斑马导丝及穿刺针在复杂性肾结石PCNL中的应用经验

Application experience of zebra guidewire and puncture needle in treating complex kidney stone with PCNL

目的 探讨经皮肾镜取石术中斑马导丝及穿刺针在治疗复杂性肾结石中临床应用价值。方法 选择2019年2月—2021年11月在本院经皮肾镜治疗的复杂性肾结石、且在术中X线或彩超复查发现残留结石患者100例作为研究对象,随机分为实验组和对照组两组,每组各50例。实验组利用斑马导丝及穿刺针功能经皮肾镜处理残留结石,对照组应用常规再建立通道经皮肾镜处理残留结石,比较两组在手术时间、出血量、术后发热、清除率、通道个数、住院时间。结果 两组在结石清除率上比较(90%US 94%),差异无统计学意义(P>0.05),而手术时间实验组平均为(77.89±6.11)分钟,对照组为(95.12±6.81)分钟,住院时间实验组平均为(7.13±1.25)天,而对照组平均为(9.13±1.55)天,差异均有统计学意义(P<0.05)。术中出血量实验组为(77.36±2.08)ml,明显少于对照组的(95.12±6.81)ml,差异有统计学意义(P<0.05)。术后发热比例实验组也较对照组少(4%vs 20%),差异有统计学意义(P<0.05)。结论 在经皮肾镜取石术中利用斑马导丝及穿刺针治疗复杂性肾结石具有手术时间、住院时间短、出血少、术后并发症少等优点,临床效果好,值得临床推广。

Objective To explore the clinical application value of zebra guidewire and puncture needle in percutaneous nephrolithotomy in the treatment of complex kidney stones.Methods One hundred patients suffered from complex kidney stones those were admitted to our hospital from February 2019 to November 2021 were enrolled in this study.The patients were treated with percutaneous nephrolithotomy in our hospital,residual stones were found during intraoperative X-ray or color Doppler ultrasound examination.They were randomly divided into experimental group and control group,50 cases in each group.In experimental group,residual stones were treated with zebra guidewire and puncture needle function through percutaneous nephroscope.In control group,a routine channel was re-established to treat residual stones through percutaneous nephroscope.The surgical time,bleeding volume,postoperative fever,clearance rate,number of channels,and average hospital stay were compared between the two groups.Results There was no significant difference in stone clearance rate between the two groups(90%VS 94%)(P>0.05).The average operation time in the experimental group was 77.89±6.11 minutes,and that in the control group was 95.12±6.81 minutes.The average length of hospital stay in the experimental group was 7.13±1.25 days,and that in the control group was 9.13±1.55 days.The differences in operation time and hospital stay between the two groups were statistically significant(P<0.05).The amount of intraoperative blood loss in the experimental group was significantly reduced compared with the control group(experimental group:77.36±2.08ml,control group:95.12±6.81),and the difference was statistically significant(P<0.05).The proportion of postoperative fever in the experimental group was also lower than that in the control group(4%VS 20%),and the difference was statistically significant(P<0.05).Conclusions In percutaneous nephrolithotomy,zebra guidewire and puncture needle are used in the treatment of complex kidney stones,which has the advantages of short operation time,short hospital stay,less bleeding,less postoperative complications and so on.The clinical effect is good,worthy of clinical promotion.