[1]姜福金,马松,王洪兵,等.22F通道结合双J管反流人工肾积水经皮肾镜治疗肾结石[J].中华腔镜泌尿外科杂志(电子版),2016,10(01):47-50.[doi:10.3877/cma.j.issn.1674-3253.2016.01.013 ]
　Jiang Fujin,Ma Song,Wang Hongbin,et al.The use of 22 F tract combined with double J tube reverse flow artificial hydronephrosis in percutaneous nephrolithotomy（PCNL）for the treatment of renal stone[J].,2016,10(01):47-50.[doi:10.3877/cma.j.issn.1674-3253.2016.01.013 ]
点击复制

22F通道结合双J管反流人工肾积水经皮肾镜治疗肾结石()
分享到：

中华腔镜泌尿外科杂志(电子版)[ISSN:1006-6977/CN:61-1281/TN]

卷:
10
期数:
2016年01期
页码:
47-50
栏目:
临床研究
出版日期:
2016-04-29

文章信息/Info

Title:
The use of 22 F tract combined with double J tube reverse flow artificial hydronephrosis in percutaneous nephrolithotomy（PCNL）for the treatment of renal stone
作者:
姜福金; 马松; 王洪兵; 李强; 张先云; 吴自余
223001江苏省淮安市第二人民医院泌尿外科
Author(s):
Jiang Fujin;  Ma Song;  Wang Hongbin;  Li Qiang;  Zhang Xianyun;  Wu Ziyu.
Department of Urology, Huai'an Second Hospital, Jiangsu 223001, China
关键词:
肾结石; 肾造口术; 经皮; 双 J管
DOI:
10.3877/cma.j.issn.1674-3253.2016.01.013
摘要:
目的比较 22 F通道和 16 F通道经皮肾镜治疗肾结石的临床疗效，并研究双 J管反流人工肾积水临床疗效。方法回顾分析 2011年 8月至 2014年 6月在江苏省淮安市第二人民医院泌尿外科接受不同通道经皮肾镜治疗的 49例肾结石患者临床资料。16例行 22 F单通道（ A组）、14例行 22 F单通道及双 J管反流人工肾积水（ B组）、12例行 16 F单通道（ C组）、7例 16 F单通道及双 J管反流人工肾积水（ D组）经皮肾镜碎石取石术。分析比较各组在通道建立时间、手术时间、术中出血量、一期结石取净率、术后并发症等指标方面的差异。结果各组患者均成功进行经皮肾镜碎石。A与 B组比较： A组通道建立时间明显长于 B组（[7±2）min vs（3±1）min，P<0.05]，手术时间亦长于 B组（[ 65±23）min vs（50±20）min，P<0.05]，两组术中失血量、一期结石清除率和术后发热率无显著差异（P>0.05）。A组与 C组比较，手术时间明显缩短（[ 65±23）min vs（82±19）min，P<0.05]。其余方面无统计学差异（ P>0.05）。C组与 D组比较，手术时间及通道建立时间方面 C组明显长于 D组（[ 82±19）min vs（71±17）min，（6±1）min vs（3±1）min，P均 <0.05]。结石清除率及出血方面无差异（ P>0.05）。B组与 D组比较：手术时间缩短（[ 50±20）min vs（71±17）min，P<0.05]，通道建立时间、出血及结石清除率方面无明显差异（ P>0.05）。结论 22 F通道结合双 J管反流人工肾积水经皮肾镜碎石取石术与传统微通道手术相比具有缩短手术时间及通道建立时间、安全、实用可行等优点，值得临床推荐。

参考文献/References:

