[1]袁强,杜丹.输尿管软镜与经皮肾镜处理一期经皮肾镜术后残石的比较[J].中华腔镜泌尿外科杂志(电子版),2017,11(05):315-318.[doi:10.3877/cma.j.issn.1674-3253.2017.05.006 ]
 Yuan Qiang,Du Dan.Comparsion of percutaneous nephrolithotomy and retrograde intrarenal surgery for residual kidney stones after percutaneous nephrolithotomy[J].,2017,11(05):315-318.[doi:10.3877/cma.j.issn.1674-3253.2017.05.006 ]
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输尿管软镜与经皮肾镜处理一期经皮肾镜术后残石的比较()
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中华腔镜泌尿外科杂志(电子版)[ISSN:1006-6977/CN:61-1281/TN]

卷:
11
期数:
2017年05期
页码:
315-318
栏目:
临床研究
出版日期:
2017-10-08

文章信息/Info

Title:
Comparsion of percutaneous nephrolithotomy and retrograde intrarenal surgery for residual kidney stones after percutaneous nephrolithotomy
作者:
袁强杜丹
443000 湖北,三峡大学第二人民医院&宜昌市第二人民医院泌尿外科
Author(s):
Yuan Qiang Du Dan
Department of Urology, the Second People's Hospital of the Three Gorges University of Medicine, Yichang 443002, China
关键词:
复杂性肾结石 经皮肾镜 输尿管镜
DOI:
10.3877/cma.j.issn.1674-3253.2017.05.006
摘要:
目的 比较输尿管软镜与经皮肾镜处理复杂性肾结石经皮肾镜碎石取石术(PCNL)术后残石的疗效与安全性。方法 回顾性分析2015 年9 月至2016 年12 月我院一期PCNL 术后残石再次手术的73 例复杂性肾结石患者的临床资料。按再次手术方式不同分为经皮肾镜组(PCNL组,34 例)和输尿管软镜组(RIRS 组,39 例)。比较两组患者再次手术的残石清除率、手术时间、术中出血量、平均住院日、住院费用、留置造瘘管时间及并发症情况。结果 PCNL 组及RIRS 组在年龄、性别、残石总直径、体质量指数、结石位置方面差异无统计学意义。术中出血量为(60±17)ml和(12±6)ml,差异有统计学意义(P<0.01)。手术时间为(35±4)min 和(60±13)min,差异有统计学意义(P<0.01)。住院费用为(17 118±1 719)元和(24 026±1 013)元,差异有统计学意义(P<0.01)。平均住院日为(9.0±1.0)d 和(4.0±0.8)d,差异有统计学意义(P<0.01)。留置肾造瘘管时间为(6.2±0.7)d 和(2.8±0.8)d,差异有统计学意义(P<0.01)。残石清除率为73.6%(25/34)和92.3%(36/39),差异有统计学意义(P=0.031)。PCNL 组发生术后重症感染3 例,术后大出血1 例,使用敏感抗生素及选择性肾动脉栓塞后治愈RIRS 组未出现术后重症感染及大出血。结论输尿管软镜处理复杂性肾结石PCNL 术后残石较经皮肾镜具有结石清除率高、术中出血少、术后并发症少、留置肾造瘘管时间和平均住院日短等优势,值得在临床应用中大力推广。

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备注/Memo

备注/Memo:
基金项目:2016 年三峡大学研究生科研创新基金项目(SDYC2016095)
通讯作者:杜丹,Email:yishengdudan@163.com
更新日期/Last Update: 2017-10-25