一步法建立取石通道在经皮肾镜碎石术的临床应用  

Clinical Study on the Application of Percutaneous Renal Access in a One-Step Method on Percu-taneous Nephrolithotomy

作　　者：崔建军[1] 夏宏辉[1] 杨伟锋[1] 方建明[1] 沈军[1] 汤珺[1] 叶军[1] 

机构地区：[1]广东省深圳市南山区人民医院泌尿外科,广东深圳518052

出　　处：《医学临床研究》2015年第11期2176-2178,共3页Journal of Clinical Research

摘　　要：【目的】探讨一步法建立取石通道在经皮肾镜碎石术（PNCL ）的临床效果。【方法】选择2012年1月至2015年3月本院收治的92例肾结石患者，采用随机数字表法将其分为观察组和对照组，每组各46例。观察组采用带外鞘的20‐24Fr筋膜扩张器一步经皮扩张进入肾脏集合系统，对照组采用顺序筋膜扩张法逐步反复经皮扩张进入肾脏集合系统。观察两组患者手术时间、术中出血量、术后并发症、结石清除率及生活质量。【结果】观察组手术时间和术后并发症显著低于对照组，差异具有统计学意义（均 P ＜00．5）；两组术中出血量和结石清除率比较无显著性差异（均 P ＞00．5）。治疗前和治疗后，两组生理功能、精神健康、社会功能和情感智能等生活质量评分比较，差异均无统计学意义（均 P ＞00．5）。【结论】一步法建立经皮肾通道手术方法可简化手术步骤，缩短手术时间，降低并发症的发生，是一种安全、简便的方法，值得临床推荐。Objective]To investigate the application of percutaneous renal access in a one‐step method on percutaneous nephrolithotomy .[Methods]The 92 patients with kidney stones in our hospital from Jan .2012 to Mar .2015 were divided into an observation group and a control group ,with 46 cases in each group .20‐24Fr fascial dilators with epitheca were expanded into renal in one step for patients in the observation group ,while patients in the control group were treated with sequential expansion of fascia .The operation time ,postopera‐tive complications ,stone clearance rate and life quality of two groups were determined and compared .[Re‐sults]The operation time and postoperative complications occurrence rate of patients in the observation group were significantly lower than those of the control group （ P 〈0 0.5） .There were no significant differences be‐tween the two groups for stone clearance rate and bleeding volume （ P 〉0 0.5） .Before and after treatment ,no significant differences were found between the quality of life scores of the two groups （ P 〉0 0.5） .[Conclu‐sion]Percutaneous renal access using the one step method in percutaneous nephrolithotomy could simplify the operation and reduce the operation time and complications .The method is safe ,simple and worthy of being put into clinical practice .

关 键 词：内窥镜检查 碎石术/方法 肾结石/外科学 

分 类 号：R692.4[医药卫生—泌尿科学]