超声引导下球囊扩张导管与金属扩张器在经皮肾镜取石术中应用的对比性分析-外科学专业论文.docxVIP

摘 摘 要 摘 要 目的 分析球囊扩张建立经皮肾镜通道与金属扩张器建立经皮肾镜通道在 PCNL 术 中的对比研究，探讨两种方法建立经皮肾镜通道在治疗肾及输尿管上段结石的有效性及 安全性。 方法 本研究选取河北大学附属医院自 2011 年 10 月-2012 年 08 月实施的符合病例 入选标准的 40 例肾结石及输尿管上段结石患者。所有患者根据术前影像学信息，充分 评估手术风险及难度，将 40 例患者随机分为 2 组，A 组为球囊扩张组，B 组为金属扩张 器组。对两种通道建立方法的一次成功率、结石清除率（术后 1 周；术后 1 月；术后 3 月）、效率商（Efficiency quotient，EQ）、手术时间、术后住院时间、术中出血量、 并发症发生率等反应其有效性及安全性的指标进行对比研究，应用统计学方法，计量资 料采取完全随机方差分析，计数资料采用卡方检验；计量资料两两比较应用 LSD-t 检验， P0.05 为差异有显著性。 结果 球囊扩张组（A 组）及金属扩张器组（B 组）两组间的通道建立一次成功率、 结石清除率、手术时间、术中出血量及并发症的发生均有统计学意义，差异明显 （P0.05）,A 组 EQ 值大于B组 EQ 值。 结论 超声引导下球囊扩张建立经皮肾镜通道在处理肾及输尿管上段结石具有安 全、高效的特点，值得临床推广。 关键词 球囊扩张 金属扩张器 肾结石 安全性 有效性 I Abstract Abstract Abstract Objective To analyze the balloon dilatation to establish the percutaneous nephrolithotomy channel and metal dilator establish the comparative study of of percutaneous nephrolithotomy channel PCNL surgery, explore two ways to create a of percutaneous nephrolithotomy channel in the effectiveness of the treatment of renal and upper ureteral calculi security. Methods This study selected the Affiliated Hospital of Hebei University meet the inclusion criteria of cases since October 2011 -2012 in August, 40 cases of kidney stones and ureteral stones in patients. All patients based on preoperative imaging information to fully assess the risk and difficulty of surgery, 40 patients were randomly divided into two groups, group A balloon dilatation group, B group metal dilator group. The establishment of the two-channel method after the success rate of stone clearance rate (after 1 week; postoperative January; 3 months), the efficiency quotient (Efficiency quotient, EQ), operative time, postoperative hospital stay, surgery The amount of bleeding, the incidence of complications, such as the reaction of its efficacy and safety indicators retrospective analysis, the application of statistical methods, measurement data taken completely random analysis of variance, LSD-count data using the chi-square test; pairwise comparison of the measurement data application