[1]李旭明 ,郭闯 ,程洪林 ,等.超声引导经皮肾镜术中不置输尿管导管的安全性探讨 [J/CD].中华腔镜泌尿外科杂志:电子版 , 2012, 6(4): 253-256.
[2] Kalami H, Arbab AH, Hosseini SJ, et al. Impacted uper-ureteral caleuli>1cm:blind access and totally tubeless percuhaneous antegrade removal or retrograde approach[J]. J Endourol, 2006, 20 (9): 616-619.
[3] Albala DM, Assimos DG, Clayman RV, et al. Lower Pole I: a prospective randomized trial of extracorporeal shock wave lithotripsy and percutaneous nephrostolithotomy for lower Pole nephrolithiasis-initial results[J]. J Urol, 2001, 166(6): 2072-2080.
[4]李逊 ,曾国华 ,吴开俊 ,等.微创经皮肾穿刺取石术治疗上尿路结石[J].临床泌尿外科杂志, 2003, 18(9): 516-518.
[5] Pietrow PK, Auge BK, Zhong P, et al. Clinical efficacy of a combination pneumatic and ultrasonic lithotrite [J]. J Urol, 2003, 169(4): 1247-1249.
[6] Rehman J, Monga M, Landman J, et al. Characterization of intrapelvic pressure during ureteropyeloscopy with ureteral access sheaths[J]. Urology, 2003, 61(4): 713-718.
[7]刘双林 ,操作亮 ,袁敬东 ,等.二期微创经皮肾镜术中肾盂内压的监测及其临床意义 [J].临床泌尿外科杂志 , 2013, 28(3): 164-165.
[8]何永忠 ,刘建河 ,曾国华 ,等.微创经皮肾镜取石术后迟发出血原因及介入治疗[J].中华泌尿外科杂志, 2006, 27(6): 371-373.
[9] Lee KL, Stoller ML. Minimizing and managing bleeding after percutaneous nephrolithotomy [J]. Curr Opin Urol, 2007, 17(2): 120-124.
[10] Feng MI, Tamaddon K, Mikhail A, et al. Prospective randomized study of various techniques of percutaneous nephrolithotomy[J]. Urology, 2001, 58(3): 345-350.
[11]雷华 ,王德娟 ,罗建斌 ,等.经皮肾镜术大小通道出血量的比较 [J].中华实验外科杂志, 2011, 28(12): 2090-2091.
[12]司徒杰 ,王德娟 ,刘小彭 ,等.球囊扩张导管在无积水肾建立经皮肾通道的应用[J/CD].中华腔镜泌尿外科杂志 :电子版 , 2010, 4(6): 448-451.
[13]潘铁军 ,谢旭敏 ,李功成 . F24通道下经皮肾镜取石术中碎石器的比较研究[J].微创泌尿外科杂志, 2014, 3(3): 152-154.
[14]邹高德 ,陈光彪 ,邓剑敏 ,等.B超引导下微创经皮肾镜取石术在上尿路结石治疗中的应用(附 106例报告 )[J].实用临床医学 , 2009, 10(1): 35-37, 42.
[15]郑哲明 ,郁兆存 ,邢发枢 ,等.微创经皮肾镜气压弹道碎石取石术治疗上尿路结石的临床分析[J/CD].中华腔镜泌尿外科杂志 :电子版, 2012, 6(4): 249-252.
[16] Michel MS, Trojan L, Rassweiler JJ. Complications in percutaneous nephrolithotomy [J]．Eur Urol，2007，51(4)：899-906；discussion 906.

相似文献/References:

