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1、微創(chuàng)經(jīng)皮腎鏡取石術(shù)治療腎結(jié)石的臨床研究[摘要]目的旨在對比分析微創(chuàng)經(jīng)皮腎鏡取石術(shù)治療腎結(jié)石與傳統(tǒng)開放性手術(shù)治療腎結(jié)石的手術(shù)效果。方法收集2009年1月?2014年1月來我院進(jìn)行治療的腎結(jié)石患者120例,所有患者均有完整的臨床資料,其中60例為行傳統(tǒng)腎竇內(nèi)腎盂切開取石術(shù),設(shè)立為對照組,其余60例行微創(chuàng)經(jīng)皮腎鏡取石術(shù),設(shè)立為微創(chuàng)組,比較兩組的手術(shù)時(shí)間、術(shù)中出血量、術(shù)后造痿時(shí)間及住院時(shí)間及并發(fā)癥。結(jié)果微創(chuàng)組60例患者均一期穿刺成功并順利碎石,取石成功58例,成功率96.7%(58/60)o術(shù)中未出現(xiàn)氣胸、結(jié)腸損傷等并發(fā)癥,一
2、次清石率為80.0%(48/60)o術(shù)后生命體征平穩(wěn),無腎切除、傷口尿痿、液氣胸等嚴(yán)重并發(fā)癥發(fā)生。4例泌尿系感染者術(shù)后出現(xiàn)持續(xù)高熱,經(jīng)抗感染治愈。對照組術(shù)中出現(xiàn)十二指腸損傷1例、腹膜損傷2例、術(shù)后出現(xiàn)高熱2例、腸痿1例,泌尿系感染8例。觀察組與對照組的手術(shù)時(shí)間、術(shù)中出血量、術(shù)后造痿時(shí)間及住院時(shí)間比較,差異有統(tǒng)計(jì)學(xué)意義(P<0.05或P<0.01)o結(jié)論微創(chuàng)經(jīng)皮腎鏡取石術(shù)治療腎結(jié)石具有創(chuàng)傷小、出血少、并發(fā)癥少等優(yōu)點(diǎn),且可縮短住院時(shí)間,值得推廣和應(yīng)用。[關(guān)鍵詞]腎結(jié)石;經(jīng)皮腎鏡取石術(shù);微創(chuàng);并發(fā)癥[中圖分類號]R692.4
3、[文獻(xiàn)標(biāo)識碼]B[文章編號]1673-9701(2014)27-0027-03[Abstract]ObjectiveTocompareandanalyzetheeffectofminimal1yinvasivepercutaneousnephrolithotomycomparewithtraditionalopensurgicalintreatmentofkidneystonesoutcome.MethodsSelected120patientswithkidneystonesfromJanuary2009toJanu
4、ary2014inourhospital,al1patientshadcompleteclinicaldata,included60casesofrenalsinustraditionallinespelvislithotomy,establishedasthecontrolgroup,andtheremaining60routineminimallyinvasivepercutaneousnephrolithotomysurgery,sotupminimallyinvasivcgroup,theoperativeti
5、me,bloodloss,postoperativefistillatimeandhospitalstayandcomplicationswerecomparedbetweentwogroups?Results60patientswithinvasivegrouphomogeneityofpuncturesuccessandsmoothgravel,stonesuccessfulin58cases,thesuccessratewas96.7%(58/60).Intraoperativecomplicationspneu
6、mothorax,coloninjurydoesnotappear,one-timestoneclearaneeratewas80.0%(48/60).Stablevitalsignsaftersurgery,nonephrectomy,severecomplicationswoundfistula,pneumothoraxoccurred.4casesofpostoperativeurinarytractinfectionsustainedhighfever,anti-infectioncure?1caseduode
7、nalinjurycontrolgroupintraoperativeperitonealinjuryin2cases,2casesofpostoperativefever,intestinalfistula,urinarytractinfectionin8cases.Operativetime,bloodloss,postoperativefistulacomparethetimeanddurationofhospitalization,ofobservationgroupimprovedsignificanttha
8、nthecontrolgroup,thediffereneewasstatisticallysignificant(P<0.05orP<0.01)?ConclusionMinimallyinvasivepercutaneousnephrolithotomyinthetreatmentofkidneystoneswith1esstr