B超引导下经皮肾镜联合超声波负压吸引气压弹道碎石清石系统处理鹿角形肾结石的临床应用
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摘要
目的探讨B超引导下经皮肾镜联合超声波负压吸引气压弹道碎石清石系统(EMS)处理鹿角形肾结石的临床应用价值。方法收集2008年8月~2016年10月我院80例鹿角形肾结石患者,随机分为两组:40例行B超引导下经皮肾镜联合超声波负压吸引气压弹道碎石清石系统(EMS)碎石术(实验组),40例行肾实质切开取石术(对照组),对两种治疗方法临床疗效进行评价。结果实验组手术时间为(60.65±1.03)min,对照组为(104.38±1.64)min,差异有统计学意义(P<0.05)。实验组术中出血量为(52.03±1.39)mL,对照组为(110.48±2.12)mL,差异有统计学意义(P<0.05)。实验组并发症发生率为7.5%,对照组为25.0%,差异有统计学意义(P<0.05)。实验组结石残留率为5.0%,对照组为20.0%,差异有统计学意义(P<0.05)。结论 B超引导下经皮肾镜联合超声波负压吸引气压弹道碎石清石系统(EMS)处理鹿角形肾结石是一种安全高效的手术方法。
Objective To evaluate the clinical application value of B-ultrasound gided percutaneous nephrolithotomy combined with ultrasonic negative pressure aspiration pneumatic lithotripsy system(EMS) in the treatment of antler-like kidney stone. Methods From August 2008 to October 2016,80 patients with antler-like kidney stone in our hospital were collected and were randomly divided into two groups:40 cases were given B-ultrasound guided EMS(experimental group),and 40 cases were given renal parenchymal incision(control group). The clinical efficacy of the two treatments was evaluated. Results The operation time was(60.65±1.03) min in the experimental group and(104.38±1.64)min in the control group,and the difference was statistically significant(P <0.05). The intraoperative blood loss was(52.03±1.39) mL in the experimental group and(110.48±2.12) mL in the control group(P<0.05),and the difference was statistically significant(P<0.05). The incidence rate of complications was 7.5% in the experimental group and 25.0% in the control group,and the difference was statistically significant(P<0.05). The residual rate of stones was 5.0% in the experimental group and 20.0% in the control group,and the difference was statistically significant(P<0.05). Conclusion B-ultrasound guided percutaneous nephrolithotomy combined with ultrasonic negative pressure aspiration pneumatic lithotripsy system(EMS) in the treatment of antler-like kidney stone is a safe and efficient surgical procedure.
Objective To evaluate the clinical application value of B-ultrasound gided percutaneous nephrolithotomy combined with ultrasonic negative pressure aspiration pneumatic lithotripsy system(EMS) in the treatment of antler-like kidney stone. Methods From August 2008 to October 2016,80 patients with antler-like kidney stone in our hospital were collected and were randomly divided into two groups:40 cases were given B-ultrasound guided EMS(experimental group),and 40 cases were given renal parenchymal incision(control group). The clinical efficacy of the two treatments was evaluated. Results The operation time was(60.65±1.03) min in the experimental group and(104.38±1.64)min in the control group,and the difference was statistically significant(P <0.05). The intraoperative blood loss was(52.03±1.39) mL in the experimental group and(110.48±2.12) mL in the control group(P<0.05),and the difference was statistically significant(P<0.05). The incidence rate of complications was 7.5% in the experimental group and 25.0% in the control group,and the difference was statistically significant(P<0.05). The residual rate of stones was 5.0% in the experimental group and 20.0% in the control group,and the difference was statistically significant(P<0.05). Conclusion B-ultrasound guided percutaneous nephrolithotomy combined with ultrasonic negative pressure aspiration pneumatic lithotripsy system(EMS) in the treatment of antler-like kidney stone is a safe and efficient surgical procedure.
引文
[1]吴舟,吴宏,田焕书,等.两种方法对部分性鹿角形肾结石治疗效果的比较[J].重庆医学,2011,40(29):2936-2937.
[2]宋永琳,李炯明,刘建和,等.经皮肾镜钬激光联合超声碎石治疗鹿角形肾结石:附36例报告[J].中华腔镜泌尿外科杂志(电子版)2012,6(3):195-198.
[3]胡卫列,何恢绪,吕军,等.无萎缩性肾切开取石术67例报告[J].中华泌尿外科杂志,2004,25(9):642.
[4]卓栋,姜书传,韩杰,等.经尿道气压弹道一超声碎石清石术联合前列腺等离子切除术治疗前列腺增生合并膀胱结石[J].实用医学杂志,2009,25(15):2512-2514.
[5]李先承,李秀男,郑伟,等.超声引导下微创经皮肾镜治疗上尿路结石152例临床分析[J].大连医科大学学报,2014,36(2):137-139.
[6]李文雄,梁坚,曹明欣,等.螺旋CT三维重建肾鹿角形结石影像在PCNL术中的应用价值研究[J].临床泌尿外科杂志,2010,25(12):927-929.
[7]管维,陈志强,杜广辉,等.EMS标准通道经皮肾与微创经皮肾取石治疗肾鹿角形结石的疗效比较[J].华中科技大学学报(医学版),2010,39(2):269-271.
[8]王亚林,赵立,曲楠,等.EMS超声-气压弹道碎石与微通道钬激光碎石对复杂肾结石碎石117例疗效分析[J].中华临床医师杂志(电子版),2012,6(13):35-38.
[9]徐冉,易路,王欣宇,等.经皮肾镜碎石术处理孤立肾铸型结石的安全性及有效性评价[J].中南大学学报(医学版),2012,37(6):621-624.
[10]优字,张刚,祝青再,等.彩超引导下经皮肾镜碎石取石术治疗鹿角形肾结石[J].中国综合临床,2012,28(6):604-606.
