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目的:比较微创手术经皮肾取石术分别经上盏及经中盏两种途径来治疗鹿角形肾结石的安全性及临床疗效。方法:选择2011年8月-2013年5月在我院接受经皮肾取石术(微创手术)治疗鹿角形肾结石患者113例,随机分成经上盏组(49例)及经中盏组(64例),对两组患者的手术时间、手术前后血液中血红蛋白水平下降幅度、是否开通第2通道和联合体外碎石术、手术并发症情况及术后I期及最终肾结石清除率。结果:两组患者经皮肾镜取石术(微创)均比较成功,并未出现严重并发症;两组患者手术持续时间、术后I期肾结石清除情况、开通第2通道情况,以及联合体外碎石治疗术情况比较,差异具有统计学意义(P<0.05);基于血红蛋白下降数值、微创术后并发症发生情况以及治疗后最终结石清除率,两组患者数据比较,差异无统计学意义(P>0.05)。结论:微创手术经皮肾取石术分别经上盏及经中盏两种途径来治疗鹿角形肾结石过程中的安全性比较差异不明显,均具有良好安全性;联合体外碎石术进行治疗,均能够获得良好的临床疗效;经上盏路径进行微创手术,具有更开阔的手术视野、手术时间相对较短、手术创伤更小、术后I期治疗结果显示,经上盏组患者具有更高的结石清除率,值得在临床进一步开展及探索。
OBJECTIVE: To compare the safety and clinical efficacy of percutaneous nephrolithotomy treated with antithrombotic nephrolithiasis via upper and lower middle cucumbers. Methods: A total of 113 patients with antler kidney stones who underwent percutaneous nephrolithotomy (minimally invasive surgery) in our hospital from August 2011 to May 2013 were randomly divided into two groups: the Shangan group (49 cases) and the Zhongzhong group (64 cases), the operation time of the two groups of patients, blood hemoglobin levels before and after the decline, whether to open the second channel and combined with extracorporeal lithotripsy, complications and postoperative stage I and the final renal stone clearance rate. Results: Percutaneous nephrolithotomy (minimally invasive) was successful in both groups, with no serious complications. The duration of operation, stage I renal stone clearance, stage 2 access, and joint The difference between the two groups was statistically significant (P <0.05). Based on the decrease of hemoglobin, the incidence of postoperative complications and the final stone clearance after treatment, there was no significant difference between the two groups Significance (P> 0.05). Conclusion: The safety of minimally invasive percutaneous nephrolithotomy is superior to that of upper labrum and middle cucumber respectively. There is no significant difference in the safety of anthronal nephrolithiasis, both of which have good safety. Combined with external lithotripsy , Were able to get a good clinical effect; pathways through the light of minimally invasive surgery, has a broader surgical field of vision, the operation time is relatively short, less surgical trauma, postoperative I treatment showed that the patients in Shangguan group had Higher stone clearance rate, it is worth further clinical development and exploration.