斜侧卧位下超声联合X线引导经皮肾镜碎石取石术治疗鹿角形肾结石的效果  

Effect of Ultrasound Combined with X-ray Guided Percutaneous Nephrolithotomy in the Treatment of Staghorn Calculus in Oblique Lateral Position

作　　者：杨志炯 曹雷华 舒特标 YANG Zhijiong;CAO Leihua;SHU Tebiao(Department of Urology,Nanchang People's Hospital,Nanchang 330025,China;不详)

机构地区：[1]南昌市人民医院(南昌市第三医院)泌尿外科,江西南昌330025 [2]南昌市人民医院(南昌市第三医院)超声科,江西南昌330025

出　　处：《中国医学创新》2024年第23期130-134,共5页Medical Innovation of China

摘　　要：目的:观察斜侧卧位下超声联合X线引导经皮肾镜碎石取石术(PCNL)治疗鹿角形肾结石(SC)的应用效果。方法:选取2020年1月—2022年3月南昌市人民医院收治的80例于斜侧卧位下行PCNL治疗SC的患者为研究对象,根据引导方式不同分为联合组和对照组,各40例。对照组在斜侧卧位下行常规的X线引导PCNL治疗,联合组在斜侧卧位下采用超声联合X线引导PCNL治疗。比较两组的手术情况、血清炎症应激指标、血清肾功能指标及术后指标。结果:联合组手术期间的穿刺次数、术中出血量均少于对照组,手术时间、操作通道建立时间均明显短于对照组,且操作通道建立成功率高于对照组,差异均有统计学意义(P<0.05)。术后1 d,两组皮质醇(Cor)、血尿素氮(BUN)、血清中性粒细胞明胶酶相关脂质运载蛋白(NGAL)、C反应蛋白(CRP)及降钙素原(PCT)水平均较治疗前上升,且联合组的PCT、Cor、BUN、NGAL水平均显著低于对照组,差异均有统计学意义(P<0.05)。联合组术后的并发症发生率及输血率均显著低于对照组,住院时间短于对照组,而首次结石清除率较对照组高,差异均有统计学意义(P<0.05)。结论:斜侧卧位下超声联合X线引导PCNL治疗SC效果显著,能有效降低患者术后并发症发生率。Objective:To observe the application efficacy of ultrasound combined with X-ray guided percutaneous nephrolithotomy(PCNL)in the treatment of staghorn calculus(SC)in the oblique lateral position.Method:A total of 80 patients with SC treated with PCNL in oblique lateral position admitted to Nanchang People's Hospital from January 2020 to March 2022 were selected as the study subjects,according to the guide way they were divided into the joint group and the control group,with 40 cases in each group.The control group was treated with conventional X-ray guided PCNL in oblique lateral position,and the joint group was treated with ultrasound combined with X-ray guided PCNL in oblique lateral position.The operation status,serum inflammatory stress index,serum renal function index and postoperative index were compared between the two groups.Result:The number of puncture times and intraoperative blood loss in the joint group were less than those in the control group,and the operation time and operation channel establishment time were significantly shorter than those in the control group,and the success rate of operation channel establishment was higher than that in the control group,the differences were statistically significant(P<0.05).On day 1 after surgery,the levels of cortisol(Cor),blood urea nitrogen(BUN),neutrophil gelatinase associated lipocalin(NGAL),C reactive protein(CRP)and procalcitonin(PCT)in two groups were increased compared with before treatment,and the levels of PCT,Cor,BUN and NGAL in joint group were significantly lower than those in control group,the differences were statistically significant(P<0.05).The postoperative complication rate,blood transfusion rate of the joint group were significantly lower than those in the control group,length of hospital stay was shorter than that in the control group,the first stone clearance rate was significantly higher than that in the control group,the differences were statistically significant(P<0.05).Conclusion:The integration of ultrasound and X-ray guided PCNL in

关 键 词：超声联合X线 经皮肾镜碎石取石术 鹿角形肾结石 

分 类 号：R699.2[医药卫生—泌尿科学]