经皮肾镜与输尿管软镜在孤立肾结石的应用比较
发布时间：2018-05-10 07:02
本文选题：孤立肾 + 肾结石 ； 参考：《中国微创外科杂志》2016年04期
【摘要】：目的比较经皮肾镜取石术(percutaneous nephrolithotomy,PCNL)与输尿管软镜碎石术(retrograde intrarenal surgery,RIRS)治疗孤立肾结石的疗效。方法我院2010年4月~2015年6月治疗孤立肾结石64例,其中41例行PCNL,患者取俯卧位,在B超引导下建立皮肾通道,然后碎石取石;23例行RIRS,患者取截石位,沿斑马导丝安置输尿管鞘,插入输尿管软镜碎石取石。结果 PCNL组手术时间(73.0±27.9)min明显短于RIRS组(106.1±29.5)min(t=4.462,P=0.000);术中出血(141.7±15.0)ml明显多于RIRS组(32.8±6.7)ml(t=32.935,P=0.000);住院时间(12.8±1.3)d明显长于RIRS组(10.3±1.6)d(t=6.788,P=0.000);一期清石率78.0%(32/41)明显高于RIRS组52.2%(12/23)(χ~2=4.592,P=0.032);术后感染率2.4%(1/41)明显低于RIRS组21.7%(5/23)(χ~2=4.388,P=0.036)。61例随访2个月~5年(中位随访时间2.5年):5例结石复发,中位复发时间2.8年,行ESWL后排出;9例仍有肾功能不全,血肌酐(156.5±17.6)μmol/L,均无须血透治疗,其余病人恢复好。结论 PCNL、RIRS是治疗孤立肾结石的有效手段,两者各有优势:PCNL手术时间短、清石率较高、感染发生率低,RIRS出血少、住院时间短。
[Abstract]:Objective to compare the efficacy of percutaneous nephrolithotomy with percutaneous nephrolithotomy (PCNL) and retrograde intrarenal SurgeryRIRS in the treatment of isolated renal calculi. Methods from April 2010 to June 2015, 64 cases of isolated renal calculi were treated in our hospital. Among them, 41 cases were treated with PCNL.The patients took prone position, established the cutaneous renal passage under the guidance of B-ultrasound, and 23 cases of RIRSby lithotripsy. The patients took the lithotomy position and placed ureteral sheath along the zebra guide wire. Insert ureteral soft mirror lithotripsy to take stone. 缁撴灉 PCNL缁勬墜鏈椂闂，
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