were 43 and 74 respectively. The total surgery time, the decrease of hemoglobin, the changed value of creatinine clearance pre-and post-operative, the incidence of post-operative fever, the stone clearance rate at the first stage, post-operative hospital stay and other complications were compared between the two groups. Result: The total operative time of micro-channel and standard-channel PCNL group was(58.6±11.2) min and(35.4±7.9) min(P<0.05) respectively. The decrease of hemoglobin of micro-channel and standard-channel PCNL group was(6.8±6.3) g/L and(9.2±7.1) g/L(P<0.05) respectively. The changed value of creatinine clearance, the post-operative fever incidence, the stone clearance rate at the first stage, the post-operative hospital stay had no statistically significant difference between two groups.Conclusion: Compared with standard-channel PCNL, micro-channel PCNL had significantly longer total surgery time, but significantly less surgical bleeding. Micro-channel and standard channel PCNL have its own superiority and inferiority.
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Key words:
- percutaneous nephrolithotomy /
- micro-channel /
- standard-channel /
- operative time /
- surgical bleeding
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