本文選題：孤立腎 + 腎結(jié)石�。� 參考：《中國(guó)微創(chuàng)外科雜志》2016年04期

【摘要】：目的比較經(jīng)皮腎鏡取石術(shù)(percutaneous nephrolithotomy,PCNL)與輸尿管軟鏡碎石術(shù)(retrograde intrarenal surgery,RIRS)治療孤立腎結(jié)石的療效。方法我院2010年4月~2015年6月治療孤立腎結(jié)石64例,其中41例行PCNL,患者取俯臥位,在B超引導(dǎo)下建立皮腎通道,然后碎石取石;23例行RIRS,患者取截石位,沿斑馬導(dǎo)絲安置輸尿管鞘,插入輸尿管軟鏡碎石取石。結(jié)果 PCNL組手術(shù)時(shí)間(73.0±27.9)min明顯短于RIRS組(106.1±29.5)min(t=4.462,P=0.000);術(shù)中出血(141.7±15.0)ml明顯多于RIRS組(32.8±6.7)ml(t=32.935,P=0.000);住院時(shí)間(12.8±1.3)d明顯長(zhǎng)于RIRS組(10.3±1.6)d(t=6.788,P=0.000);一期清石率78.0%(32/41)明顯高于RIRS組52.2%(12/23)(χ~2=4.592,P=0.032);術(shù)后感染率2.4%(1/41)明顯低于RIRS組21.7%(5/23)(χ~2=4.388,P=0.036)。61例隨訪2個(gè)月~5年(中位隨訪時(shí)間2.5年):5例結(jié)石復(fù)發(fā),中位復(fù)發(fā)時(shí)間2.8年,行ESWL后排出;9例仍有腎功能不全,血肌酐(156.5±17.6)μmol/L,均無(wú)須血透治療,其余病人恢復(fù)好。結(jié)論 PCNL、RIRS是治療孤立腎結(jié)石的有效手段,兩者各有優(yōu)勢(shì):PCNL手術(shù)時(shí)間短、清石率較高、感染發(fā)生率低,RIRS出血少、住院時(shí)間短。
[Abstract]:Objective to compare the efficacy of percutaneous nephrolithotomy with percutaneous nephrolithotomy (PCNL) and retrograde intrarenal SurgeryRIRS in the treatment of isolated renal calculi. Methods from April 2010 to June 2015, 64 cases of isolated renal calculi were treated in our hospital. Among them, 41 cases were treated with PCNL.The patients took prone position, established the cutaneous renal passage under the guidance of B-ultrasound, and 23 cases of RIRSby lithotripsy. The patients took the lithotomy position and placed ureteral sheath along the zebra guide wire. Insert ureteral soft mirror lithotripsy to take stone. 緇撴灉 PCNL緇勬墜鏈椂闂，

本文編號(hào)：1868290