论文部分内容阅读
目的:探讨经皮肾镜辅助小切口取石术在合并糖尿病、高血压病及再次手术结石患者中的临床应用价值。方法:观察组20例采用经皮肾镜辅助小切口取石术式,手术切口长5~7cm,肾脏穿刺通道用2-0可吸收缝合线全层缝合,不留置肾造瘘管,肾周不留置血浆引流管。对照组21例采用经皮肾镜取石术式,留置F18~20肾造瘘管。两组患者均使用瑞士EMS-Vario混合动力碎石清石系统进行手术。结果:两组中合并糖尿病、高血压病及再次手术患者人数比较,差异无统计学意义。观察组患者无大出血、气胸、邻近脏器损伤等严重并发症,伤口均甲、乙级愈合,随访3个月无继发性肾出血。对照组继发性肾出血4例,发生率19.05%,经超选择性肾动脉介入栓塞治疗后痊愈出院。结论:经皮肾镜辅助小切口取石术能有效降低合并糖尿病、高血压病及再次手术患者继发性肾出血的发生率,有实际临床应用价值。
Objective: To investigate the clinical value of percutaneous nephrolithotomy assisted small incision lithotripsy in patients with diabetes mellitus, hypertension and reoperation stone. Methods: 20 cases of observation group were treated by percutaneous nephrolithotomy with small incision lithotomy, surgical incision length 5 ~ 7cm, renal puncture channel with 2-0 absorbable suture full-thickness suture, without indwelling nephrostomy, kidney indwelling Plasma drainage tube. The control group of 21 patients with percutaneous nephrolithotomy, indwelling F18 ~ 20 renal fistula. Both groups underwent surgery using the Swiss EMS-Vario hybrid gravel system. Results: There was no significant difference in the number of patients with diabetes mellitus, hypertension and reoperation in both groups. Patients in the observation group had no serious hemorrhage, pneumothorax and other serious complications such as organ injury. The wounds were treated with grade A and B healed. No secondary renal hemorrhage was observed after 3 months of follow-up. The control group of 4 cases of secondary renal hemorrhage, the incidence of 19.05%, by ultra-selective renal artery embolization cured and discharged. Conclusion: Percutaneous nephrolithotomy with small incision lithotripsy can effectively reduce the incidence of secondary renal hemorrhage in patients with diabetes mellitus, hypertension and re-operation, and has practical clinical value.