B超引导改良两步扩张法建立皮肾通道经皮肾镜取石术治疗非积水肾结石的临床效果

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摘要目的探讨B超引导改良两步扩张法建立皮肾通道经皮肾镜取石术（PCNL）治疗非积水肾结石的方法和安全性，评价其临床价值。方法选取2016年1～12月我院收治的80例非积水肾结石患者作为研究对象，随机分成A组和B组，每组40例。A组采用B超引导改良两步扩张法建立皮肾通道PCNL治疗，B组采用常规B超引导逐级扩张法的PCNL治疗，比较两组的通道成功率、通道建立时间、手术时间﹑平均失血量﹑住院时间﹑结石清除率、并发症发生率等。结果A组与B组的结石清除率及住院时间比较，差异无统计学意义（P＞0.05）。A组的通道成功率高于B组，通道建立时间、手术时间短于B组，失血量少于B组，差异有统计学意义（P＜0.05）。两组的并发症发生率比较，差异无统计学意义（P＞0.05）。结论B超引导改良两步扩张法建立皮肾通道PCNL治疗非积水肾结石安全、可行，效果确切，具有通道建立简单、通道成功率高、手术时间短、出血少等优点，值得推广。

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	刘佛林
	邹毓华
	徐瑞权
	袁源湖
	伍耿青
	谢昆林

关键词 ：二步扩张法, 皮肾通道, 经皮肾镜取石术, 非积水肾结石

Abstract：Objective To investigate the method and safety of percutaneous nephrolithotomy(PCNL)with renal access created by modified B ultrasound guided two-step dilation in the treatment of non-hydronephrosis renal calculus,and to evaluate its clinical value.Methods From January to December in 2016,80 patients with non-hydronephrosis renal calculus in our hospital were selected and randomly divided into group A and group B,40 cases in each group.Group A was treated with PCNL with renal access created by modified B ultrasound guided two-step dilation,group B was treated with PCNL with conventional B ultrasound guided gradual dilation.The success rate of renal access,renal access creation time,operation time,the average blood loss,hospitalization time,the calculus clearance rate and the incidence rate of complications between the two groups were analyzed and compared respectively.Results There was no significant difference between A group and B group in the stone clearance rate and hospital stay(P＞0.05).The success rate of group A was higher than that of group B,channel establishment time,operation time of group A was shorter than that group B, the blood loss of group A was less than of group B,with significant difference(P＜0.05).There was no significant difference in the incidence rate of complications between the two groups(P＞0.05).Conclusion PCNL with renal access created by modified B ultrasound guided two-step dilation in the treatment of non-hydronephrosis renal calculus is safe and feasible,the effect is significant,it has some advantages of simple channel,high success rate,shorter operation time and less bleeding,it is worthy of promotion.

Key words： Two-step dilate Renal access Percutaneous nephrolithotomy Non-hydronephrosis renal calculus

基金资助:江西省卫生计生委科技计划项目（20171108）

作者简介: 刘佛林（1976-），男，江西高安人，硕士，副主任医师，主要研究方向：微创泌尿外科学

引用本文:

刘佛林；邹毓华；徐瑞权；袁源湖；伍耿青；谢昆林. B超引导改良两步扩张法建立皮肾通道经皮肾镜取石术治疗非积水肾结石的临床效果[J]. 中国当代医药, 2017, 24(10): 68-71.
LIU Fo-lin；ZOU Yu-hua；XU Rui-quan；YUAN Yuan-hu▲；WU Geng-qing；XIE Kun-lin. Clinical effect of percutaneous nephrolithotomy with renal access created by modified B ultrasound guided two-step dilation in the treatment of nonhydronephrosis renal calculus. 中国当代医药, 2017, 24(10): 68-71.

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