局部麻醉下无管化微创经皮肾镜取石术的疗效评价  

Evaluation of tubeless mini-pereutaneous nephrolithotomy under local anesthesia

作　　者：龙大治 熊思清[1] 傅恩君[1] 文中华[1] 鲁小民[1] 黄冬莲[1] 李晓飞[1] Da-zhi Long;Si-qing Xiong;En-jun Fu;Zhong-hua Wen;Xiao-min Lu;Dong-lian Huang;Xiao-fei Li(Department of Urology,Ji’an Central Hospital,Ji’an,Jiangxi 343000,China)

机构地区：[1]吉安市中心人民医院泌尿外科,江西吉安343000

出　　处：《中国内镜杂志》2020年第7期58-62,共5页China Journal of Endoscopy

摘　　要：目的评价局部麻醉下无管化微创经皮肾镜取石术(MPCNL)的安全性、可行性及疗效。方法回顾性分析133例在局部麻醉下实施无管化MPCNL患者的相关临床资料,与145例同期常规MPCNL的患者资料进行比较。结果成功完成手术133例,其中未留置双J管28例。局部麻醉无管化MPCNL组术中患者耐受良好,疼痛模拟评分(VAS)(3.8±3.0)分。两组患者结石直径、手术时间、并发症发生率和结石清除率比较,差异均无统计学意义(P>0.05)。局部麻醉无管化MPCNL组的血压变化、术后VAS、镇痛药需求和术后住院时间均明显低于常规MPCNL组(P<0.05)。随访3~40个月,所有患者均未出现肾周感染和尿囊肿等并发症。结论局部麻醉下实施无管化MPCNL安全可行,效果良好,术后恢复快、疼痛轻,值得临床推广应用。Objective To evaluate the feasibility,safety and efficacy of tubeless mini-percutaneous nephrolithotomy(MPCNL)under local anesthesia.Methods Clinical data of 133 cases received tubeless MPCNL under local anesthesia were summarized retrospectively.All the cases were compared respectively with 145 cases who received standard MPCNL.Results All the patients successfully received tubeless MPCNL under the local anesthesia.Of the 133 patients,28 patients had total tubeless MPCNL.The mean visual analog scale(VAS)of tubeless MPCNL under the local anesthesia in operation was(3.8±3.0).The difference in the stones size,operation time,stone free rate and complications among the two groups were not statistically significant(P>0.05).While the fluctuation of BP in operation,postoperative visual analog pain scale scores,analgesia requirement and postoperative hospitalization days of tubeless MPCNL under the local anesthesia were statistically significant(P<0.05)compared with the standard MPCNL.During the 3 to 40 monthes follow-up period,no obviously urinous extravasation and perinephric urinary cyst occured in all patients,and the puncture passages were all accreted well.Conclusions Tubeless MPCNL handled under local anesthesia was simple safe and effective for the indication patients,it showed less pain,shorter hospital stay,deserved clinical popularizing use.

关 键 词：肾结石 输尿管上段结石 局部麻醉 无管化 经皮肾镜取石术 

分 类 号：R691.4[医药卫生—泌尿科学]