完全无管化与部分无管化经皮肾镜取石术适应证的探讨  

Discussion of percutaneous nephrolithotomy with complete non-tubular and partial non-tubular usages

作　　者：翟玉章 孙峰 孙新成 颉亮 许衍超 马凰斌 史庆路 ZHAI Yuzhang;SUN Feng;SUN Xincheng;JIE Liang;Xu Yanchao;Ma Huangbin;Shi Qinglu(Department of Urology,Cangzhou People′s Hospital,Cangzhou,Hebei 061000,China)

机构地区：[1]沧州市人民医院泌尿外科,河北沧州061000

出　　处：《安徽医药》2018年第5期900-903,共4页Anhui Medical and Pharmaceutical Journal

摘　　要：目的探讨符合无管化经皮肾镜取石术(PCNL)适应证患者行完全无管化(不留置肾造瘘管及双J管)与部分无管化(不留置肾造瘘管,仅留置双J管)的有效性和安全性。方法选取经皮肾镜取石术治疗的患者122例,排除术中严重出血需输血等不适应无管化PCNL治疗患者20例,共102例患者被作为研究对象,按照随机数字表法分为完全无管化PCNL组51例和部分无管化PCNL组51例。所有手术均由同一组手术医生实施,比较两组治疗效果和并发症发生率。结果完全无管化PCNL组手术时间(47.93±9.44)min短于部分无管化PCNL组(52.93±6.01)min(P<0.05);两组住院时间差异无统计学意义(P>0.05);完全无管化PCNL组术后发热、膀胱刺激发生率均为0,均显著低于部分无管化PCNL组(P<0.05);两组术后肾周积液、肾绞痛、尿瘘发生率差异无统计学意义(P>0.05)。结论无管化PCNL具有有效、安全的特点,但要恰当掌握其适应证,有条件的实施完全无管化PCNL则更加简便。Objective To explore the efficacy and safety of the patients with tubeless percutaneous nephrolithotomy(PCNL)with complete non-tubular(no indwelling renal fistula and Double J-tube)and partial non-tubular(no indwelling renal fistula,only two-J tube).Methods One hundred and twenty-two patients with percutaneous nephrolithotomy were selected,excluding 20 cases with severe bleeding during operation required blood transfusions who not fit tubeless PCNL,a total of 102 patients were made as the object of research,according to the random draw methods assigned into completely tubeless PCNL group of 51 cases and partially tubeless PCNL of 51 cases.All operations are implemented by the same group of surgeons,comparing the therapeutic outcomes and the incidence rate of complication between the two groups.Results All operations were successful.The operation time of the completely PCNL group(47.93±9.44)min was shorter than(52.93±6.01)min in the partially PCNL group(P<0.05),and there was no statistical significant difference in hospitalization time between the two groups(P>0.05),and the incidence of fever and bladder stimulation in the completely PCNL group(0.00%)was significantly lower than that in the partially PCNL group(P<0.05).There was no statistical significant difference in the incidence of renal effusion,renal colic and urinary fistula after operation in the two groups(P>0.05).Conclusions The PCNL has an effective and safe characteristic.With the proper control of its indications,it is more convenient to implement.

关 键 词：经皮肾镜取石术 无管化 完全无管化 尿路结石 疗效 

分 类 号：R699[医药卫生—泌尿科学]