经皮肾镜辅助小切口取石术在高危结石患者中的临床应用价值分析

汪自力; 杨进; 易炜; 陈刚; 胡海峰; 歧宏政; 王云汉

经皮肾镜辅助小切口取石术在高危结石患者中的临床应用价值分析

- 成都大学附属医院泌尿外科(成都, 610081)

详细信息

通讯作者: 汪自力,E-mail:436036274@qq.com

中图分类号: R692.4

收稿日期: 2012-12-28

The clinical application value of small-incision assisted percutaneous nephrostolithotomy among high risk patients

- Department of Urology, Affiliated Hospital of Chengdu University, Chengdu, 610081, China

More Information

Corresponding author: WANG Zili, E-mail: 436036274@qq.com

Received Date: 28 December 2012

摘要

摘要: 目的：探讨经皮肾镜辅助小切口取石术在合并糖尿病、高血压病及再次手术结石患者中的临床应用价值。方法：观察组20例采用经皮肾镜辅助小切口取石术式，手术切口长5~7 cm，肾脏穿刺通道用2-0可吸收缝合线全层缝合，不留置肾造瘘管，肾周不留置血浆引流管。对照组21例采用经皮肾镜取石术式，留置F_18~20肾造瘘管。两组患者均使用瑞士EMS-Vario混合动力碎石清石系统进行手术。结果：两组中合并糖尿病、高血压病及再次手术患者人数比较，差异无统计学意义。观察组患者无大出血、气胸、邻近脏器损伤等严重并发症，伤口均甲、乙级愈合，随访3个月无继发性肾出血。对照组继发性肾出血4例，发生率19.05%，经超选择性肾动脉介入栓塞治疗后痊愈出院。结论：经皮肾镜辅助小切口取石术能有效降低合并糖尿病、高血压病及再次手术患者继发性肾出血的发生率，有实际临床应用价值。
- 经皮肾镜取石术 /
- 辅助小切口 /
- 高危结石患者
Abstract: Objective: To explore the clinical application value of small-incision assisted percutaneous nephrostolithotomy(PCNL) among patients who suffer from diabetes mellitus, hypertension and re-operation.Methods: The small-incision assisted PCNL was used in experimental group (20 cases), which the operative incision was 5-7 cm long, sewed up by 2-0 absorbable suture. Nephrostomy tube and blood plasma tube were not reserved. Meanwhile the PCNL was used in control group (21 cases), which the NO. F_18-20 nephrostomy tube was reserved. However the Swiss Litho Clast Msater VARIO was used in two groups.Results: The difference of the cases of the patients who suffered from diabetes mellitus, hypertension and re-operation between two groups was not statistically significant (P>0.05). No hemorrhea, pneumothorax, injury of peripheral organs and other serious complication occurred in experimental group. The incision healed on the first or second level, and the related nephrorrhagia did not occur after 3 months. However, there were 4 cases occurring related nephrorrhagia in control group (incidence rate was 19.05%) who were healed by super selective renal artery embolization. The difference of the related nephrorrhagia between the two groups was statistically significant (P<0.05).Conclusions: The small-incision assisted PCNL can effectually reduce the incidence rate of the related nephrorrhagia among the patients who suffered from diabetes mellitus, hypertension and re-operation. The value of clinical application is obvious.
- percutaneous nephrolithotomy /
- small-incision assisted /
- high risk calculus patients

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