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目的:探讨球囊扩张法经皮肾镜治疗复杂肾结石的临床价值及安全性和有效性。方法:回顾性分析2014年1月~2015年4月收诊的89例复杂性肾结石患者的临床资料,按通道扩张方式分为球囊组(采用球囊扩张至F24,43例)和筋膜组(采用筋膜扩张器至F24,46例),两组患者的性别、年龄、结石位置、大小比较差异无统计学意义(P>0.05)。分别记录两组的通道建立时间、一次性通道建立成功率、穿刺并发症、结石清除时间、结石清除率、术后出血及发热例数等。结果:球囊组及筋膜组建立通道时间[(6.1±1.6)、(9.6±1.9)min]、一次性通道建立成功率[100%(43/43)、89%(41/46)]、结石清除时间[(38.2±3.8)、(51.8±2.4)min]、一期结石清除率[93%(40/43)、76%(35/46)]、术后血红蛋白下降值[(16.1±2.9)、(27.9±1.4)g/L]及术后发热率[14%(6/43)、35%(16/46)],比较均差异有统计学意义(P<0.05)。89例患者均未出现胸膜、腹膜损伤,未伤及临近脏器。结论:应用球囊扩张法建立F24经皮肾通道快速、安全、成功率高、出血少,应用于复杂肾结石经皮肾镜取石术结石清除率高、并发症少。
Objective: To investigate the clinical value, safety and efficacy of balloon dilation and percutaneous nephrolithotomy in the treatment of complex renal calculi. Methods: The clinical data of 89 patients with complicated renal calculi admitted from January 2014 to April 2015 were retrospectively analyzed. They were divided into balloon group (with balloon expansion to F24 and 43 cases) and tendons There was no significant difference in gender, age, location and size of stones between the two groups (P> 0.05). The two groups were recorded channel establishment time, one-time channel to establish success rate, puncture complications, stone removal time, stone removal rate, postoperative bleeding and fever cases. Results: The time of establishing channel in balloon group and fascia group [(6.1 ± 1.6), (9.6 ± 1.9) min], success rate in establishing one time channel [100% (43/43), 89% (41/46)] (38.2 ± 3.8), (51.8 ± 2.4) min, grade I stone clearance rates (93% (40/43), 76% (35/46)], postoperative hemoglobin decrease ± 2.9), (27.9 ± 1.4) g / L and postoperative fever rate [14% (6/43), 35% (16/46)] respectively. There were significant differences between the two groups (P <0.05). 89 patients did not appear pleural, peritoneal injury, did not hurt the adjacent organs. CONCLUSION: F24 percutaneous balloon neoplasty is a fast and safe method for percutaneous nephrostomy. It has high success rate and less bleeding. It is used in complicated renal calculi with percutaneous nephrolithotomy and has few complications.