经皮肾镜取石术治疗70岁以上高龄肾结石患者的安全性分析
The safety analysis of percutaneous nephrolithotomy in elderly patients(age≥70 years)
杨登科 1陈书奎 1焦湘 1孔令军 1闫俊领 1郭大勇 1王文浩1
作者信息
- 1. 解放军第159中心医院泌尿外科,河南驻马店463000
- 折叠
摘要
目的 分析70岁以上高龄复杂肾结石患者经皮肾镜取石术(PCNL)的安全性.方法 总结我院2008-06-2011-06间58例年龄≥70岁高龄肾结石并行PCNL患者的临床资料,评价术前结石最大直径、结石数量、并发症情况、手术时间、手术成功率、结石取净率、术后血红蛋白下降值、住院时间、并发症等指标,并与同期215例年龄20～40岁年轻肾结石PCNL患者对比,分析70岁以上高龄患者PCNL的安全性.结果 高龄组58例手术全部成功,青年组手术成功214例(99.5％)(P=0.60)；高龄组和青年组一期结石取净分别为49例(84.5％)、190例(88.4％)(P=0.39);手术时间分别为(65.5±13.8)min、(60.7±12.3) min(P=0.65)；术后血红蛋白下降值分别为(15.0±8.0)g/L、(13.0±7.0) g/L(P=0.78);住院时间分别为(8.5±3.7)d、(7.6±3.5)d(P=0.49)；并发症如术中出血、肾周血肿、邻近器官损伤、肾盂穿孔、术后发热、术后迟发性出血等两组差异均无统计学意义(P＞0.05).结论 采用个体化的围手术期风险控制及防范措施,PCNL治疗70岁以上高龄肾结石患者仍然是一种安全有效的方法.
Abstract
Objective To analyze the safety of percutaneous nephrolithotomy ( PCNL) in elderly patients (age ≥ 70 years). Methods We retrospectively reviewed 58 PCNLs performed in the elderly patients (age ≥70 years) carried out during June 2008 to June 2011 and compared those with 215 PCNLs performed in younger patients (age 20-40 years) during the same period. Results The operation success rates were 100% for the elderly patients and 99.5 % for the younger patients (P=0. 60). The stone-free rates were 84. 5% and 88. 4% (P=0. 39),and the operative time was 65.5±13.8 minutes and 60.7±12.3 minutes (P=0.65) in the elderly and younger patients, respectively. The mean hemoglobin level decrease was 1. 5±0. 8 mg/dL and 1.3±0.7 mg/dL(P=0. 78), and the mean hospital stay was 8. 5±3. 7 days and 7. 6±3. 5 days (P=0.49), respectively. No significant difference was seen in complications between the two groups (P>0. 05). Conclusion By use of individual risk controlling strategy and precautionary measure in perioperative period, PCNL in elderly patients (age≥70 years) may be safe and effective.
关键词
肾结石/外科学/肾造口术,经皮/方法Key words
Kidney Calculi/surgery/Nephrostomy, Percutaneous/methods引用本文复制引用
出版年
2012
NETL
NSTL
维普
万方数据