标准通道与微通道经皮肾镜取石术对肾功能不全患者肾功能的近期影响  

Standard-tract and mini-tract percutaneous nephrolithotomy:a comparative studyof short-term impact on renal function of patients with renal insufficiency

作　　者：李守宾[1] 招青[1] 崔世芳[1] 李双利[1] 王晓玲[1] 张晓威[2] 杨波[2] 李建兴[2] 

机构地区：[1]开滦总医院泌尿外科,河北唐山063000 [2]北京大学人民医院泌尿外科

出　　处：《临床泌尿外科杂志》2014年第1期18-20,共3页Journal of Clinical Urology

摘　　要：目的：探讨标准通道及微通道经皮肾镜取石术（PCNL）对肾功能不全患者肾功能的近期影响，以期提高临床诊治水平。方法：回顾性分析2005年12月~2013年4月期间行PCNL的172例肾功能不全患者资料，其中标准通道手术96例，微通道手术76例，统计患者术前、术后1天及术后7天的血肌酐水平，分析两种手术方式对肾功能的影响。结果：术后第1天，标准通道组血肌酐水平无明显变化（P＞0.05），而微通道组血肌配水平明显升高（P＜0.05）；肾功能好转、稳定、恶化例数在标准通道组分别为39（40.6%）、22（22.9%）、35（36.5%）例，在微通道组分别为18（23.7%）、17（22.4%）、41（53.9%）例，两组间差异有统计学意义（P＜0.05）。术后7天两组的血肌酐水平均较术前有明显下降（P＜0.05），两组间肾功能好转、稳定、恶化比例差异无统计学意义（P＞0.05）。结论：标准通道PCNL对肾功能不全患者的肾功能短期影响更小。Objective： To investigate short-term impact on renal function of patients with renal insufficiency by mini-tract percutaneous nephrolithotomy （PCNL） or standard-tract PCNL in order to improve the treatment outcome. Method： We performed a retrospective cohort analysis of 172 cases with renal insufficiency who underwent PCNL from December, 2005 to April, 2013. Ninety six cases underwent standard-tract PCNL, and 76 cases were performed by mini-tract PCNL. Serum creatinine level of patients were respectively analyzed preoperatively, the first and seventh day postoperatively. Thus the effect of surgery on renal function could be evaluated. Result： On the first post-operative day, serum creatinine level of the mini-tract group increased significantly （P〈0. 05）, while there was no obvious change in the standard-trnct group compared with the preoperative level （P〉0.05）. The case of improvement, stabilization and deterioratioa of renal function in the standard-tract group was 39 （40.6%）, 22 （22. 9%）, 35 （36. 5%）, while 18 （23. 7%）, 17 （22. 4%）, 41 （53.9 % ） could be seen in the mini-tract group. Thus, there was a significant difference between two groups （P〈 0.05）. Whereas on the seventh post-operative day, the serum creatinine level of both the mini-tract group and standard-tract group decreased significantly （P〈 0. 05）, compared with the preoperative data. There was no significant difference between the ratio of improvement, stabilization and deterioration of renal function in each group （P〉0.05）. Conclasion： Standard tract PCNL has less short-term impact on renal function, compared with mini-tract.

关 键 词：标准通道 微通道 经皮肾镜取石术 肾功能不全 

分 类 号：R692.4[医药卫生—泌尿科学]