[1]彭伟 魏世平** 李辉明 陶维雄 顾鹏 余晓晖.腰肋悬空半截石位与俯卧位经皮肾镜碎石术的前瞻性对照研究[J].中国微创外科杂志,2018,18(11):964-968.
 Peng Wei,Wei Shiping,Li Huiming,et al.Flank Suspended Semilithotomy Position Versus Prone Position in Percutaneous Nephrolithotomy: a Prospective Controlled Study[J].Chinese Journal of Minimally Invasive Surgery,2018,18(11):964-968.
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腰肋悬空半截石位与俯卧位经皮肾镜碎石术的前瞻性对照研究()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
18
期数:
2018年11期
页码:
964-968
栏目:
临床论著
出版日期:
2018-11-20

文章信息/Info

Title:
Flank Suspended Semilithotomy Position Versus Prone Position in Percutaneous Nephrolithotomy: a Prospective Controlled Study
作者:
彭伟 魏世平** 李辉明 陶维雄 顾鹏 余晓晖
(长江航运总医院泌尿外科,武汉430010)
Author(s):
Peng Wei Wei Shiping Li Huiming et al.
Department of Urology, General Hospital of Changjiang Shipping, Wuhan 430010, China
关键词:
经皮肾镜碎石术上尿路结石体位
Keywords:
Percutaneous nephrolithotomyUpper urinary calculiPosition
文献标志码:
A
摘要:
目的比较腰肋悬空半截石位与俯卧位经皮肾镜钬激光碎石治疗上尿路结石的效果。方法2017年3~12月我院56例肾或输尿管上段结石,按入院顺序分为腰肋悬空半截石位组和俯卧位组,每组28例,均行经皮肾镜钬激光碎石治疗,比较2组经皮肾穿刺造瘘时间、手术时间、穿刺成功率、一期手术完成率、结石清除率、术后感染发生率、住院时间及患者体位舒适度。结果所有患者均完成手术,无气胸、肠道损伤、大出血等严重并发症发生。腰肋悬空半截石位组手术时间(85.4±21.2)min,明显短于俯卧位组(114.0±39.4)min(t=-3.378,P=0.001);住院时间(8.0±1.7)d,明显短于俯卧位组(9.6±2.2)d(t=-3.074,P=0.003);术后感染发生率3.6%(1/28),明显低于俯卧位组28.6%(8/28)(χ2=4.766,P=0029);一期手术完成率96.4%(27/28),明显高于俯卧位组71.4%(20/28)(χ2=4.766,P=0.029);患者舒适度评分(7.4±1.5)分,明显高于俯卧位组(4.7±1.9)分(t=5.953,P=0.000)。2组经皮肾穿刺造瘘时间分别为(6.8±2.7)、(7.1±26)min,无统计学差异(t=-0552,P=0.583);结石清除率分别为89.3%(25/28)、85.7%(24/28),无统计学差异(χ2=0000,P=1.000)。2组患者穿刺成功率均为100%(28/28)。7例残留结石(结石>04 cm)行体外冲击波碎石治疗1~3次后排出结石。所有患者随访2~4个月,平均2.6月,未发现结石需要再次处理。结论腰肋悬空半截石位经皮肾镜钬激光碎石治疗上尿路结石,是一种安全可靠的方法,优势明显,值得在临床上推广应用。
Abstract:
ObjectiveTo compare the efficacy between flank suspended semilithotomy position and prone position in holmium laser percutaneous nephrolithotomy for the treatment of upper urinary calculi.MethodsBetween March 2017 and December 2017, 56 patients with kidney or upper ureteral stones receiving holmium laser percutaneous nephrolithotomy were divided into either flank suspended semilithotomy position group or prone position group according to the order of admission, with 28 cases in each group. The percutaneous nephrostomy time, operation time, puncture success rate, completion rate of the first stage operation, total stone free rate, postoperative infection rate, total hospital stay, and postural comfort were compared between the two groups.ResultsAs compared to the prone position group, the flank suspended semilithotomy position group had shorter operation time [(85.4±21.2) min vs. (114.0±39.4) min, t=-3.378, P=0.001], shorter total hospital stay [(8.0±1.7) days vs. (9.6±2.2) days, t=-3074, P=0.003], lower postoperative infection rate [3.6% (1/28) vs. 28.6% (8/28), χ2=4.766, P=0029], higher completion rate of the first stage operation [96.4% (27/28) vs. 71.4% (20/28), χ2=4.766, P=0.029], and better postural comfort [(7.4±1.5) points vs. (4.7±1.9) points, t=5.953, P=0.000]. There was no statistical significance between the two groups in the percutaneous nephrostomy time [(6.8±2.7) min vs. (7.1±2.6) min, t=-0.552, P=0.583] and stone clearance rate [89.3% (25/28) vs. 85.7% (24/28), χ2=0.000, P=1.000]. The puncture success rate of both groups was 100% (28/28).ConclusionsHolmium laser percutaneous nephrolithotomy is a safe and effective procedure for upper urinary calculi under the flank suspended semilithotomy position. It is worthy of application in clinical practice.

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备注/Memo

备注/Memo:
*基金项目:武汉市卫生与计划生育委员会青年项目(WX17Q40)**通讯作者,Email:wgy820578@126.com
更新日期/Last Update: 2019-03-01