摘要
目的评估＂两步扩张法＂建立微通道在经皮肾镜碎石术中的可行性和安全性。方法 2013年1月至2015年10月我科完成微通道经皮肾镜术（mPCNL）213例,其中采用F8~F18筋膜扩张器逐级扩张的为A组（98例）;采用先F8筋膜扩张器扩张见尿液溢出,确定穿刺方向和深度后,直接用F18筋膜扩张器扩张的为B组（115例）。两组患者在通道建立时间、结石清除率、术后住院时间、肾盂穿孔率、术后发热、失血量、X线照射时间等方面进行比较。结果两组患者均成功进行mPCNL,A、B两组在通道建立时间分别为（8±2.5）和（3±1）min、肾盂穿孔率分别为12和1例、术后发热分别为18和7例、失血量分别为（16±7.5）和（10±2.5）g/L、X线照射时间分别为（3.5±1.5）和（1.0±0.5）min,两组比较,差异有统计学意义（P〈0.05）;两组结石清除率分别为95.2%和96.6%,术后住院时间分别为8.0和7.5天,两组比较差异无统计学意义（P〉0.05）。结论 ＂两步扩张法＂建立微通道节约了手术时间,降低了并发症的发生,减少了X线对患者和术者的损害,在经皮肾镜术中应用是安全、可行的。
Objective To assess the safety and feasibility of＂two-step dilation＂to establish a microchannel in percutaneous nephrolithotomy（PCNL）.Methods During Jan.2013 and Oct.2015,213 cases of microchannel PCNL（mPCNL）were successfully performed at our department,including 98 cases using F8-F18 fascia dilator to expand step by step（group A）,and115 cases which firstly used F8 fascia dilator until urine overflew,and then used F18 fascia dilator after the puncture direction and depth were determined（group B）.The time used to establish channel,stone clearance rate,postoperative hospital stay,postoperative pelvic perforation rate,postoperative fever,blood loss,and postoperative X-ray irradiation time were compared between the two groups.Results Both groups successfully performed mPCNL.In group A and B,the time used to establish channel was（8±2.5）and（3±1）min,pelvis perforation occurred in12 cases and1 case,postoperative fever occurred in18 cases and 7 cases,blood loss was（16±7.5）and（10±2.5）g/L,X-ray irradiation time was（3.5±1.5）and（1.0±0.5）min,with statistical differences between the two groups（all P〈0.05）.The stone clearance rate was 95.2% and 96.6%,postoperative hospital stay was 8.0and7.5 days,respectively,with no statistically significant difference（both P〈0.05）.Conclusion The＂two-step dilation＂to establish a microchannel can save operation time,reduce the complications and reduce the X-ray irradiation time.It is safe and feasible in percutaneous nephrolithotomy.
出处
《现代泌尿外科杂志》
CAS
2016年第6期455-458,共4页
Journal of Modern Urology
关键词
碎石术
经皮肾镜碎石术
肾结石
两步扩张法
微通道
lithotripsy
percutaneous nephrolithotomy
nephrolithiasis
two-step dilation
microchannel
