肾脏开放手术病史对经皮肾镜取石的影响  

Effect of history of open nephrolithotomy on percutaneous nephrolithotomy

作　　者：张慧民[1] 裴琼[1] 崔海军[1] 王琳[1] 刘建辉[1] 高彬[1] 才胜勇[1] 陈沛林[1] 

机构地区：[1]河北医科大学附属唐山工人医院泌尿外一科,063000

出　　处：《中华老年医学杂志》2011年第7期578-580,共3页Chinese Journal of Geriatrics

摘　　要：目的评估经皮肾镜取石病例与经历开放手术经皮肾镜取石病例的手术操作及临床疗效。方法选取自2006年1月至2011年1月行经皮肾镜取石病例98例，其中34例既往行肾脏开放手术病史，采用筋膜扩张建立标准通道，所有病例均留置22F肾造瘘管，比较手术时间、肾造瘘通道术、输血量、残余结石率、住院天数、肾造瘘管拔出时间。结果有开放手术史组和无开放手术史组平均手术时间分别为[（84．0±24．6）min和（94．0±22．7）min，t＝1．372，P＝0．1773，住院时间分别为（6．5±1．1）d和（6．3±1．8）d（t=0．49，P＝0．621），输血量分别为（82．9±10．6）ml和（85．0±11．8）ml（t=0．415，P＝0．682），肾造瘘通道单通道分别为（70．6％和75．0％）和双通道分别为（29．4％和25．0％）（X＾2＝0．22，p＝0．638），残余结石率分别为5％和3％（X＾2＝0．42，P＝0．282），两组比较差异均无统计学意义。结论既往患者曾有肾脏开放手术病史，但仍可取的与非肾脏开放手术病史对经皮肾镜取石的患者同样的临床效果。Objective To investigate the effects of previous open nephrolithotomy on the technical features, outcomes and morbidities of subsequent percutaneous nephrolithotomy （PCNL）. Methods Ninety eight patients who underwent PCNL from January 2006 to January 2011 were selected in this study. The 34 patients of them who had previous open nephrolithotomy on the same kidney were assigned as group A, and the other 64 patients who had no previous open surgery as group B. The data of operation time, blood transfusion quantity, residual stones rate, hospitalization time and time of tube evulsion were collected and compared between the two groups. Results There were no significant differences between the group A and B with respect to the mean operative time [（84. 0±24. 6） min vs. （94.04±22.7） min, t=1.372, P =0.177], hospitalization time [（6.5±1.1） days vs. （6.3±1.8）days, t=0.49, P=0.261）, blood transfusion quantity （（82.9±10.6） ml vs. （85.0 ±11.8） ml, t= 0. 415, P= 0. 682], kidney and colostomy channels [single channel（70.6 % vs. 75.0%）, double channel （29.4%vs. 25.0%）, X^2=0.22, P= 0.6383 and residual stones rate （5% vs. 3% ,X^2= 0.42, P=O. 282）. Conclusions When PCNL is performed after previous open neDhrolithotomv, there is no difference in success rate and morbidities.

关 键 词：肾结石 肾造口术 经皮 

分 类 号：R699.2[医药卫生—泌尿科学]