无管化微通道PCNL的初期临床研究  

Initial clinical study on tubeless microchannel PCNL

作　　者：蔡国烽 邓君鹏[1] 阙宏亮 李权[1] 谢建军[1] 曹文舟[1] 沈华[1] CAI Guofeng;DENG Junpeng;QUE Hongliang;LI Quan;XIE Jianjun;CAO Wenzhou;SHEN Hua(Department of Urology,Affiliated Suzhou Hospital of Nanjing Medical University,Suzhou,Jiangsu,215000,China)

机构地区：[1]南京医科大学附属苏州医院泌尿外科,江苏苏州215000

出　　处：《临床泌尿外科杂志》2021年第4期276-280,共5页Journal of Clinical Urology

基　　金：苏州市医学重点学科项目(No:Szxk201810)。

摘　　要：目的:探讨无管化微通道经皮肾镜取石术(mPCNL)治疗上尿路结石的疗效性及安全性。方法:选取我院2018年9月—2019年12月100例上尿路结石病例,根据手术方案不同分为无管化mPCNL(观察组)与标准mPCNL(对照组)两组,每组各50例。研究比较两组手术相关指标、术后疼痛、术后并发症发生率及术后住院相关指标。结果:两组患者年龄、性别、结石直径和部位、基础疾病等一般临床资料比较差异均无统计学意义(P>0.05)。观察组相比对照组的手术时间[(61.57±4.52)min vs.(64.27±5.21)min]、术后尿管留置时间[(3.10±0.71)d vs.(4.17±1.68)d]、术后住院时间[(3.73±0.94)d vs.(5.00±1.84)d]均明显缩短,并且住院费用也比对照组减少[(21469.76±2940.37)元vs.(24384.67±3307.71)元],差异有统计学意义(P<0.05)。观察组患者术后第1天的VAS评分比对照组低[(2.53±0.68)分vs.(3.97±0.77)分],术后镇痛药物使用率也较对照组低,差异有统计学意义(P<0.05)。而两组的手术相关指标及术后并发症发生率差异无统计学意义(P>0.05)。结论:无管化mPCNL治疗上尿路结石是安全有效的手术方式,具有减少术后疼痛、缩短住院时间及降低住院费用等优势。Objective:To investigate the efficacy and safety of tubeless microchannel percutaneous nephrolithotomy(mPCNL)in the treatment of upper urinary calculi.Methods:From Sep.2018 to Dec.2019,100 cases of upper urinary calculi in our hospital were selected.According to the different operation plans,they were divided into two groups:the tubeless mPCNL(observation group)and the standard mPCNL(control group).Each group had 50 cases.The operation related indexes,postoperative pain,postoperative complications and hospitalization related indexes of the two groups were compared with each other.Results:There was no significant difference in general clinical data of age,gender,stone diameter or location,basic diseases between the two groups(P>0.05).The operation time\[(61.57±4.52)min vs.(64.27±5.21)min\],the indwelling time\[(3.10±0.71)d vs.(4.17±1.68)d\]and the postoperative hospitalization time\[(3.73±0.94)d vs.(5.00±1.84)d\]were shorter in observation group than those in control group(P<0.05),and the hospitalization cost\[(21469.76±2940.37)yuan vs.(24384.67±3307.71)yuan\]was also significantly lower in observation group compared with control group(P<0.05).Furthermore,the pain score of first day after operation in observation group was lower than that in control group\[(2.53±0.68)vs.(3.97±0.77)\],in that case the utilization rate of analgesic drugs in observation group was also lower than that in control group(P<0.05).However,there was no significant difference in operation related indexes or postoperative complications between the two groups(P>0.05).Conclusion:Tubeless mPCNL is a safe and effective method for the treatment of upper urinary calculi,which has the advantages of reducing postoperative pain,shortening hospital stay and reducing hospital costs.

关 键 词：无管化 微通道经皮肾镜取石术 上尿路结石 

分 类 号：R69[医药卫生—泌尿科学]