肾积水程度对微通道经皮肾镜碎石术失血的影响研究  

Study of Renal Haemorrhage after Micro- percutaneous Nephrolithotomy( MPCNL) with Different Hydronephrosis Degree

作　　者：陈超[1,2] 王鑫洪[1] 林考兴[1] 李峰[1] 盛茂[1] 符二[1] 曹治列[1] 

机构地区：[1]中国人民解放军第117医院,杭州310013 [2]杭州市第一人民医院泌尿外科,310000

出　　处：《医学研究杂志》2015年第12期132-135,共4页Journal of Medical Research

摘　　要：目的探讨微通道经皮肾镜碎石术（micro-percutaneous nephrolithotomy,MPCNL）出血与患肾积水程度之间的相关性。方法回顾性分析2012年1月～2014年4月143例行单侧微通道（F16～18）经皮肾镜联合钬激光碎石治疗肾结石患者的临床资料。根据术前肾积水的程度分为无积水、轻度、中度及重度4组,比较各组间手术前后血红蛋白的丢失量以及是否输血、介入栓塞止血等情况的差异。结果143例患者平均年龄50（21～74）岁。4组患者性别构成、手术部位、年龄、结石大小、手术时间、术后残石率等比较,差异均无统计学意义（P〉0.05）。4组术后血红蛋白含量均出现了不同程度的下降,无积水组至重度组分别为17.0±11.9、14.9±10.8、13.5±14.2和11.2±5.9g/L,4组比较差异无统计学意义（P=0.373）;术后无积水组至重度组的输血率分别为7.1%、6.6%、6.3%、0,4组比较差异无统计学意义（P=0.756）。术后需介入栓塞止血治疗的患者无积水组和轻度积水组各有1例（无积水组3.6%,轻度积水组1.2%）,而中、重度积水组没有患者行介入栓塞止血,差异无统计学意义（P=0.692）。结论不同程度的肾积水可能对MPCNL出血没有直接影响。Objective To investigate the relationship between hydronephrosis degree and blood loss during micro-percutaneous nephrolithotomy （MPCNL）. Methods A retrospective analysis of 143 patients with renal stone who had undergone MPCNL with holmium laser was performed. According to hydronephrosis degree, patients were divided into four groups：nil group,mild group,moderate group and severe group. Hemoglobin drop, blood transfusion and angiographic embolization were compared among the four groups. Results The mean age of patients was 50 years （range 21 to 74 years）. There was no statistically significant difference in gender, operation site, age, stone size, operation time and residual stone rate among the four groups. From nil group to severe group,the mean drop in hemoglobin content was 17.0±11.9, 14.9±10.8, 13.5±14.2 and 11.2±5.9g/L, respectively （P=0.373）,the blood transfusion rate was 7.1%, 6.6%, 6.3% and 0, respectively （P=0.756）, and angiographic embolization rate was 3.6%, 1.2%, 0 and 0, respectively （P=0.692）. Conclusion There is no direct association between the hydronephrosis degree and blood loss after MPCNL.

关 键 词：微通道经皮肾镜碎石术 肾积水 失血量 

分 类 号：R692[医药卫生—泌尿科学]