一步扩张法建立微创通道在经皮肾镜碎石术中的应用

Application of One-step Expansion Method to Establish Minimally Invasive Channel in Percutaneous Nephrolithotripsy

【目的】探讨一步扩张法建立微创通道在经皮肾镜碎石术中应用的可行性、安全性及效果。【方法】回顾性分析本院2019年1月至2020年12月90例上尿路结石患者实施经皮肾碎石术的临床资料。依据通道设立一步扩张法组(观察组)及逐级扩张法组(对照组)各45例。观察组用F18或F20单支带通道鞘筋膜扩张器;对照组采用F5-F20筋膜扩张套件。对比两组通道建立时间、手术时间、出血量、平均住院时间、耗材费用、手术并发症、净石率等方面的差异。【结果】研究结果显示,观察组在通道建立时间、手术时间、出血量、耗材费用等优于对照组(P<0.05);平均住院时间、手术并发症总发生率、净石率等与对照组差异无显著性(P>0.05)。【结论】一步扩张法建立微创通道在经皮肾镜碎石术中是安全、可行、有效的,能显著缩短建立通道及手术时间、减少出血及耗材费用。

【Objective】To investigate the feasibility,safety,and clinical efficacy of one step expansion method to establish minimally invasive channel in percutaneous nephrolithotripsy.【Methods】Th clinical date of 90 patients with urinary tract stones in our hospital from January 2019 to December 2020 were analyzed retrospectively.According to different channel establishments,they were divided into one-step expansion group(the observation group)and step-by-step expansion group(the control group).There were 45 cases in the one-step group,using only F18 or F20 single fascia expansion sheath,and 45 cases in the step by step expansion group,using F5-20 fascia expansion kit.The differences in channel establishment time,operation time,blood loss,average hospital vStay,cost of consumables,surgical complications,and stone removal rate were compared between the two groups.【Results】The channel establishment time,operation time,surgical blood loss,average hospital stay,proportion of consumables in the observation group were better than those in the control group(P<0.05).There was no significant difference between the two groups in terms of average hospital stay,surgical complications and stone removal rate(P>0.05).【Conclusions】The one step expansion method to establish minimally invasive channel in percuta-neous nephrolithotripsy is safe,feasible and effective,and it can significantly shorten the channel establishment time,operation time,and reduce bleeding and consumable costs.