Effects and safety of PCNL for senile patients with kidney stones after failed ESWL
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国家科技期刊平台
NETL
NSTL
维普
万方数据
目的 研究既往行体外冲击波碎石(ESWL)失败的老年肾结石患者接受经皮肾镜取石术(PCNL)治疗的有效性及安全性.方法 将本院收治的ESWL治疗失败并接受PCNL治疗的老年肾结石49例作为观察组,同期65例既往无结石相关手术史接受PCNL治疗的老年肾结石患者作为对照组,分析比较两组临床资料、结石清除率(SFR)及并发症发生情况等.结果 观察组的结石显著小于对照组(P＜0.05),两组其余基本资料无统计学差异(P＞0.05).经PCNL术后,观察组和对照组SFR分别为85.7％和90.8％,差异无统计学意义(P＞0.05).两组住院时间无统计学差异(P＞0.05),但观察组的手术时间(110.4±15.9)min明显长于对照组(92.9±13.8)min(P＜ 0.05).术后两组肌酐均有升高,血红蛋白均有下降,但组间无统计学差异(P＞0.05).观察组需要建立两个以上通道的概率更高(P＜0.05).最常见并发症为发热,其次为出血,但两组并发症无统计学差异(18.4％ vs 12.3％,P＞ 0.05).结论 尽管ESWL失败的老年肾结石患者与既往无结石手术病史的老年肾结石患者接受PCNL治疗的有效性和安全性无明显差异,但由于ESWL对肾组织的影响和肾盏黏膜对结石碎片的包裹,导致ESWL失败的老年肾结石患者PCNL手术难度更大,手术时间延长.
Objective To study the effects and safety of percutaneous nephrolithotripsy (PCNL) for senile patients with kidney stones after failed extracorporeal shock wave lithotripsy (ESWL).Methods a total of 49 senile patients with kidney stones who had failed in ESWL and were to receive PCNL treatment in our hospital were selected to constitute an observation group,and another 65 senile patients with kidney stones who had received no stone related operation but were to receive PCNL treatment in our hospital were selected to constitute a control group.The clinical data,stone removal rate (SRR) and complications between the two groups were analyzed and compared.Results The stones in the observation group were significantly smaller than those in the control group (P ＜ 0.05).There was no statistical difference in other basic data between the two groups (P ＞ 0.05).After PCNL,the SRR in the observation group and the control group was 85.7％ vs 90.8％,showing no statistical difference(P ＞ 0.05).The length of stay (LOS) in the two groups had no statistical difference (P ＞ 0.05),but the operation time in the observation group was significantly longer than that in the control group (110.4 ± 15.9 vs 92.9 ± 13.8)min (P＜ 0.05).The creatinine in the two groups increased and the HGB decreased after the operation,but there was no statistical difference between the groups (P ＞ 0.05).The observation group had higher probability to establish more than two channels (P ＜ 0.05).The most common complication was fever,followed by bleeding.The complication in the two groups showed no statistical difference (18.4％ vs 12.3％,P ＞ 0.05).Conclusion Even though the effects and safety of PCNL for senile patients with kidney stones between those who had failed in ESWL and who have received no stone related operation showed no significance difference,it is more difficult to conduct PCNL on senile patients with kidney stones who have failed in ESWL due to the impacts of ESWL on nephridial tissue and the wrapping of stone fragments by renal mucosa and the operation time is longer.
国家科技期刊平台
NSTL
维普
万方数据
