微创经皮肾镜碎石术在高风险手术患者中的应用及安全性评价

目的探讨微创经皮肾镜碎石术(MPCNL)在高风险患者中的疗效及安全性。方法将120例输尿管上段结石高风险患者随机分为MPCNL组(A组)和标准经皮肾镜碎石组(B组),比较两组结石清除率和入室(T1)、筋膜扩张(T2)、碎石(T3)、术毕(T4)的血压、心率、中心静脉压及并发症差异。结果两组患者在T2、T3、T4的血压、心率、中心静脉压比较差异有统计学意义(P<0.05);两组Ⅰ、Ⅱ级并发症比较差异有统计学意义(P<0.05)。结论 MPCNL由于对患者血流动力学影响小,安全性高,用于高风险患者碎石手术具有优势。

Application and Safety of Minimally-invasive Percutaneous Nephrolithotomy in High-risk Patients

Objective To compare the clinical effects and safety of minimally-invasive percutaneous nephrolithotomy(MPCNL)in high-risk patients.Methods 120 cases of upper ureteral calculi high-risk patients were collected,then randomly divided two groups:MPCNL group(group A)and percutaneous nephrolithotomy(PCNL)group(group B),the differences of the clearance rate of calculi,blood pressure,heart rate,central venous pressure at "into operation room(T1)","fascia expansion(T2)","lithotriy(T3)","operation over(T4)" and the complications were compared.Results T2,T3,T4 blood pressure,heart rate,central venous pressure of the two groups had significant difference(P<0.05);level Ⅰ,Ⅱ complications of the two groups had significant difference(P<0.05).Conclusion MPCNL is of small hemodynamic impact and good safety for the patients,thus is advantageous for the treatment of the high-risk patients.