斜仰卧位B超引导下大通道经皮肾镜取石术治疗肾铸型结石的疗效观察

Efficacy observation on B ultrasound-guided large-channel percutaneous nephrolithotomy in recumbent-supine position for treating kidney staghorn stone

目的:观察斜仰卧位B超引导下大通道经皮肾镜取石术(PCNL)治疗肾铸型结石的临床疗效。方法:选取我院于2015年7月~2016年8月期间收治的200例肾铸型结石患者为研究对象,随机分为对照组(n=100)与研究组(n=100)。对照组采用俯卧位中、小通道(传统体位)PCNL治疗,研究组采用斜仰卧位B超引导下大通道PCNL治疗。比较两组手术建立通道时间、手术时间、术中出血量、Ⅰ期结石清除率、术后感染率、手术舒适度及并发症发生情况。结果:研究组手术建立通道时间、手术时间、术中出血量均低于对照组,差异有统计学意义(P<0.05);研究组Ⅰ期结石清除率、手术舒适度高于对照组,而术后感染率低于对照组,差异有统计学意义(P<0.05);研究组并发症发生率较对照组明显更低,差异有统计学意义(P<0.05)。结论:对肾铸型结石患者采用斜仰卧位B超引导下大通道经皮肾镜取石术治疗,可显著提高临床疗效,降低术后感染率,提高手术舒适度,减少并发症的发生,促进患者身体恢复,具有临床推广意义。

Objective：To observe the clinical efficacy of B ultrasound-guided large-channel percutaneous nephrolithotomy（PCNL）in recumbent-supine position for treating kidney staghorn stone.Method：From July 2015 to August 2016,200 patients with kidney staghorn stone admitted into our hospital were randomly divided into control group（n=100）and research group（n=100）.Control group was treated with middle-,small-channel PCNL in traditional prone position,while research group was treated with B ultrasound-guided large-channel PCNL in recumbent-supine position.The surgical channel establishment time,surgery time,intraoperatve bleeding volume,Ⅰ-phase stone clearance rate,postoperative infection rate,surgical comfort and complications of two groups were compared.Result：The surgical channel establishment time,surgery time,intraoperatve bleeding volume of research group were lower than those of control group（P〈0.05）.TheⅠ-phase stone clearance rate and surgical comfort of research group were higher than those of control group,but postoperative infection rate of research group was lower than that of control group（P〈0.05）.The incidence of complications of research group was significantly lower compared with control group（P〈0.05）.Conclusion：B ultrasound-guided large-channel PCNL in recumbent-supine position for treating kidney staghorn stone can significantly increase clinical efficacy,decrease postoperative infection rate,improve surgical comfort,reduce complications and promote patients＇ recovery,which is worthy of clinical popularization.