经皮穿刺肾盂微导丝贯通技术在肾盂输尿管连接部狭窄术中应用  

Efficiency of percutaneous puncture of renal pelvis with micro-guide wire penetration technique in the operation of ureteropelvic junction stenosi

作　　者：刘沛[1] 韩广业[1] 余泉锋 李振辉 张冠英 吴春磊[1] Liu Pei;Han Guangye;Yu Quanfeng;Li Zhenhui;Zhang Guanying;Wu Chunlei(Department of Urology,the First Affiliated Hospital of Xinxiang Medical College,Henan 453100,China)

机构地区：[1]新乡医学院第一附属医院泌尿外科,453100

出　　处：《实用医技杂志》2021年第12期1391-1395,共5页Journal of Practical Medical Techniques

基　　金：河南省医学科技攻关计划项目(2018020350)。

摘　　要：目的探讨经皮穿刺肾盂微导丝贯通技术在肾盂输尿管连接部狭窄(UPJO)术中有效率。方法回顾性分析我院2019年1月至2021年1月间收治的126例UPJO患者,按手术方式不同分为对照组(采用后腹腔镜离断式肾盂成形术治疗,60例)和观察组(采用经皮穿刺肾盂微导丝贯通技术治疗,66例)。比较2组患者围术期一般指标、血肌酐值、肾积水严重程度及手术有效率。结果观察组在术中出血量、手术时间、住院时间优于对照组(P<0.05);观察组并发症发生率低于对照组(3%与30%)(P<0.05);观察组术后肌酐[(82±30)μmol/L与(113±35)μmol/L]小于对照组,差异有统计学意义(P<0.05);在术后随访期间观察组严重肾积水发生率(3%和10%)低于对照组(P<0.05)。2组患者手术有效率比较,观察组手术有效率高达98%,高于对照组手术有效率90%,差异有统计学意义(P<0.05)。结论经皮穿刺肾盂微导丝贯通技术较后腹腔镜离断式肾盂成形术具有创伤小、术后恢复快、手术有效率高等优点。Objective To investigate the efficiency of percutaneous puncture of renal pelvis with micro-guide wire penetration technique in the operation of ureteropelvic junction stenosis(UPJO).Methods A retrospective analysis of 126 UPJO patients admitted to our hospital between January 2019 and January 2021 were divided into control groups(60 cases treated with retroperitoneal pelvic pyeloplasty)and observation Group(using percutaneous puncture of renal pelvis with micro-guide wire penetration technique,66 cases)according to different surgical methods.The general indicators of perioperative period,blood creatinine value,severity of hydronephrosis and effective rate of operation were compared between the two groups of patients.Results The observation group was significantly better than the control group in terms of intraoperative blood loss,operation time,and hospital stay(P<0.05);the complication rate of the observation group(3%vs 30%)was significantly lower than that of the control group(P<0.05);Observation group postoperative creatinine[(82±30)μmol/L vs(113±35)μmol/L]was significantly lower than that of the control group,the difference was significant(P<0.05);during the postoperative follow-up period,the incidence of severe hydronephrosis in the observation group(3%vs 10%)was significantly lower than that of the control group(P<0.05).Comparing the effective rate of operation between the two groups,the effective rate of operation in the observation group was as high as 98%,which was significantly higher than the effective rate of 90%in the control group(P<0.05).Conclusion Compared with retroperitoneal laparoscopic cut-off pyeloplasty,the percutaneous micro-guide wire penetration technique of renal pelvis has the advantages of lower trauma,faster postoperative recovery,and obvious surgical efficiency.

关 键 词：泌尿外伤手术 最小侵入性外伤手术 肾盂积水 

分 类 号：R699[医药卫生—泌尿科学]