经皮肾镜取石术对于孤立性结石的疗效分析

目的运用经皮肾镜技术（PCNL）治疗尿路孤立性结石,根据清除结石率来对其疗效进行评估。方法选择江西省会昌县人民医院64例孤立性肾结石患者,运用PCNL对患者进行治疗,收集患者的临床资料进行统计分析,判断PCNL的安全性及其疗效。结果手术经一期或二期对64例患者进行取石,取净结石率为92.2%。有15例患者产生了热源反应,经加强肾内管道畅通及抗感染处理3~4d后达到正常水平。手术后有4例患者出现症状性出血,1利用造瘘管夹闭及止血等处理后,出血停止,给予输血治疗的患者2例,1例采取开放性手术进行止血治疗。结论 PCNL治疗孤立性结石手术操作容易,手术过程时间短,创伤小,并发症发生率较低,手术创口出血少及清除结石率高。

经皮肾镜碎石术300例经验总结

目的:回顾性分析经皮肾镜碎石术的治疗效果。方法:回顾分析2015年2月-2019年8月本院收治的300例经皮肾镜碎石术患者,观察治疗效果、并发症(发热、腰部胀痛、肺部感染)发生率,临床指标(手术时间、术中出血量、住院时间)、发现结石率、结石清除率,生活质量(情感职能、身体健康、精神健康、躯体疼痛、社会功能)评分。结果:观察患者治疗效果,显效150例(50.00%)、有效140例(46.67%)、无效10例(3.33%),治疗总有效290例(96.67%);显效150例(50.00%)、有效140例(46.67%)、无效10例(3.33%),治疗总有效290例(96.67%)。术后并发症发生情况为发热1例(0.33%)、腰部胀痛1例(0.33%)、肺部感染3例(1.00%),术后并发症总发生5例(1.67%),患者治疗后6个月生活质量评分高于治疗前,差异有统计学意义(P<0.05),发现结石298例(99.33%)、结石清除291例(97.00%),手术时间(55.21±13.24)min、术中出血量(46.98±6.54)ml、住院时间(12.32±4.26)d。结论:应用经皮肾镜碎石术能够有效清除肾结石,产生的并发症较少,全面提升患者的生活质量,值得在治疗肾结石中应用。

COMPARISON OF TWO-STEP DILATION VERSUS STEP BY STEP DILATION IN MINIMAL PERCUTANEOUS NEPHROLITHOTOMY

Objective To investigate minimizing dilation times of percutaneous nephrolithotomy （PCNL） in treating large renal stones. Methods A total of 105 consecutive patients undergoing minimal PCNL by using the two-step dilation protocol （ Group I ） and step by step dilation protocol （ Group 1I ） were reviewed. Two groups were compared in terms of stone size, dilating time, operation time, and blood loss. Results In all patients, the dilating of channel was finished and the success rate was 100%. The stone-free rate was 88. 7% （47/53） in Group [ and84.6% （44/52） in Group O . There were significant differences in the time of dilating and the blood loss in dilating channel （P = O. 000）. But there was no significant difference in the operation time of PCNL. Conclusion PCNL of the urinary calculi is safe in Chinese patients. Two-step dilation in PCNL has advantages of shorter dilating time and lower blood loss in different types of calculi during dilating.