本文選題：輸尿管軟鏡　切入點(diǎn)：經(jīng)皮腎鏡　出處：《延邊大學(xué)》2014年碩士論文　論文類型：學(xué)位論文

【摘要】：目的：比較輸尿管軟鏡碎石術(shù)與經(jīng)皮腎鏡碎石術(shù)治療腎結(jié)石的療效和安全性。方法：2012年3月-2013年12月手術(shù)治療的89例腎結(jié)石患者,其中37例采用組合式輸尿管軟鏡鈥激光碎石術(shù)治療(URL組),52例采用經(jīng)皮腎鏡超聲聯(lián)合氣壓彈道碎石術(shù)治療(PCNL組),比較兩組的手術(shù)并發(fā)癥和結(jié)石取凈率。 結(jié)果：URL組手術(shù)時(shí)間35-175min,平均58min；術(shù)后血紅蛋白損失量為0-6g/L,平均2g/L；術(shù)后4例出現(xiàn)輕度貧血、3例出現(xiàn)發(fā)熱,并發(fā)癥發(fā)生率為18.9%(7/37)；手術(shù)成功率94.6%(35/37)；結(jié)石取凈率為85.7%(30/35)。PCNL組手術(shù)時(shí)間30-86min,平均46min；術(shù)后血紅蛋白損失量為4-36g/L,平均14g/L；術(shù)后21例出現(xiàn)輕度貧血、3例出現(xiàn)中度貧血進(jìn)行輸血治療,其中1例行超選擇性腎動(dòng)脈栓塞術(shù),術(shù)后4例出現(xiàn)發(fā)熱,并發(fā)癥發(fā)生率為53.8%(28/52)；手術(shù)成功率94.2%(49/52)；結(jié)石取凈率為91.8%(45/49)。 結(jié)論：PCNL治療腎結(jié)石具有損傷小、并發(fā)癥少、療效確切等優(yōu)點(diǎn),但PCNL對(duì)腎實(shí)質(zhì)有一定損傷,可能導(dǎo)致大出血,需輸血治療,甚至行超選擇性腎動(dòng)脈栓塞術(shù)。URL治療腎結(jié)石則損傷更小、并發(fā)癥更少,接近無創(chuàng),而且療效確切,特別在治療腎結(jié)石合并脊柱側(cè)彎等復(fù)雜性腎結(jié)石時(shí)具有獨(dú)特的優(yōu)勢。
[Abstract]:Objective: to compare the efficacy and safety of soft ureteral lithotripsy and percutaneous nephrolithotripsy in the treatment of renal calculi. Among them, 37 cases were treated with combined ureteral soft endoscope holmium: YAG laser lithotripsy. 52 cases were treated with percutaneous nephroscopy combined with pneumatic lithotripsy. The complications of operation and the rate of stone removal were compared between the two groups. Results the operative time was 35-175 mins (mean 58 mins), hemoglobin loss was 0-6 g / L (mean 2 g / L), 4 cases had mild anemia and 3 cases had fever. The incidence of complications was 18.9 / 7 / 37; the successful rate of operation was 94.6% / 37%; the stone removal rate was 85.7% / 35% .PCNL group was 30-86 min (mean 46 min); postoperative hemoglobin loss was 4-36 g / L (14 g / L); postoperative 21 cases had mild anemia and 3 cases had moderate anemia for blood transfusion. One of them received superselective renal artery embolization, 4 cases developed fever after operation, the incidence of complications was 53.8% or 28 / 52%, the success rate of operation was 94.22% 49 / 52%, and the stone removal rate was 91.8% 45 / 49%. Conclusion PCNL has the advantages of less injury, less complications and definite curative effect in the treatment of renal calculi. However, PCNL may cause massive hemorrhage and need blood transfusion therapy. Even super-selective renal artery embolization. URL treatment of renal calculi is less damage, less complications, close to non-invasive, and the curative effect is accurate, especially in the treatment of renal calculi complicated with scoliosis and other complex renal calculi have a unique advantage.
【學(xué)位授予單位】：延邊大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R699.2

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