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目的探讨老年上尿路结石患者运用微创经皮肾取石术的临床疗效。方法将我院2010年3月至2013年1月收治的90例年龄大于70岁的上尿路结石老年患者,根据患者意愿及不同手术方法将其分为微创组和常规组各45例,微创组采用微创经皮肾取石手术,常规组运用临床常规经皮肾取石术。对两组患者术后疗效及手术综合情况进行对比分析。结果两组患者一期碎石取石67例,二期碎石取石23例;单通道碎石取石20例,多通道碎石取石70例;微创组患者术后净石率为90.6%,常规组净石率为90.9%,两组患者结石清除率差异无统计学意义(P>0.05)。但手术中综合情况比较两组差异有统计学意义(P<0.05)。结论微创经皮肾取石手术具有创伤小,出血量少以及术后恢复快,净石疗效显著,安全性高等优势,为肾结石患者理想治疗方案。
Objective To investigate the clinical effect of minimally invasive percutaneous nephrolithotomy on elderly patients with upper urinary tract calculi. Methods 90 elderly patients with upper urinary tract stones older than 70 years admitted from March 2010 to January 2013 in our hospital were divided into minimally invasive group and conventional group according to their wishes and different surgical methods. Minimally invasive group with minimally invasive percutaneous nephrolithotomy surgery, conventional group using clinical routine percutaneous nephrolithotomy. The two groups of patients after surgery and surgical comprehensive comparative analysis. Results In the two groups, 67 cases were treated by gravel in one stage, 23 cases were treated by two stage lithotripsy, 20 cases were treated by single-channel lithotripsy and 70 cases were treated by multichannel gravel. The net rate of post-procedure was 90.6% The net stone rate was 90.9%. There was no significant difference in the stone clearance between the two groups (P> 0.05). However, there was significant difference between the two groups in the comprehensive situation during operation (P <0.05). Conclusion Minimally invasive percutaneous nephrolithotomy has the advantages of less trauma, less blood loss, quick recovery after operation, significant effect of nephelometer, and higher safety. It is an ideal treatment for patients with kidney stones.