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中国当代医药  2022, Vol. 29 Issue (16): 15-19转24    
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超微通道与微通道经皮肾镜治疗>2 cm的肾结石患者的效果及安全性分析
谭日钊
广东省佛山复星禅诚医院泌尿外科
Analysis on efficacy and safety of supermicro percutaneous channel nephrolithotripsy and micro percutaneous channel nephrolithotripsy in patients with kidney stones with diameter >2 cm
TAN Rizhao
Department of Urological Surgery, Foshan Fuxing Chancheng Hospital
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摘要 目的 探讨超微通道与微通道经皮肾镜治疗结石直径>2 cm 肾结石患者的效果及安全性。 方法 选取2016年1月至2020年12月佛山复星禅诚医院收治的40 例结石直径>2 cm 的肾结石患者作为研究对象,采用随机数字表法将其分为观察组和对照组,每组各20 例。 观察组患者采用超微通道经皮肾镜碎石术治疗,对照组患者采用微通道经皮肾镜碎石术治疗。 比较两组患者术后3 d 的结石清除率(SFR);比较两组患者的术中建立通道时间、碎石时间、手术全程所耗时间及住院时间;比较两组患者手术前后的血红蛋白(Hb)、血肌酐(SCr)、C 反应蛋白(CRP)、降钙素原(PCT)水平;比较两组患者的术后并发症(出血、发热)发生情况。 结果 两组患者的SFR 比较,差异无统计学意义(P>0.05);观察组患者术中建立通道时间短于对照组,碎石时间及手术全程时间长于对照组,差异有统计学意义(P<0.05);两组患者的住院时间比较,差异无统计学意义(P>0.05);术前,两组患者的SCr、CRP、PCT、Hb 指标水平比较,差异无统计学意义(P>0.05);术后,两组患者的SCr、CRP、PCT 指标水平比较,差异无统计学意义(P>0.05);观察组患者术后的Hb 水平高于对照组,差异有统计学意义(P<0.05);两组患者术后的SCr、CRP、PCT 均高于术前,Hb 均低于术前,差异有统计学意义(P<0.05);两组患者术后的并发症总发生率比较,差异无统计学意义(P>0.05)。 结论 超微通道经皮肾镜与微通道经皮肾镜术均是高效、安全的碎石方式,两者术后SFR以及并发症总发生率无明显差异,但超微通道经皮肾镜术中建立通道时间相对较短,对组织损伤较小,更推荐临床应用。
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谭日钊
关键词 肾结石超微通道经皮肾镜微通道经皮肾镜安全性疗效    
Abstract: Objective To investigate the efficacy and safety of supermicro percutaneous channel nephrolithotripsy and micro percutaneous channel nephrolithotripsy in the treatment of patients with kidney stones with diameter >2 cm.Methods A total of 40 patients with kidney stones with diameter >2 cm who were admitted to Foshan Fuxing Chancheng Hospital from January 2016 to December 2020 were selected as the research subjects. They were divided into the observation group and the control group by the random number table method, with 20 patients in each group.The observation group was treated with supermicro percutaneous channel nephrolithotripsy, while the control group was treated with micro percutaneous channel nephrolithotripsy. The stone clearance rate (SFR) of 3 d after surgery was compared between the two groups. The intraoperative channel establishment time, lithotripsy time, whole surgery time and hospital stay were compared between the two groups. The levels of hemoglobin (Hb), serum creatinine (SCr), Creactive protein (CRP) and procalcitonin (PCT) in the two groups before and after surgery were compared. The incidence of postoperative complications (bleeding and fever) was compared between the two groups. Results There was no significant difference in SFR between the two groups (P>0.05). The intraoperative channel establishment time in observation group was shorter than that in control group, the lithotripsy time and whole surgery time were longer than those in control group, with statistically significant differences (P<0.05). There was no significant difference in the length of hospital stay between the two groups (P>0.05). Before surgery, there were no significant differences in the levels of SCr, CRP, PCT and Hb between the two groups(P>0.05).After surgery,there were no significant differences in the levels of SCr, CRP and PCT between the two groups (P>0.05). The Hb level in observation group was higher than that in control group, the difference was statistically significant (P<0.05). The SCr, CRP, PCT levels in the two groups after operation were higher than those before surgery, and Hb levels in the two groups after operation were lower than those before surgery, the differences were statistically significant (P<0.05). There was no significant difference in the total incidence of postoperative complications between the two groups (P>0.05). Conclusion Supermicro percutaneous channel nephrolithotripsy and micro percutaneous channel nephrolithotripsy are both efficient and safe lithotriptic methods, and no significant differences are observed in the incidences of postoperative SFR and complications between the two. However, supermicro percutaneous channel nephrolithotripsy is recommended for clinical application due to its relatively short time of establishing channels and less damage to tissues.
Key wordsKidney stone;Supermicro percutaneous channel nephrolithotripsy;Micro percutaneous channel nephrolithotripsy    Safety    Therapeutic effect
    
基金资助:广东省佛山市科技创新项目自筹经费类科技计划项目(2020001005043)。
引用本文:   
谭日钊. 超微通道与微通道经皮肾镜治疗>2 cm的肾结石患者的效果及安全性分析[J]. 中国当代医药, 2022, 29(16): 15-19转24.
TAN Rizhao. Analysis on efficacy and safety of supermicro percutaneous channel nephrolithotripsy and micro percutaneous channel nephrolithotripsy in patients with kidney stones with diameter >2 cm. 中国当代医药, 2022, 29(16): 15-19转24.
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