超声引导微创经皮肾镜气压弹道碎石术治疗肾结石的临床疗效分析.docVIP

超声引导微创经皮肾镜气压弹道碎石术治疗肾结石的临床疗效分析 　　[摘要] 目的 探讨在超声引导下微创经皮肾镜气压弹道碎石术治疗肾结石的临床效果。 方法 整群选取2015 年2―8月该院泌尿科收治的86例肾结石患者，将患者随机分成两组每组43例，实验组进行超声引导微创经皮肾镜气压弹道碎石术治疗肾结石，对照组进行常规治疗，观察并分析两组患者的临床疗效。 结果 经过治疗后，实验组患者的结石处理时间、住院时间、术中出血量、并发症发病率均明显低于对照组，实验组并发症发病率为7.08%， 明显低于对照组的32.56%，差异具有统计学意义（P中国论文网 /6/view-7242156.htm 　　[关键词] 超声；微创经皮肾镜；气压弹道碎石术；肾结石 　　[中图分类号] R692 [文献标识码] A [文章编号] 1674-0742（2016）02（a）-0074-02 　　Analysis of Clinical Curative Effect of Minimally Invasive Percutaneous Nephrolithotomy under Ultrasound Guidance in Treatment of Renal Calculi 　　LI Da-peng， WANG An， WU Ming-ming 　　Urinary Surgery， Rongcheng People s Hospital，264300 China 　　[Abstract] Objective To discuss the clinical effect of minimally invasive percutaneous nephrolithotomy under ultrasound guidance in treatment of renal calculi. Methods 86 cases of renal calculi patients treated in the urology department of our hospital from February 2015 to August 2015 were selected and randomly divided into two groups with 43 cases in each， the experimental group were treated with minimally invasive percutaneous nephrolithotomy under ultrasound guidance， the control group were treated with routine method， the clinical curative effect of the two groups was observed and analyzed. Results After treatment， the calculi treatment time， length of stay， intraoperative bleeding volume and incidence of complications were obviously lower than those in the control group， the incidence of complications in the experimental group was obviously lower than that in the control group （7.08% vs 32.56%）， the difference was statistically significant （P0.05），具有可比性。 　　1.2 方法 　　对照组43例患者进行外科手术取石。根据患者术前X线光片显示的结石位置，用穿刺针头在显示结石部位的肾实质表面进行穿刺探查，当针尖触及结石时将穿刺针留在原位，然后使用尖刀片沿穿刺针切开肾实质，取出结石[3]。 　　实验组43例患者进行超声引导微创经皮肾镜气压弹道碎石术治疗肾结石，观察并分析两组患者的临床疗效。具体方法为：①全麻，对患者进行连续硬膜外麻醉；②定位，让患者先取膀胱截石位，置入输尿管导管至肾盂或结石处，持续滴注生理盐水充盈扩张肾盂，通过超声检查选择最佳进行穿刺的部位[4]；③穿刺，用18G 穿刺针在超声引导下开始穿刺，建立经皮肾取石通道[5]；④取石，插入经皮肾镜寻找结石，使用气压弹道联合超声碎石清石系统，较小的结石从经皮肾通道排出，较大的结石块用异物钳取出[6]；⑤拔管，碎石完成后，将输尿管从患者尿道外口拔出，无其他临床症状术后1～3