摘要
目的比较标准通道和微通道经皮肾镜取石术(PCNL)治疗直径20 mm以上肾结石的临床效果。方法选择2019年1月至2023年1月于南通市通州区人民医院泌尿外科住院接受手术治疗的106例直径20 mm以上肾结石患者为研究对象,按照通道大小将其分为标准通道组(54例,建立24F经皮肾通道进行碎石)和微通道组(52例,建立18F经皮肾通道进行碎石)。比较两组的临床相关指标、疼痛情况、结石清除率及术后并发症发生情况。结果微通道组的手术时间长于标准通道组,碎石时间、住院时间短于标准通道组,血红蛋白(Hb)下降值低于标准通道组,差异具有统计学意义(P<0.05)。术后第1、2、3天,微通道组的视觉模拟量表(VAS)评分低于标准通道组,差异具有统计学意义(P<0.05)。两组的结石清除率、术后发热发生率比较,差异无统计学意义(P>0.05);微通道组的术后出血发生率低于标准通道组,差异具有统计学意义(P<0.05)。结论标准通道与微通道PCNL治疗肾结石都可取得理想效果,标准通道可借助的器械较多,操作过程相对简单,而微通道操作中能借助的器械较少,对操作者技术要求较为严格,但其在减少术后疼痛以及出血量、缩短临床恢复时间方面更具备优势,临床应该根据患者的具体情况而选择合适的手术方式。
Objective To compared the clinical effects of standard channel and microchannel percutaneous nephrolithotomy(PCNL)in the treatment of kidney stones with a diameter of more than 20 mm.Methods A total of 106 patients with kidney stones with a diameter of more than 20 mm who underwent surgical treatment in the urology department,Nantong Tongzhou People's Hospital from January 2019 to January 2023 were selected as the research objects.According to the size of the channel,the patients were divided into standard channel group(54 cases,24F percutaneous renal channel was established for lithotripsy)and microchannel group(52 cases,18F percutaneous renal channel was established for lithotripsy).The clinical related indexes,pain,stone clearance rate and postoperative complications were compared between the two groups.Results The operation time of the microchannel group was longer than that of the standard channel group,and the gravel time and hospitalization time were shorter than those of the standard channel group,and the decrease of hemoglobin(Hb)was lower than that of the standard channel group,and the differences were statistically significant(P<0.05).On the 1 st,2 nd and 3 rd day after operation,the Visual Analogue Scale(VAS)score of the microchannel group was lower than that of the standard channel group,and the difference was statistically significant(P<0.05).There were no significant differences in the stone clearance rate and the incidence of postoperative fever between the two groups(P>0.05);the incidence of postoperative bleeding in the microchannel group was lower than that in the standard channel group,and the difference was statistically significant(P<0.05).Conclusion Both standard channel and microchannel PCNL can achieve ideal results in the treatment of kidney stones.The standard channel can use more instruments,and the operation process is relatively simple,while the microchannel operation can use fewer instruments,and the operator's technical requirements are more stringent.However,it has more advantages
作者
张小松
ZHANG Xiaosong(Urology Department,Nantong Tongzhou People's Hospital,Nantong 226300,China)
出处
《临床医学研究与实践》
2024年第26期86-89,共4页
Clinical Research and Practice
关键词
标准通道
微通道
肾结石
经皮肾镜取石术
结石清除率
standard channel
microchannel
kidney stone
percutaneous nephrolithotomy
stone clearance rate