[1]石磊,高振利,姜仁慧,等.经皮肾镜气压弹道联合超声碎石清石的并发症防治[J].中华腔镜泌尿外科杂志(电子版),2007,(02):76.
　SHI Lei,GAO Zhen-li,JIANG Ren-hui,et al.Prevention and treatment of complications of combined pneumatic and ultrasoud lithotripsy during percutaneous nephrolithotomy[J].,2007,(01):76.
[2]朱建国,孙兆林,王元林,等.微创经皮肾镜术治疗孤立肾合并肾结石[J].中华腔镜泌尿外科杂志(电子版),2008,(01):52.
　ZHU Jian-guo,SUN Zhao-lin,WANG Yuan-lin,et al.Treatment of solitary kidney calculi with minimally invasive percutaneous nephrolithotomy[J].,2008,(01):52.
[3]朵永福,龙启,张勇科,等.经皮肾微造瘘气压弹道碎石取石术治疗复杂性肾结石[J].中华腔镜泌尿外科杂志(电子版),2008,(02):121.
　DUO Yong-fu,LONG Qi,ZHANG Yong-ke,et al.Mini-puncture percutaneous nephrostomy lithotripsy for the treatment of complicated nephrolithiasis[J].,2008,(01):121.
[4]温晓飞,陆佳荪,温机灵,等.微造瘘经皮肾镜大功率钬激光治疗肾结石128例报告[J].中华腔镜泌尿外科杂志(电子版),2008,(02):145.
　WEN Xiao-fei,LU Jia-sun,WEN Ji-ling,et al.Mini-percutaneous nephrolithotomy with high-power holmium laser lithotripsy for the treatment of upper ureteral stones(report of 128 cases)[J].,2008,(01):145.
[5]汪溢,蔡鑫,朱家利.经皮肾穿刺气压弹道碎石治疗肾结石58例[J].中华腔镜泌尿外科杂志(电子版),2008,(03):31.
　WANG Yi,CAI Xin,ZHU Jia-li.Percutaneous ureteroscope lithotripsy with pneumatic power (reports of 58 cases)[J].,2008,(01):31.
[6]刘杰,周兴,谢文琪,等.经皮肾钬激光与气压弹道碎石术治疗肾结石的疗效比较[J].中华腔镜泌尿外科杂志(电子版),2008,(03):48.
　LIU Jie,ZHOU Xing,XIE Wen-qi,et al.Comparison of Percutaneous Nephrolithotomy with Holmium: YAG Laser Lithotripsy and Penumatic Lithotripsy for the treatment of Renal Calculi[J].,2008,(01):48.
[7]杨秀书,罗光恒,刘军,等.局部浸润麻醉超声引导下经皮肾镜取石术[J].中华腔镜泌尿外科杂志(电子版),2008,(04):28.
[8]宋飞,黄伟,郭环宇,等.多层螺旋CT三维成像在经皮肾镜取石术中的应用价值[J].中华腔镜泌尿外科杂志(电子版),2009,(01):43.
　SONG Fei,HUANG Wei,GUO Huan-yu,et al.Clinical evaluation of three dimensional spiral CT reconstruction in percutaneous nephrolithotomy[J].,2009,(01):43.
[9]韩杰,黄群联,程庆水,等.经皮肾镜超声碎石术治疗上尿路结石[J].中华腔镜泌尿外科杂志(电子版),2009,(02):13.
　HAN Jie,HUANG Qun-lian,CHEN Qing-shui,et al.Treatment of upper urinary tract stones by ultrasound guided lithotripsy in percutaneous nephrolithotomy(report of 120 cases)[J].,2009,(01):13.
[10]王卫峰,米其武,张志刚,等.微创经皮肾镜取石术治疗复杂性肾结石65例[J].中华腔镜泌尿外科杂志(电子版),2009,(02):19.
　WANG Wei-feng,MI Qiwu,ZHANG Zhi-gang,et al.Treatment of complex renal stone with minimally invasive percutaneous nephrolithotomy (Report of 65 cases)[J].,2009,(01):19.
[11]李旭明,郭闯,程洪林,等.超声引导经皮肾镜术中不置输尿管导管的安全性探讨[J].中华腔镜泌尿外科杂志(电子版),2012,(04):253.
　LI Xu-ming,GUO Chuang,CHENG Hong-lin,et al.The security explore in percutaneous nephrolithotripsy under B-type ultrasound without ureteral catheter[J].,2012,(01):253.
[12]覃智标 雷华 张家宙 毕革文 黄瑞旭 赵书晓 郑仿 黄崛倬.实时低剂量CT定位穿刺在复杂肾结石经皮肾镜术中的应用[J].中华腔镜泌尿外科杂志(电子版),2016,10(01):37.[doi:10.3877/cma.j.issn.1674-3253.2016.01.010 ]
　Qin Zhibiao,Lei Hua Zhang Jiazhou Bi Gewen Huang Ruixu Zhao Shuxiao Zheng Fang,Huang Quzhuo..Treatment of complex renal stone with percutaneous nephrolithotomy under real-time low-dose CT guidance[J].,2016,10(01):37.[doi:10.3877/cma.j.issn.1674-3253.2016.01.010 ]
