3D打印技术联合PCNL对肾结石患者清除率及并发症的影响

王建喜; 李信; 李明亮; 曾向阳

doi:10.13201/j.issn.1001-1420.2021.08.001

3D打印技术联合PCNL对肾结石患者清除率及并发症的影响

- 1. 长沙市第三医院泌尿外科(长沙, 410000);
- 2. 郴州市第一人民医院泌尿外科
基金项目:
湖南省卫生计生委科研项目(No:20201567)

湖南省卫生科研计划项目(No:B2016203)

详细信息

通讯作者: 王建喜,E-mail:xjprh9@163.com

中图分类号: R692.4

收稿日期: 2020-12-05

Effect of 3D printing technology combined with PCNL on clearance rate and complications of patients with renal stones

- 1. Department of Urology, Changsha Third Hospital, Changsha, 410000, China;
- 2. Department of Urology, Chenzhou First People's Hospital

More Information

Corresponding author: WANG Jianxi, E-mail: xjprh9@163.com

Received Date: 05 December 2020

摘要

摘要: 目的:探究3D打印技术联合经皮肾镜取石术(PCNL)对肾结石患者清除率及并发症的影响。方法:根据不同治疗方法将2018年9月—2019年12月在长沙市第三医院泌尿外科进行治疗的74例肾结石患者分为PCNL组(PC组)和3D打印技术联合PCNL组(PP组),每组患者37例,进行回顾性分析。PC组和PP组患者一般资料比较差异无统计学意义。通过分析PC组和PP组患者肾功能指标、术中情况、术后并发症、清石率的差异性来探究3D打印技术联合PCNL手术对肾结石患者清除率及并发症的影响。结果:PP组患者手术时间、术中出血量、住院时间分别为(96.93±6.43) min、(349.87±11.94) mL、(132.98±49.45) h,PC组手术时间、术中出血量、住院时间分别为(189.09±8.83) min、(702.98±13.45) mL、(168.64±72.65) h,两组比较,PP组患者术中指标显著优于PC组(P＜0.05)。PC组患者尿微量白蛋白(UmAlb)、血肌酐(Scr)、尿微量白蛋白/肌酐(ACR)指标分别为(67.14±15.35) mg/L、(150.36±23.18)μmol/L、(139.05±23.47) mg/g,PP组分别为(53.32±14.98)mg/L、(138.47±21.06)μmol/L、(120.31±25.46) mg/g,两组比较,PP组患者肾功能指标表达水平显著低于PC组(P＜0.05)。术后4周检测结果表明,PC组30例患者清石成功,PP组36例患者清石成功,两组患者清石率分别为81.08%、97.30%,PP组患者的清石率略高于PC组,但差异无统计学意义(χ²=0.288,P=0.591)。PC组共有6例患者出现术后并发症,PP组共有3例患者出现术后并发症,两组患者均未出现尿路堵塞、肾钙质沉积等严重并发症,PP组患者的术后并发症的发生概率略低于PC组,但差异无统计学意义(P＞0.05)。结论:3D打印技术联合PCNL与单一PCNL比较,前者对肾结石患者的临床治疗效果更佳,前者能够通过3D技术在术前就对肾脏进行全面观察,有利于提高结石清除率,显著改善患者肾功能,降低术后并发症的发生概率。
- 3D打印技术 /
- 经皮肾镜取石术 /
- 肾结石 /
- 并发症
Abstract: Objective: To explore the effect of 3 D printing technology combined with percutaneous nephrolithotomy(PCNL) on the clearance rate and complications of kidney stone patients.Methods: According to different treatment methods, 74 patients with kidney stones who were treated in the Department of Urology, Changsha Third Hospital from September 2018 to December 2019 were divided into PCNL group(PC group) and 3 D printing technology combined PCNL group(PP group). There was no statistically significant difference in general information between the PC group and the PP group. The effects of 3 D printing technology combined with PCNL on the removal rate and complications of kidney stone patients were explored by analyzing the difference in renal function indexes, intraoperative conditions, postoperative complications and stone removal rates between the PC group and the PP group.Results: The operation time, intraoperative blood loss and hospital stay in the PP group were(96.93±6.43) min,(349.87±11.94) mL and(132.98±49.45) h, respectively. The operation time, intraoperative blood loss and hospital stay in the PC group were(189.09±8.83) min,(702.98±13.45) mL and(168.64±72.65) h. Comparing the two groups, the intraoperative indexes of the PP group were significantly better than those of the PC group(P＜0.05). Renal function indexes such as microalbumin(UmAlb), serum creatinine(Scr), urine microalbumin/creatinine(ACR) in the PC group were(67.14±15.35) mg/L,(150.36±23.18) μmol/L,(139.05±23.47) mg/g, respectively,(53.32±14.98) mg/L and,(138.47±21.06) μmol/L,(120.31±25.46) mg/g in the PP group. The expression levels of renal function indexes in the PP group were significantly lower than those in the PC group(P＜0.05). Four weeks after the operation, the results showed that 30 patients in the PC group and 36 patients in the PP group were successfully removed. The removal rates of the two groups were 81.08% and 97.30%, respectively. The removal rate of the patients in the PP group was slightly higher, but the difference was not statistically significant(χ²=0.288, P=0.591). A total of 6 patients in the PC group had postoperative complications, while a total of 3 patients in the PP group had postoperative complications. None of the two groups had serious complications such as urinary tract blockage or nephrocalcinosis. The incidence of postoperative complications in the PP group was slightly lower than that in the PC group, but the difference was not statistically significant(P＞0.05).Conclusion: Compared with single PCNL, 3 D printing technology combined with PCNL has a better clinical treatment effect for patients with kidney stones. Three D printing technology combined with PCNL can observe the kidneys before surgery, so it is beneficial to increase the stone removal rate, significantly improve the renal function of patients and reduce the probability of postoperative complications.
- 3D printing technology /
- percutaneous nephrolithotomy /
- kidney stones /
- complications

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