完全无管化与传统经皮肾镜取石术治疗肾与输尿管上段结石的对照分析.pdfVIP

摘 要 摘 要 目的 探讨完全无管化经皮肾镜取石术（PCNL）治疗肾及输尿管上段结石的疗效、 安全性。通过与传统PCNL对比评估完全无管化经皮肾镜取石术的优势。 方法 选择河北大学附属医院泌尿外科 2010 年 12 月～2011 年 9 月住院行经皮肾镜 取石术的结石患者60例，取石结束时随机（符合标准没有严重的出血、残留结石、集 合系统的穿孔）分为2组，一组为完全无管化组30例，另一组为对照组30例，两组间 比较手术时间、术后血红蛋白的变化、住院时间、结石清除率、医疗费用、术后疼痛程 度等指标。 结果 60例结石患者中完全无管化组和对照组平均手术时间、术后血红蛋白的变 化、结石清除率、并发症的发生率无显著性差异(PO.05)；住院时间、术后疼痛的程度、 医疗费用完全无管化组显著低于对照组(P0.05)。 结论 对于无严重出血、无残留结石、无明显集合系统的损伤的患者完全无管化的 经皮肾镜取石术是一种安全、有效、经济的方法，是否行完全无管化决定于取石结束时 术者的判断。 关键词 完全无管化 经皮肾镜取石术 肾结石 输尿管上段结石 I Abstract Abstract Objective ：To evaluate the safety, effectiveness, and feasibility of totally tubeless percutaneous nephrolithotomy comparing traditional method in the treatment of renal and upper-ureteral calculi. Methods: 60 patients who underwent percutaneous nephrolithotomy when they were hospitalized in the urology of affiliated hospital of Hebei University during December 2010 to September 2011 were chosen. Patients were randomized to either a totally tubeless approach (30 patients) or control group(30 patients). Patients were considered uncomplicated and suitable for randomization at the end of the operation if there was no significant bleeding or residual stone, and the pelvicaliceal system was intact. The incidence of operative time, postoperative hemoglobin ，complications, hospital stay, pain, and stone-free rates were compared in 2 groups. Results: No statistical significant differences were found with the time of operation， postoperative hemoglobin change ,stone clearance rate ，complication incidence between the totally tubeless group and the cont