[13]杨炜青李逊何永忠 冯钢 李天 徐桂彬 赖德辉 徐巍 谢清灵赵海波 杨敏龙.输尿管软镜与微创经皮肾镜治疗多囊肾合并肾结石的疗效比较[J].中华腔镜泌尿外科杂志(电子版),2016,10(03):144.[doi:10.3877/cma.j.issn.1674-3253.2016.03.002 ]
　Yang Weiqing,Li Xun,He Yongzhong,et al.Retrograde intrarenal surgery versus minimally invasive percutaneous nephrolithotomy for polycystic kidney merger kidney stones[J].,2016,10(01):144.[doi:10.3877/cma.j.issn.1674-3253.2016.03.002 ]
[14]周晓波 方友强.体位对经皮肾镜碎石取石术治疗效果和安全性的影响[J].中华腔镜泌尿外科杂志(电子版),2016,10(04):247.[doi:10.3877/cma.j.issn.1674-3253.2016.04.008 ]
　Zhou Xiaobo,Fang Youqiang..Effect of body position on the effects and safety of percutaneous nephrolithotomy in the treatment of renal calculi[J].,2016,10(01):247.[doi:10.3877/cma.j.issn.1674-3253.2016.04.008 ]
[15]肖龙明 杨巧智 陈建发 陈壮 陈威 湛海伦.球囊与筋膜扩张法建立经皮肾镜标准通道的比较[J].中华腔镜泌尿外科杂志(电子版),2016,10(04):255.[doi:10.3877/cma.j.issn.1674-3253.2016.04.010 ]
　Xiao Longming,Yang Qiaozhi,Chen Jianfa,et al.Comparison of balloon and fascial dilation for channel establishment in percutaneous nephrolithotomy[J].,2016,10(01):255.[doi:10.3877/cma.j.issn.1674-3253.2016.04.010 ]
[16]赵书晓 吴杰英 覃智标 黄新 雷华 黄崛倬 狄金明.18F通道经皮肾镜碎石取石术联合尿石通治疗肾结石[J].中华腔镜泌尿外科杂志(电子版),2016,10(04):259.[doi:10.3877/cma.j.issn.1674-3253.2016.04.011 ]
　Zhao shuxiao,Wu jieying,Qin Zhibiao,et al.18 F-channel percutaneous nephrolithotomy with holmium laser combined with Niaoshitong for the treatment of renal calculi[J].,2016,10(01):259.[doi:10.3877/cma.j.issn.1674-3253.2016.04.011 ]
[17]何国永 莫志伟 温俏玲 湛海伦.女性斜卧截石位与俯卧位经皮肾镜的比较[J].中华腔镜泌尿外科杂志(电子版),2015,(05):331.[doi:10.3877/cma.j.issn.1674-3253.2015.05.006 ]
　He Guoyong,Mo Zhiwei,Wen Qiaoling,et al.A comparative study between recumbent and lithotomy position and prone position in percutaneous nephrolithtomy in female[J].,2015,(01):331.[doi:10.3877/cma.j.issn.1674-3253.2015.05.006 ]
[18]张华,李逊,何永忠,等.脊柱畸形合并肾结石的微创经皮肾镜治疗[J].中华腔镜泌尿外科杂志(电子版),2015,(05):339.[doi:10.3877/cma.j.issn.1674-3253.2015.05.008 ]
　Zhang Hua,Li Xun,He Yongzhong,et al.Percutaneous Nephrolithotomy in patients with spinal scoliosis[J].,2015,(01):339.[doi:10.3877/cma.j.issn.1674-3253.2015.05.008 ]
[19]宋光鲁 牛刚 拜合提亚·阿扎提 安尼瓦尔 ·牙生 王玉杰.微创经皮肾镜取石术术后无管化治疗 3岁以下婴幼儿肾结石的评价[J].中华腔镜泌尿外科杂志(电子版),2015,(04):259.[doi:10.3877/cma.j.issn.1674-3253.2015.04.006 ]
　Song Guanglu,Niu Gang,BaihetiyaAzhati,et al.Tubeless minimally invasive percutaneous nephrolithotomy for infants under three years old with renal calcnli[J].,2015,(01):259.[doi:10.3877/cma.j.issn.1674-3253.2015.04.006 ]
[20]阮东丽 张更 李智斌 马帅军 刘克普 杨力军 袁建林.经尿道输尿管软镜与经皮肾镜治疗单侧肾结石的比较[J].中华腔镜泌尿外科杂志(电子版),2015,(03):181.[doi:10.3877/cma.j.issn.1674-3253.2015.03.006 ]
　Ruan Dongli,Zhang Geng,Li Zhibin,et al.Comparison of the therapeutic effect of kidney calculi: ureteroscopy lithtripsy versus percutaneous nephrolithotomy[J].,2015,(01):181.[doi:10.3877/cma.j.issn.1674-3253.2015.03.006 ]

备注/Memo

备注/Memo:
通讯作者：姜福金，Email：jiang717299@sina.com
本文编辑：阮星星 李文标） 姜福金,马松,王洪兵,等. 22F通道结合双 J管反流人工肾积水经皮肾镜治疗肾结石[J/CD].中华腔镜泌尿外科杂志:电子版, 2016, 10(1
更新日期/Last Update: 1900-01-01