中国医学创新
中國醫學創新
중국의학창신
MEDICAL INNOVATION OF CHINA
2013年
22期
24-25
,共2页
经皮肾穿刺%微造瘘取石术%复杂性肾结石%临床疗效
經皮腎穿刺%微造瘺取石術%複雜性腎結石%臨床療效
경피신천자%미조루취석술%복잡성신결석%림상료효
Percutaneous nephrolithotomy%Reno lithotomy%Complex renal calculi%Clinical efficacy
目的：探讨经皮肾穿刺微造瘘取石术治疗复杂性肾结石的临床疗效与安全性。方法：选择于2009年2月-2011年2月在本院治疗的复杂性肾结石患者120例，随机分为治疗组与对照组，每组60例，治疗组以经皮肾穿刺微造瘘取石术治疗，对照组以常规体外碎石术进行治疗，两组患者术前均给予相应的止痛、解痉、抗炎、补液、中药等对症治疗，对比两组患者的治疗有效率、并发症与不良反应的发生率和住院时间，并于术后1个月进行KUB检查，术后6个月比较两组患者的复发率。结果：治疗结束后，治疗组一次性碎石52例，两次碎石5例，单通道取石55例，多通道取石2例，结石清除率为95%，术中平均出血（145±36）ml，平均手术时间（104±21）min，平均住院时间（6.5±2.3）d，术中无大出血、脏器损伤等并发症，无一例死亡，穿刺成功率为100%，术后大部分患者有轻、中度血尿，3 d后自动好转，术后6个月随访有2例复发。对照组一次性碎石21例，两次及以上碎石12例，结石清除率为55%，平均手术时间（96±6）min，平均住院时间（14±2.3）d，无一例死亡，术后大部分患者有轻、中度血尿，3 d后好转，患者发热4例、肾绞痛2例、咳血1例，术后6个月随访有9例复发。结论：经皮肾穿刺微造瘘取石术治疗复杂性肾结石具有创伤小、恢复快、并发症少、复发率低的优点，值得临床推广。
目的：探討經皮腎穿刺微造瘺取石術治療複雜性腎結石的臨床療效與安全性。方法：選擇于2009年2月-2011年2月在本院治療的複雜性腎結石患者120例，隨機分為治療組與對照組，每組60例，治療組以經皮腎穿刺微造瘺取石術治療，對照組以常規體外碎石術進行治療，兩組患者術前均給予相應的止痛、解痙、抗炎、補液、中藥等對癥治療，對比兩組患者的治療有效率、併髮癥與不良反應的髮生率和住院時間，併于術後1箇月進行KUB檢查，術後6箇月比較兩組患者的複髮率。結果：治療結束後，治療組一次性碎石52例，兩次碎石5例，單通道取石55例，多通道取石2例，結石清除率為95%，術中平均齣血（145±36）ml，平均手術時間（104±21）min，平均住院時間（6.5±2.3）d，術中無大齣血、髒器損傷等併髮癥，無一例死亡，穿刺成功率為100%，術後大部分患者有輕、中度血尿，3 d後自動好轉，術後6箇月隨訪有2例複髮。對照組一次性碎石21例，兩次及以上碎石12例，結石清除率為55%，平均手術時間（96±6）min，平均住院時間（14±2.3）d，無一例死亡，術後大部分患者有輕、中度血尿，3 d後好轉，患者髮熱4例、腎絞痛2例、咳血1例，術後6箇月隨訪有9例複髮。結論：經皮腎穿刺微造瘺取石術治療複雜性腎結石具有創傷小、恢複快、併髮癥少、複髮率低的優點，值得臨床推廣。
목적：탐토경피신천자미조루취석술치료복잡성신결석적림상료효여안전성。방법：선택우2009년2월-2011년2월재본원치료적복잡성신결석환자120례，수궤분위치료조여대조조，매조60례，치료조이경피신천자미조루취석술치료，대조조이상규체외쇄석술진행치료，량조환자술전균급여상응적지통、해경、항염、보액、중약등대증치료，대비량조환자적치료유효솔、병발증여불량반응적발생솔화주원시간，병우술후1개월진행KUB검사，술후6개월비교량조환자적복발솔。결과：치료결속후，치료조일차성쇄석52례，량차쇄석5례，단통도취석55례，다통도취석2례，결석청제솔위95%，술중평균출혈（145±36）ml，평균수술시간（104±21）min，평균주원시간（6.5±2.3）d，술중무대출혈、장기손상등병발증，무일례사망，천자성공솔위100%，술후대부분환자유경、중도혈뇨，3 d후자동호전，술후6개월수방유2례복발。대조조일차성쇄석21례，량차급이상쇄석12례，결석청제솔위55%，평균수술시간（96±6）min，평균주원시간（14±2.3）d，무일례사망，술후대부분환자유경、중도혈뇨，3 d후호전，환자발열4례、신교통2례、해혈1례，술후6개월수방유9례복발。결론：경피신천자미조루취석술치료복잡성신결석구유창상소、회복쾌、병발증소、복발솔저적우점，치득림상추엄。
Objective:To explore the clinical efficacy and safety of complex renal calculi by minimally invasive percutaneous nephrolithotomy lithotomy treatment.Method:120 patients with complex renal calculi were selected in our hospital from February 2009 to February 2011,all of them were randomly divided into 60 cases of the treatment group and 60 cases of the control group,the treatment group was treated with minimally invasive percutaneous nephrolithotomy lithotomy treatment,the control group was treated with conventional in vitro lithotripsy treatment,the patients of two groups were given preoperative symptomatic treatment analgesic,antispasmodic,anti-inflammatory,rehydration,chinese medicine,compared patients of two groups with treatment efficiency,complications and adversereaction incidence and duration of hospitalization,and after a month KUB check,six months after the recurrence rates of two groups were compared.Result:After the end of treatment,the treatment group,one-time gravel 52 cases,five cases of secondary gravel,single-channel,55 cases of stone,multi-channel,two cases of stone,the stone clearance rate of 95%,the mean blood loss was(145±36)ml,the average operation time was(104±21)min,the average length of stay was(6.5±2.3)d,intraoperative bleeding,organ damage and other complications,with no deaths,puncture success rate of 100%,the majority of patients after surgery with mild to moderate hematuria, 3 d automatically improved 2 cases of patients relapsed after 6 months follow-up,one-time gravel 12 cases. 21 cases of the control group disposable gravel,secondary and higher gravel,stone clearance rate was 55%,the average operation time was(96±6)min,average length of stay(14±2.3)d, with no deaths,after the majority of patients with mild,moderate hematuria,3 d improved after four cases of fever,2 cases of renal colic,one cases of hemoptysis,9 relapsed after 6 months follow-up.Conclusion:Minimally invasive percutaneous nephrolithotomy lithotomy treatment of complex renal calculi with less trauma,quicker recovery,fewer complications,and the advantages of the low recurrence rate,is worthy of promotion.
