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中华腔镜泌尿外科杂志(电子版) ›› 2019, Vol. 13 ›› Issue (06) : 405 -409. doi: 10.3877/cma.j.issn.1674-3253.2019.06.011

所属专题: 文献

临床研究

无管化经皮肾镜治疗肾和输尿管上段结石
李腾成1, 方友强1, 杨飞1, 蔡佳荣1, 李文标1, 刘柏隆1, 周祥福1, 湛海伦1,()   
  1. 1. 510530 广州,中山大学附属第三医院岭南医院泌尿外科
  • 收稿日期:2017-12-11 出版日期:2019-12-01
  • 通信作者: 湛海伦
  • 基金资助:
    广州市科技计划项目(201806020067); 广州市科技计划项目(201704020052)

Tubeless percutaneous nephrolithotomy in treatment of renal and proximal ureteral calculi

Tengcheng Li1, Youqiang Fang1, Fei Yang1, Jiarong Cai1, Wenbiao Li1, Bolong Liu1, Xiangfu Zhou1, Hailun Zhan1,()   

  1. 1. Department of Urology, Lingnan Hospital, the Third Afflimed Hospitd of Sun Yat-sen University, Guangzhou 510530, China
  • Received:2017-12-11 Published:2019-12-01
  • Corresponding author: Hailun Zhan
  • About author:
    Corresponding author: Zhan Hailun, Email:
引用本文:

李腾成, 方友强, 杨飞, 蔡佳荣, 李文标, 刘柏隆, 周祥福, 湛海伦. 无管化经皮肾镜治疗肾和输尿管上段结石[J/OL]. 中华腔镜泌尿外科杂志(电子版), 2019, 13(06): 405-409.

Tengcheng Li, Youqiang Fang, Fei Yang, Jiarong Cai, Wenbiao Li, Bolong Liu, Xiangfu Zhou, Hailun Zhan. Tubeless percutaneous nephrolithotomy in treatment of renal and proximal ureteral calculi[J/OL]. Chinese Journal of Endourology(Electronic Edition), 2019, 13(06): 405-409.

目的

探讨无管化经皮肾镜碎石取石术(PCNL)治疗肾和输尿管上段结石的安全性、可行性和禁忌证。

方法

回顾性研究中山大学附属第三医院·岭南医院泌尿外科2016年11月至2018年5月80例PCNL患者临床资料,已排除脓肾结石患者,根据是否留置肾造瘘管分组:患者术后输尿管内留置双J管,同时留置肾造瘘管40例(传统PCNL组),术后只留置双J管,无留置肾造瘘管40例(无管化PCNL组)。

结果

两组患者年龄、肾和输尿管结石位置和结石负荷、肾积水直径、总手术时间和结石清除率等差异比较均无统计学意义。患者术后第一天疼痛评分(VAS)试验组比对照组低(3.4±0.9 vs 5.6±1.4),平均住院时间与对照组比较缩短(7.9±1.4 vs 8.8±1.6)d,差异均有统计学意义(P<0.05)。

结论

无管化PCNL治疗非脓性肾输尿管上段结石安全可行,且可减轻患者术后疼痛,缩短住院时间。

Objective

To investigate efficacy and safety of tubeless percutaneous nephrolithotomy (PCNL) for the treatment of renal stone and proximal ureteral calculi.

Methods

From Nov. 2016 to May. 2018, the data of 80 inpatients without pyonephrosis underwent PCNL in Lingnan Hospital, the Third Affiliated Hospital of Sun Yat-sen University, were retrospectively evaluated. One group treated with traditional PCNL (D-J tube and nephrostomy tube, 40 cases) and the other with tubeless PCNL (D-J tube only and without nephrostomy tube, 40 cases).

Results

There was no significant difference between the two groups for the age, calculi location, stone load, diameter of hydronephrosis, total operative time and stone free rate(P>0.05). The mean postoperative VAS pain score and length of hospital stay were significantly lower and shorter in the tubeless PCNL group compared with the standard PCNL group [(3.4±0.9 vs 5.6±1.4); (7.9±1.4 vs 8.8±1.6) days; P<0.05].

Conclusion

Tubeless PCNL is safe and effective for managing renal and proximal ureteral calculi without pyonephrosis, which has the advantage of reducing postoperative pain and shortening hospital stay.

图1 无管化PCNL患者术后伤口无需缝合
表1 患者术前临床资料
表2 患者手术相关指标比较
表3 无管化PCNL组中18 F和24 F通道亚组临床资料比较
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