摘要/Abstract
摘要： 目的·探究球囊扩张联合气压弹道超声碎石术在经皮肾镜取石术(percutaneous nephrolithotomy，PCNL) 治疗单侧肾结石中的应用效果。方法·回顾性分析2017年6月至2019年7月期间在上海交通大学医学院附属新华医院泌尿外科行PCNL的94例单侧肾结石患者，将其分为A组与B组。其中，68例（A组）行球囊扩张联合气压弹道超声碎石术，26例（B组）行筋膜扩张联合钬激光碎石术，比较2种方法治疗单侧肾结石的临床效果。结果·A组手术时间短于B组[ （107.82±10.87）min vs（115.41±10.68）min，P=0.003]，术后白细胞（white blood cell，WBC）升高率低于B组（4.41% vs 23.08%，P=0.018），术后发热（≥38.5 ℃）率低于B组（4.41% vs 23.08%，P=0.018）。2组在血红蛋白下降值、WBC计数、住院时间、结石清除率、输血率和集合系统穿孔率上差异无统计学意义（均P>0.05）。结论·在PCNL治疗单侧肾结石中应用球囊扩张联合气压弹道超声碎石术可缩短手术时间，降低术后WBC升高率和发热率，值得临床推广应用。
关键词: 球囊扩张, 经皮肾镜取石术, 气压弹道超声碎石术, 肾结石, 筋膜扩张, 钬激光碎石术
Abstract:
Objective · To investigate the application effect of balloon dilatation and percutaneous nephrolithotomy (PCNL) combined with pneumatic and ultrasound lithotripsy on the clinical treatment of unilateral kidney stones. Methods · Ninety-four patients with unilateral kidney stones who accepted PCNL in the Department of Urology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine from June 2017 to July 2019, were retrospectively analyzed and divided into group A and group B. Among them, 68 patients (group A) were subjected to balloon dilatation combined with pneumatic and ultrasound lithotripsy, while 26 patients (group B) underwent fascia dilatation combined with holmium laser lithotripsy. The clinical effects of two kinds of lithotripsy on the treatment of unilateral kidney stones were compared. Results · The operation time was shorter in group A than that in group B [(107.82±10.87) min vs (115.41±10.68) min, P=0.003]. The increase rate of postoperative white blood cell (WBC) was lower in group A than that in group B (4.41% vs 23.08%, P=0.018). The fever (≥ 38.5 ℃) rate was lower in group A than that in group B (4.41% vs 23.08%, P=0.018). There were no significant differences in hemoglobin reduction, WBC count, hospital stay, stone-free rate, blood transfusion rate and perforation rate of collection system between the two groups (all P>0.05). Conclusion · Balloon dilatation combined with pneumatic and ultrasound lithotripsy in treatment of unilateral renal stones by PCNL can shorten the operation time, and reduce the increase rate of postoperative WBC and fever rate, which is worthy of being promoted in the clinical treatment of patients with unilateral kidney stones.
Key words: balloon dilatation, percutaneous nephrolithotomy (PCNL), pneumatic and ultrasound lithotripsy, kidney stones, fascia dilatation, holmium laser lithotripsy
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