微创经皮肾镜取石术中X线或B超引导穿刺目标肾盏治疗上尿路结石的疗效比较  

Compared the clinical effect with X-ray or B ultrasound guided puncture target calyces of treatment upper urinary calculi in MPCNL

作　　者：戴红峰[1] 袁顺辉[2] 李泽惠[2] 李志鹏[2] 付立杰[1] 李金昆[1] 

机构地区：[1]昆明医科大学第一附属医院泌尿外二科,昆明650032 [2]昆明医科大学第二附属医院泌尿外科二病区,昆明650101

出　　处：《国际外科学杂志》2015年第1期16-19,共4页International Journal of Surgery

摘　　要：目的 比较微创经皮肾镜取石术中,用X线或B超引导穿刺目标肾盏治疗上尿路结石的临床疗效.方法 回顾性分析2010年10月-2012年10月,昆明医科大学第二附属医院泌尿外科住院行微创经皮肾镜取石术的患者,抽取116例作为研究对象,失访8例.X线定位48例,B超定位53例,就两种不同定位方式的术前、术中、术后的一些临床客观指标进行比较.结果 X线定位48例,年龄6 ～65（44.86±12.84）岁;结石直径（1.43±0.70） cm;结石位于上盏1例、中盏23例、下盏8例、输尿管上段16例.B超定位53例,年龄15 ～76（46.36±14.29）岁;结石直径（1.34±0.62）cm;结石位于上盏2例、中盏24例、下盏8例、输尿管上段16例,充满全部肾盏3例.比较两组术前一般资料,差异无统计学意义（P＞0.05）.X线组,手术时间（130.43±31.63） min;术中出血量（80.42±43.75） mL;术后住院时间（6.20±2.08）d;术后并发感染8例（17％）,出血2例（4％）;一期结石取尽率90％ （43/47）.B超组,手术时间（102.45±36.32） min;术中出血量（160.07 ±52.33） mL;术后住院时间（5.62±2.37）d;术后并发感染16例（30％）,出血9例（17％）;一期结石取尽率83％（46/53）.通过比较,X线组与B超组在手术时间、术中出血量、术后感染率、一期结石取尽率有统计学意义（P＜0.05）,而术后住院时间无统计学意义（P＞0.05）.结论 微创经皮肾镜取石术中,X线定位与B超比较,X线比B超手术时间长,术中出血量少,一期结石取尽率高,术后感染率低.Objective To compare with the efficiency between X-ray or B ultrasound guided puncture target calyces of treatment of upper urinary calculi in MPCNL.Methods From October 2010 to October 2012,we have a retrospective analysis of the 116 cases in urological department in the second affiliated hospital of Kunming Medical University,it had the sugery that was MPCNL.Selected 116 cases as the research object,（8 patients were lost to follow-up）.With X-ray locating （48 cases）,B ultrasound locating （53 cases）,and compared with preoperative,intraoperative and postoperative clinical objective indicators of two different methods.Results X-ray locating （48 cases）,the mean age was （44.86 ± 12.84） years; the mean Stone diameter（1.43 ±0.70） cm; Stone is located in the upper calyx in 1 case,the middle of calyx in 23 cases,under the calyx in 8 cases,the upper ureter in 16 cases.B ultrasonic locating （53 cases）,the mean age was（46.36 ± 14.29） years; the mean Stone diameter （1.34 ±0.62） cm; Stone is located in the upper calyx in 2 cases,the middle of calyx in 24 cases,under the calyx in 8 cases,the upper ureter in 16 cases.Compared with preoperative general data of two groups,there was no statistically significant difference （P 〉 0.05）.X-ray group,the mean operation time （130.43 ± 31.63） min ; Intraoperative blood loss（80.42 ± 43.75） mL; Postoperative hospital stay （6.20 ± 2.08） d; Infected with 8 cases （17%） of postoperative,hemorrhage in 2 cases （4%） ; and calculi exhausted rate was 90% （43/47）.B Ultrasound group,the mean operation time（102.45 ± 36.32） min.Intraoperative blood loss（160.07 ± 52.33） mL;Postoperative hospital stay（5.62 ±2.37） d; Infected with 16 cases （30%） of postoperative,bleeding in 9 cases （17%） ; and calculi exhausted rate was 83% （46/53）.By comparison,X-ray and B ultrasound group in operation time,intraoperative blood loss,postoperative infection,a stone exhausted rate was statistically significant （P 〈0.05）

关 键 词：肾造口术 经皮 X线 B超 尿路结石 

分 类 号：R693.4[医药卫生—泌尿科学]