摘要
目的评估球囊扩张与筋膜扩张建立标准经皮肾通道的疗效及安全性。方法对56例肾结石患者分别采用球囊扩张与筋膜扩张建立标准经皮肾通道,行钬激光碎石取石,观察两组术中建立通道的时间、建立通道一次成功率、手术时间、出血量、结石清除率及术后住院时间。结果两组手术均获成功,无中转开放手术。球囊扩张组建立通道时间短于筋膜扩张组[(15±7)min vs(27±12)min,P=0.032)]。球囊扩张组的平均手术时间也短于筋膜扩张组[(48±14)min vs(70±21)min,P=0.038)]。球囊扩张组建立通道一次成功率为高于筋膜扩张组[(92.3%vs 66.7%,P=0.020)]。球囊扩张组手术出血量少于筋膜扩张组[(58±14)ml vs(110±32)ml,P=0.035)]。但两组术后平均住院时间[(7.1±1.3)d vs(7.2±1.0)d,P=0.425]和结石清除率[(92.3%vs 80.0%,P=0.189)]差异无统计学意义。结论球囊扩张法建立经皮肾镜通道可提高一次建立通道成功率,减少术中出血,有效缩短手术时间。
Objective To compare the efficacy and safety of balloon and fascial dilation for channel establishment in percutaneous nephrolithotomy（PCNL）. Methods There were 56 patients with kidney stones in our study, who underwent percutaneous nephrolithotomy by balloon dilation or fascial dilation. The holmium laser lithotripsy was used. Data including the establishing time, the success rate of establishing channel, operation time, blood loss, stone clearance rate, and postoperative hospital stay were collected. Results All surgeries were successful and no one converted to open surgery. The establishing time in the balloon dilation group was shorter than the fascial dilation group [（15＋_7） min vs （27＋_12） min, P--0.032]. The operation time in the balloon dilation group was also shorter than the fascial dilation group [ （48＋14） min vs （70＋21） min, P=0.038]. The success rate of establishing channel in the balloon dilation group was higher than the fascial dilation group [（92.3% vs 66.7%, P--0.020）]. The blood loss in the balloon dilation group was less than the fascial dilation group [（58±14） ml vs （110±32） ml, P=0.035）]. There was no difference in postoperative hospital stay [（7.1±1.3） d vs （7.2±1.0） d, P=0.425] and the stone clearance rate [（92.3% vs 80.0%, P=0.189）] between the two groups. Conclusions The balloon dilatation in PCNL can improve success rate of establishing channel, reduce blood loss and shorten operation time.
出处
《中华腔镜泌尿外科杂志（电子版）》
2016年第4期34-37,共4页
Chinese Journal of Endourology(Electronic Edition)
基金
广西玉林市科学研究与技术开发计划项目(201426008)
关键词
肾结石
肾造口术
经皮
球囊扩张
筋膜扩张
Kidney stone
Percutaneous nephrolithotomy
Balloon dilation
Fascial dilation