[11]邓佩林,马靖远,卢虎,等.超声引导经皮肾镜气压弹道联合超声碎石术治疗无积水肾结石[J].中华临床医师杂志(电子版),2010,4(9):1698-1700.
[12]钟东亮,郑少斌,单炽昌,等.经皮肾镜取石术后结石残留的原因分析[J].实用医学杂志,2014,30(17):2809-2811.
[13]胡卫国,李建兴,杨波,等.标准通道经皮肾镜碎石术前预测方案与术中手术方案差异的分析[J].中华泌尿外科杂志,2013,34(1):17-19.
[14]张雪培,可方,王声政,等.经皮肾镜碎石术术中及术后出血风险因素分析[J].现代泌尿外科杂志,2016,21(2):108-111.
[15]王磊,徐伟,王宏辉,等.经皮肾镜取石术后肾出血的急诊动脉栓塞治疗[J].实用放射学杂志,2014,30(7):1183-1185.
[16]钟百书,张胜,彭志毅,等.超选择性肾动脉栓塞治疗经皮肾镜取石术后严重出血[J].中华泌尿外科杂志,2012,33(1):41-43.
[17]马凯,黄晓波,许清泉,等.肾鹿角形结石患者结石成分的红外光谱分析[J].中华医院杂志,2010,99(4):3150-3152.
[18]肖仁举,陈伟,王时龙.经皮肾镜超声气压弹道碎石术治疗鹿角形结石(附34例报告)[J].海南医学,2009,20(5):35-36,49.
[19]李淦洪,王亚东,罗文辉,等.体外冲击波碎石治疗经皮肾镜术后残石的时机选择及部分相关因素分析[J].中华腔镜泌尿外科杂志(电子版),2016,10(4):17-19.
[20]王博涵,余琥,姚炜敏,等.微创经皮肾镜碎石术后临床无意义残中期随访结果[J].中华泌尿外科杂志,2012,33(7):529-531.
[2]宋永琳,李炯明,刘建和,等.经皮肾镜钬激光联合超声碎石治疗鹿角形肾结石:附36例报告[J].中华腔镜泌尿外科杂志(电子版)2012,6(3):195-198.
[3]胡卫列,何恢绪,吕军,等.无萎缩性肾切开取石术67例报告[J].中华泌尿外科杂志,2004,25(9):642.
[4]卓栋,姜书传,韩杰,等.经尿道气压弹道一超声碎石清石术联合前列腺等离子切除术治疗前列腺增生合并膀胱结石[J].实用医学杂志,2009,25(15):2512-2514.
[5]李先承,李秀男,郑伟,等.超声引导下微创经皮肾镜治疗上尿路结石152例临床分析[J].大连医科大学学报,2014,36(2):137-139.
[6]李文雄,梁坚,曹明欣,等.螺旋CT三维重建肾鹿角形结石影像在PCNL术中的应用价值研究[J].临床泌尿外科杂志,2010,25(12):927-929.
[7]管维,陈志强,杜广辉,等.EMS标准通道经皮肾与微创经皮肾取石治疗肾鹿角形结石的疗效比较[J].华中科技大学学报(医学版),2010,39(2):269-271.
[8]王亚林,赵立,曲楠,等.EMS超声-气压弹道碎石与微通道钬激光碎石对复杂肾结石碎石117例疗效分析[J].中华临床医师杂志(电子版),2012,6(13):35-38.
[9]徐冉,易路,王欣宇,等.经皮肾镜碎石术处理孤立肾铸型结石的安全性及有效性评价[J].中南大学学报(医学版),2012,37(6):621-624.
[10]优字,张刚,祝青再,等.彩超引导下经皮肾镜碎石取石术治疗鹿角形肾结石[J].中国综合临床,2012,28(6):604-606.
[11]邓佩林,马靖远,卢虎,等.超声引导经皮肾镜气压弹道联合超声碎石术治疗无积水肾结石[J].中华临床医师杂志(电子版),2010,4(9):1698-1700.
[12]钟东亮,郑少斌,单炽昌,等.经皮肾镜取石术后结石残留的原因分析[J].实用医学杂志,2014,30(17):2809-2811.
[13]胡卫国,李建兴,杨波,等.标准通道经皮肾镜碎石术前预测方案与术中手术方案差异的分析[J].中华泌尿外科杂志,2013,34(1):17-19.
[14]张雪培,可方,王声政,等.经皮肾镜碎石术术中及术后出血风险因素分析[J].现代泌尿外科杂志,2016,21(2):108-111.
[15]王磊,徐伟,王宏辉,等.经皮肾镜取石术后肾出血的急诊动脉栓塞治疗[J].实用放射学杂志,2014,30(7):1183-1185.
[16]钟百书,张胜,彭志毅,等.超选择性肾动脉栓塞治疗经皮肾镜取石术后严重出血[J].中华泌尿外科杂志,2012,33(1):41-43.
[17]马凯,黄晓波,许清泉,等.肾鹿角形结石患者结石成分的红外光谱分析[J].中华医院杂志,2010,99(4):3150-3152.
[18]肖仁举,陈伟,王时龙.经皮肾镜超声气压弹道碎石术治疗鹿角形结石(附34例报告)[J].海南医学,2009,20(5):35-36,49.
[19]李淦洪,王亚东,罗文辉,等.体外冲击波碎石治疗经皮肾镜术后残石的时机选择及部分相关因素分析[J].中华腔镜泌尿外科杂志(电子版),2016,10(4):17-19.
[20]王博涵,余琥,姚炜敏,等.微创经皮肾镜碎石术后临床无意义残中期随访结果[J].中华泌尿外科杂志,2012,33(7):529-531.