标准通道经皮肾镜取石术联合负压吸引清石鞘治疗肾结石临床分析.docVIP

标准通道经皮肾镜取石术联合负压吸引清石鞘治疗肾结石临床分析 　　【摘要】目的探讨标准通道经皮肾镜取石术（PCNL）联合负压吸引清石鞘治疗肾结石的效果。 　　方法选择2013年1月～2015年1月在泌尿外科接受手术治疗的肾结石患者96例，随机分为两组，观察组52例，采用标准通道PCNL联合负压吸引清石鞘治疗，对照组44例，采用普通经皮肾镜取石术治疗，观察两组患者的手术时间、术中出血量、住院时间、一期清石率以及并发症。 　　结果两组病例均顺利完成手术，无穿刺失败或者中转开放手术者，观察组手术时间、术中出血量、住院时间均明显短于对照组，一期清石率明显高于对照组，差异有统计学意义（P001），手术无肾盂穿孔、肝脾及结肠损伤、气胸、感染性休克等严重的并发症。 　　结论应用标准通道PCNL联合负压吸引清石鞘治疗肾结石比普通经皮肾镜取石治疗肾结石具有明显的优势，创伤小，出血少，负压吸引能主动、快速、即时清石，一次性清石率明显提高，手术时间短，并发症少，手术安全，患者再次手术率显著降低，缩短住院时间，值得临床推广。 　　【关键词】标准通道；经皮肾镜取石术；负压吸引；肾结石 　　中图分类号：R699.2文献标识码：ADOI：10.3969/j.issn2016.02.009 　　【Abstract】ObjectiveTo study curative effect of the standard channel percutaneous nephrolithotomy（PCNL） combined with negative pressure suction in the treatment of renal calculi. 　　Methods96 cases of renal calculi，who received operation in Urology Department from January，2013 to January，2015，were randomly divided into observation group（52 cases） and control group（44 cases）.The observation group were given standard channel PCNL combined with negative pressure suction，while the control group were given common PCNL.Then， the operation time，blood loss，length of stay，one-time stone clearing rate and complications of the two groups were observed. 　　ResultsBoth groups successfully completed the surgery，no puncture failure or conversion to open surgery were found.The operation time and length of stay of the observation group were shorter than those of the control group，blood loss during operation was less than that of the control group，and one-time stone clearing rate was higher than that of the control group，so difference was statistically significant（P0.01）.No severe complications such as perforation of the renal pelvis，liver and spleen and colon injury，pneumothorax，septic shock，etc.were found during the operation. 　　ConclusionComparing to common PCNL，standard channel PCNL combined with negative pressure suction has obvious advantages such as less trauma，less bleeding，negative pressure suction can clear stones actively，rapi