部分无管化与留置造瘘管经皮肾镜治疗肾及上段尿路结石的研究  

Study of Partial Ductless and Indwelling Fistula Percutaneous Nephrolithotomy in the Treatment of the Calculi in the Kidney and Upper Urinary Tract

作　　者：周浴[1] 张少峰[1] 贾洪涛[1] 甘伟[1] 罗茂华[1] 

机构地区：[1]湖北医药学院附属人民医院泌尿外科,湖北十堰442000

出　　处：《医学综述》2014年第8期1510-1512,共3页Medical Recapitulate

摘　　要：目的探讨部分无管化与传统经皮肾镜取石术(PCNL)治疗肾及上段尿路结石的临床效果。方法选择湖北医药学院附属人民医院2008年2月至2013年1月收治的上尿路结石并拟行PCNL治疗的上尿道结石患者109例,依据随机数字表法分为两组:其中采用部分无管化经皮肾镜碎石术(MPCNL)者57例(MPCNL组),传统留置造瘘管PCNL者52例(PCNL组)。观察并比较两组患者的手术时间、结石清除率、术后镇痛药的使用、术后并发症率及住院天数等指标。结果 MPCNL组和PCNL组平均手术时间、结石清除率、术后并发症发生率比较差异无统计学意义(P>0.05);MPCNL组术后第1天疼痛评分以及术后镇痛药需要量、住院天数均少于PCNL组(P<0.05)。结论 MPCNL治疗肾及上段尿路结石具有安全性高,术后疼痛轻、术后并发症少以及患者恢复较快等诸多优势,在严格掌握适应证的基础上,提倡临床推广应用。Objective To explore the effect of partial ductless and conventional percutaneous nephrolithotomy lithotripsy（PCNL） in the treatment of urinary tract calculi. Methods A total of 109 patients with kidney and urinary tract calculi admitted to Affiliated People＇s Hospital of Hubei Medical College were randomly divided into two groups ,57 eases were given minimally-invasive percutaneous nephrolithotomy lithotripsy（MPCNL） （MPCNL group） ,52 eases were given traditional fistula percutaneous nephrolithotomy lithotripsy（ PCNL group）. The indicators such as operative time, calculi clearance rate, postoperative complications and hospital days of the patients were observed and compared between the two groups. Results There was no significant difference of mean operative time, calculi clearance rate, incidence of postoperative complications between MPCNL group and PCNL group（ P 〉 0.05 ）. Postoperative pain degree, postoperative analgesic application, hospital days of the MPCNL group were significantly less than the PCNL group（ P 〈 0.05 ）. Conclusion MPCNL has the advantages of high safety, postoperative less pain, fewer complications and faster recover in the treatment of the kidney and upper urinary tract calculi, and is worthy of clinical application on the basis of strict indications.

关 键 词：部分无管化 传统经皮肾镜取石术 造瘘管 尿路结石 气压弹道碎石 

分 类 号：R691.4[医药卫生—泌尿科学]