B超引导下经皮肾镜气压弹道碎石术的临床疗效及安全性研究(1)
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[摘要] 目的：研究B超引导下经皮肾镜下气压弹道碎石术的临床疗效及安全性。方法：分析2005年6月～2011年6月，本科治疗上尿路结石240例，随机分为观察组(经皮肾镜气压弹道碎石治疗)130例，对照组(体外冲击波治疗)110例，比较两组治疗疗效。结果：观察组与对照组相比，一次性碎石成功率及术后3个月结石清除率明显升高(P<0.01)，且未出现气胸、肠道损伤、大出血等手术并发症。结论：超声引导下经皮肾镜气压弹道碎石术处理上尿路结石具有高效、安全的特点，值得临床推广应用。
[关键词] 上尿路结石；经皮肾穿刺；气压弹道；安全性
[中图分类号] R691.4 [文献标识码] A [文章编号] 1674-4721(2012)01(b)-037-02
The Study of clinical efficacy and safety of B ultrasound-guided percutaneous nephrolithotomy pneumatic lithotripsy
HE Linfa1, JIANG Hongyi2
1.Department of Urology, Chinese Medicine Hospital of Dao County in Hunan Province, Dao County 425300, China; 2.Department of Urology, the Second Xiangya Hospital of Central South University, Hunan Province, ChangSha 410011, China
[Abstract] Objective: To study the clinical efficacy and safety of B ultrasound-guided percutaneous nephrolithotomy pneumatic lithotripsy. Methods: From June 2005 to June 2011, our department treatmented 240 cases of upper urinary tract stones, randomly divided into observation group (percutaneous nephrolithotomy pneumatic lithotripsy) 130 cases, control group (extracorporeal shock wave therapy) 110 cases, the clinical data of two groups were analyzed and compared. Results: Observed compared with the control group, the success rate of once treatment and the stone clearance rate of 3 months after significantly higher (P<0.01), and did not appear as pneumothorax, intestinal damage, bleeding and other complications. Conclusion: B Ultrasound-guided percutaneous nephrolithotomy pneumatic lithotripsy treatment of upper urinary tract stones with high efficiency and safety features, is worthy of clinical application.
[Key words] Upper urinary tract stones; Percutaneous renal biopsy; Pneumatic; Safety
经皮肾输尿管镜取石术(PCNL)已成为泌尿系结石的治疗方法之一，其具有创伤小、结石取净率高、术中出血及合并症少、术后恢复快等优点[1]。笔者采用瑞士EMS气压弹道碎石系统在经皮肾镜直视下治疗上尿路结石，取得良好的临床疗效。现总结如下：
1 资料与方法
1.1 一般资料
选择2005年6月～2011年6月在本科住院治疗的240例患者，术前行腹部平片、腹部B超、静脉肾盂造影、腹部CT等检查确诊为上尿路结石，其中，男138例，女102例，平均年龄(43.17±14.50)岁。多发肾脏结石58例，单发肾脏结石94例，输尿管上段结石(腰5以上)88例。经尿路平片(KUB)测量肾结石直径平均为(2.3±2.6) cm。有轻、中度肾脏积水195例，排除重度肾积水患者。将所有患者随机分为观察组130例，对照组110例，分别采用B超引导下经皮肾镜气压弹道碎石术治疗及体外冲击波碎石治疗，两组手术治疗患者的性别、年龄、结石部位等情况比较差异无统计学意义(P>0.05)，具有可比性。
1.2 手术治疗方法
1.2.1 在B超引导下经皮肾镜气压弹道碎石治疗组 全麻或连续硬膜外麻醉满意后 ......
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