發(fā)布時(shí)間：2018-03-15 00:30

  本文選題：微創(chuàng)經(jīng)皮腎取石術(shù)　切入點(diǎn)：糖尿病　出處：《實(shí)用醫(yī)學(xué)雜志》2017年06期 　論文類型：期刊論文

【摘要】：目的:探討比較糖尿病患者與非糖尿病患者腎結(jié)石行微創(chuàng)經(jīng)皮腎取石術(shù)的臨床療效。方法:回顧性分析2007年5月至2016年6月2 796例中582例糖尿病患者腎結(jié)石(糖尿病組)在X線引導(dǎo)下行F18微創(chuàng)經(jīng)皮腎取石術(shù),年齡為26~82歲,男279例,女303例,其中腎盂結(jié)石174例,多發(fā)性結(jié)石255例,鹿角狀結(jié)石153例,空腹血糖5.4~20.3 mmol/L,餐后2 h血糖9.1~28.9 mmol/L,術(shù)前均行空腹血糖、糖化血紅蛋白、餐后2 h血糖、免疫糖尿病2項(xiàng)等檢查,均符合WHO糖尿病診斷及分型標(biāo)準(zhǔn),結(jié)石標(biāo)本均行紅外線光譜自動(dòng)分析儀器測(cè)定結(jié)石成分。剩下的2 214例非糖尿病腎結(jié)石患者作為非糖尿病組。對(duì)兩組患者的手術(shù)時(shí)間、結(jié)石取凈率、手術(shù)并發(fā)癥、住院天數(shù)進(jìn)行評(píng)估。結(jié)果:糖尿病患者組手術(shù)時(shí)間、結(jié)石取凈率、手術(shù)并發(fā)癥與非糖尿病患者組差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05);而糖尿病患者組住院天數(shù)明顯高于非糖尿病患者組(P0.05);糖尿病患者組與非糖尿病患者組的結(jié)石成分相比,尿酸結(jié)石的發(fā)病率更高,兩組之間差異有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:微創(chuàng)經(jīng)皮腎取石術(shù)治療糖尿病患者腎結(jié)石是安全、有效的。針對(duì)糖尿病患者具有較高形成尿酸結(jié)石的風(fēng)險(xiǎn)和血糖控制欠佳的患者結(jié)石復(fù)發(fā)率高的特點(diǎn),提醒泌尿外科醫(yī)師對(duì)糖尿病人群進(jìn)行結(jié)石預(yù)防的重要性。
[Abstract]:Objective: to compare the clinical effect of minimally invasive percutaneous nephrolithotomy between diabetic patients and non-diabetic patients. Methods: from May 2007 to June 2nd 2016, 582 cases of diabetic nephrolithiasis were retrospectively analyzed. F18 minimally invasive percutaneous nephrolithotomy was performed under X-ray guidance. There were 279 males and 303 females, including 174 renal pelvis calculi, 255 multiple calculi, 153 staghorn calculi, fasting blood glucose 5.4 mg / L, postprandial blood glucose 9.1 mmol / L, 28.9 mmol / L postprandial blood glucose, preoperative fasting blood glucose, glycosylated hemoglobin, 2 h postprandial blood glucose, and 2 h postprandial blood glucose. The two items of immune diabetes were in accordance with the criteria of diagnosis and typing of WHO diabetes mellitus. The stone components were determined by infrared spectrum automatic analysis instrument. The remaining 2214 cases of non-diabetic renal calculi were treated as non-diabetic group. The operation time, stone removal rate, surgical complications were compared between the two groups. Results: the duration of operation, the rate of stone removal, the duration of operation and the rate of stone removal in diabetic patients were evaluated. There was no significant difference between the operative complications and the non-diabetic group (P 0.05), but the hospitalization days in the diabetic group were significantly higher than those in the non-diabetic group (P 0.05), and the stone composition in the diabetic group was significantly higher than that in the non-diabetic group. The incidence of uric acid stones was higher, and the difference between the two groups was statistically significant (P 0.05). Conclusion: minimally invasive percutaneous nephrolithotomy is safe in the treatment of renal calculi in diabetic patients. In view of the high risk of the formation of uric acid stones and the high recurrence rate of stones in patients with poor blood glucose control, urologers are reminded of the importance of urologists in the prevention of calculi in diabetics.
【作者單位】： 廣州醫(yī)科大學(xué)附屬第五醫(yī)院泌尿外科廣州醫(yī)科大學(xué)微創(chuàng)外科技術(shù)和產(chǎn)品轉(zhuǎn)化中心;中山大學(xué)附屬第一醫(yī)院泌尿外科;
【分類號(hào)】：R699.2;R587.1

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