输尿管软镜与经皮肾镜治疗肾结石的对比研究

发布时间：2018-03-19 12:23

本文选题：输尿管软镜　切入点：经皮肾镜　出处：《延边大学》2014年硕士论文　论文类型：学位论文

【摘要】：目的：比较输尿管软镜碎石术与经皮肾镜碎石术治疗肾结石的疗效和安全性。方法：2012年3月-2013年12月手术治疗的89例肾结石患者,其中37例采用组合式输尿管软镜钬激光碎石术治疗(URL组),52例采用经皮肾镜超声联合气压弹道碎石术治疗(PCNL组),比较两组的手术并发症和结石取净率。结果：URL组手术时间35-175min,平均58min；术后血红蛋白损失量为0-6g/L,平均2g/L；术后4例出现轻度贫血、3例出现发热,并发症发生率为18.9%(7/37)；手术成功率94.6%(35/37)；结石取净率为85.7%(30/35)。PCNL组手术时间30-86min,平均46min；术后血红蛋白损失量为4-36g/L,平均14g/L；术后21例出现轻度贫血、3例出现中度贫血进行输血治疗,其中1例行超选择性肾动脉栓塞术,术后4例出现发热,并发症发生率为53.8%(28/52)；手术成功率94.2%(49/52)；结石取净率为91.8%(45/49)。结论：PCNL治疗肾结石具有损伤小、并发症少、疗效确切等优点,但PCNL对肾实质有一定损伤,可能导致大出血,需输血治疗,甚至行超选择性肾动脉栓塞术。URL治疗肾结石则损伤更小、并发症更少,接近无创,而且疗效确切,特别在治疗肾结石合并脊柱侧弯等复杂性肾结石时具有独特的优势。
[Abstract]:Objective: to compare the efficacy and safety of soft ureteral lithotripsy and percutaneous nephrolithotripsy in the treatment of renal calculi. Among them, 37 cases were treated with combined ureteral soft endoscope holmium: YAG laser lithotripsy. 52 cases were treated with percutaneous nephroscopy combined with pneumatic lithotripsy. The complications of operation and the rate of stone removal were compared between the two groups. Results the operative time was 35-175 mins (mean 58 mins), hemoglobin loss was 0-6 g / L (mean 2 g / L), 4 cases had mild anemia and 3 cases had fever. The incidence of complications was 18.9 / 7 / 37; the successful rate of operation was 94.6% / 37%; the stone removal rate was 85.7% / 35% .PCNL group was 30-86 min (mean 46 min); postoperative hemoglobin loss was 4-36 g / L (14 g / L); postoperative 21 cases had mild anemia and 3 cases had moderate anemia for blood transfusion. One of them received superselective renal artery embolization, 4 cases developed fever after operation, the incidence of complications was 53.8% or 28 / 52%, the success rate of operation was 94.22% 49 / 52%, and the stone removal rate was 91.8% 45 / 49%. Conclusion PCNL has the advantages of less injury, less complications and definite curative effect in the treatment of renal calculi. However, PCNL may cause massive hemorrhage and need blood transfusion therapy. Even super-selective renal artery embolization. URL treatment of renal calculi is less damage, less complications, close to non-invasive, and the curative effect is accurate, especially in the treatment of renal calculi complicated with scoliosis and other complex renal calculi have a unique advantage.
【学位授予单位】：延边大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R699.2

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