CAJ | 학술논문

目的：对比球囊扩张F24通道下经皮肾镜取石术中三种碎石器的碎石效果。方法：回顾分析2013年1月~2014年4月收治90例肾结石患者的临床资料，按术中碎石器的应用分为气压弹道组、钬激光组及超声组，每组30例。三组患者术中均采用腰肋悬空仰卧位，应用球囊扩张法扩张至F24通道。三组患者的性别、年龄、体质指数、结石位置和大小比较差异无统计学意义(P ＞0??05)。分别记录三组患者手术时间、术中出血量、结石清除率、术后并发症发生率及术后住院时间等指标。结果：三组术中出血量、结石清除率、发热率差异无统计学意义，气压弹道组碎石时间较超声组及钬激光组明显缩短(P ＜0??05)，超声组与钬激光组碎石时间无明显差异(P ＞0??05)。所有患者术中、术后均无周围脏器损伤及集合系统穿孔等并发症发生。结论：F24通道下经皮肾镜取石术碎石器的选择更加自由，气压弹道碎石器设备便宜，手术时间短，碎石效果确切，配合球囊扩张手术效果良好，值得推广。
목적：대비구낭확장F24통도하경피신경취석술중삼충쇄석기적쇄석효과。방법：회고분석2013년1월~2014년4월수치90례신결석환자적림상자료，안술중쇄석기적응용분위기압탄도조、화격광조급초성조，매조30례。삼조환자술중균채용요륵현공앙와위，응용구낭확장법확장지F24통도。삼조환자적성별、년령、체질지수、결석위치화대소비교차이무통계학의의(P ＞0??05)。분별기록삼조환자수술시간、술중출혈량、결석청제솔、술후병발증발생솔급술후주원시간등지표。결과：삼조술중출혈량、결석청제솔、발열솔차이무통계학의의，기압탄도조쇄석시간교초성조급화격광조명현축단(P ＜0??05)，초성조여화격광조쇄석시간무명현차이(P ＞0??05)。소유환자술중、술후균무주위장기손상급집합계통천공등병발증발생。결론：F24통도하경피신경취석술쇄석기적선택경가자유，기압탄도쇄석기설비편의，수술시간단，쇄석효과학절，배합구낭확장수술효과량호，치득추엄。
To-compare-the-efficacy-of-percutaneous-nephrolithoto-my-(PNL-)with-different-intracorpo-real-lithotri-ptors-via-F24-tract-dilated-by-ball-oon-dilatati-on-.Methods-:Clinical-data-of-90-patients-with-renal-calcul-us-were-collected-and-retrospecti-vely-anal-yzed-.This-group-of-patients-had-been-ad-mitted-and-selected-according-to-the-inclusion-criteria-in-our-instituti-on-from-January-2013-to-April-2014-.All-patients-were-in-flank-supine-positi-on-during-surgery-.And-F24-tract-was-dilated-by-ball-oon-dilatati-on-.There-was-no-si-gnificant-difference-in-sex-,age-,body-mass-index-(B-MI-)and-the-size-and-the-positi-on-of-stones-.According-to-the-lithotri-pters-,the-patients-were-di-vi-ded-into-hol-mi-u-m:yttri-u-m-al-u-minu-m--garnet-(YAG-)laser-group-,ultrasonic-lithotri-ptor-group-and-pneu-matic-lithotri-pstor-group-,and-there-were-30-cases-in-each-groups-.The-operative-time-,blood-loss,stone-free-rate-,complications-and-hospital-stays-were-observed-.Results-:There-were-no-si-gnificant-differences-in-the-blood-loss,stone-free-rate-,co-mpli-cati-ons-and-hospital-stays-.The-operative-time-in-the-pneu-matic-lithotri-pstor-group-was-si-gnificantly-shorter-than-in-the-hol-mi-u-m∶YAG-laser-group-and-the-ultrasonic-lithotri-ptor-group-,and-that-in-the-ultrasonic-lithotri-ptor-group-shorter-than-in-the-the-holmium∶YAG-laser-group-.Conclusions-:The-choice-of-lithotri-ptors-is-more-opti-onal-when-PNL-is-perfor-med-via-F24-tract-dilated-by-ball-oon-dilatati-on-.In-F24-tract-,the-pneu-matic-lithotri-pstor-is-inexpensive-with-shorter-operative-time-and-hi-gh-stone-free-rate-.