摘要
目的:探讨B超X线联合引导下经皮肾镜治疗上尿路结石在基层医院应用的可行性、疗效,为基层医院实行PCNL的选择提供参考。方法:选取2014年3月-2017年3月本院收治44例上尿路结石并接受经皮肾镜碎石术治疗的患者随机分为研究组共23例和对照组共21例,研究组采用B超X线联合引导下进行定位及穿刺,而对照组只采用B超引导下穿刺。两组患者的观察指标包括平均手术时间、术后住院时间、手术前后血红蛋白变化量,以及术中或术后输血、感染情况;此外,还进行一、二、三期取石率和残石率的统计。结果:研究组的手术时间和术后住院时间明显比对照组短,比较差异均有统计学意义(P<0.05);研究组的手术前后血红蛋白变化量也比对照组少(P<0.05);术中或术后输血率明显比对照组低(P<0.05)。研究组的一期取石率明显比对照组的高,比较差异有统计学意义(P<0.05);二期取石率虽然也高于对照组,但比较差异无统计学意义(P>0.05);研究组的残留结石率明显比对照组低(P<0.05)。结论:B超和X线联合定位引导下PCNL治疗上尿路结石,能有效结合B超和X线两种定位方法的优点,并避免两者的缺点,对提高手术安全性、一期手术结石的清除率、减少住院时间和费用有很大帮助,值得在基层医院推广。
Objective： To explore the feasibility and effect of ultrasound and X-ray guidance for percutaneous nephrolithotomy treating upper urinary calculi, in order to providing reference for primary hospitals. Method： From March 2014 to March 2017 in our hospital, 44 patients with renal calculi who were performed percutaneous nephrolithotomy were collected and divided into the observation group （ B-type ultrasound＋ X-ray group ） of 23 cases and control group （ B-type ultrasound ） of 21 cases.The average operation time, postoperative hospital stay, hemoglobin variation before and after operation, intraoperative and postoperative blood transfusion and infection of two groups were analyzed.In addition, the stone-free rate and residual stone rate of two groups of patients at first, second and third phase were recorded.Result： The operation time and postoperative hospital stay in observation group were significantly shorter than that in the control group, the difference was statistical significance （P〈0.05） .The hemoglobin variation before and after operation in observation group was less than that the control group （ P〈0.05 ） .The intraoperative and postoperative blood transfusion rate in observation group were obviously lower than those of control group （ P〈0.05 ） .The first phase of stone-free rate in observation group was significantly higher than that of control group （ P〈0.05 ） .Though the second phase of stone-free rate in observation group was higher than that of control group, the difference was not statistically significant （ P〉0.05 ） .Team residual stone rate in observation group was obviously lower than that of the control group （ P〈0.05 ） .Conclusion： The ultrasound combined X-ray was useful for the percutaneous nephrolithotomy treating upper urinary calculi, which collecting each other advantage, can improve the operation safety and stone clearance rate, reduce the length of hospital stay and cost. it is worth no,3ularizing in nrimarv hos,3itals.
出处
《中国医学创新》
CAS
2017年第22期21-24,共4页
Medical Innovation of China
关键词
上尿路结石
B超
X线
经皮肾穿刺取石
基层医院
Upper urinary calculi
Ultrasound
X-ray
Percutaneous Nephrolithotomy
Primary hospital
