【摘要】 目的对比探讨套叠扩张器金属鞘和塑料扩张器peel way鞘应用于经皮肾镜碎石术中的安全性与有效性。方法回顾性分析2016年1月至2018年6月采用标准经皮肾镜单通道治疗多肾盏多发性或既往有患侧肾结石手术史或鹿角型等复杂性肾结石82例患者的临床手术资料,其中38例患者利用F9-F24套叠扩张器金属鞘建立经皮肾通道碎石,44例患者应用F10-F22塑料扩张器peel way鞘建立碎石通道清石。分别采集两组的一期结石清除率、扩穿、损伤、出血等并发症进行比较分析。结果 82例均一期成功建立经皮肾通道。金属鞘组与塑料鞘组一期结石清除率分别为:78.9%与77.3%,差异无统计学意义(P>0.05);术中扩穿对侧肾盏比率分别为:7.9%与29.5%,差异显著(P<0.01);术中粘膜、通道损伤至明显出血分别为:18.4%与40.9%,差异显著(P<0.01)。结论在复杂性肾结石经皮肾镜碎石清石术中,F9-F24套叠扩张器金属鞘值得临床推广使用。更多还原

【Abstract】 Objective Comparison of the safety and effectiveness of the telescopic metal sheath and plastic dilator peel way sheath in percutaneous nephrolithotomy. Methods Retrospective analysis of clinical surgical data from 82 patients with multiple renal pelvis multiple or previous renal calculus surgery or staghorn type complicated renal calculi from January 2016 to June 2018. Among them, 38 patients were treated with F9-F24 telescopic dilator metal sheath to establish percutaneous renal channel lithotripsy, and 44 patients were treated with F10-F22 plastic dilator peer way sheath to establish gravel channel clear stone. The first-stage stone removal rate, expansion, injury, bleeding and other complications were compared and analyzed. Results Percutaneous renal channels were successfully established in 82 cases. The first-stage stone removal rates of the metal sheath group and the plastic sheath group were 78.9% and 77.3%, respectively, and the difference was not statistically significant(P>0.05). The intraoperative spread of contralateral renal pelvis was 7.9% and 29.5%, respectively. The difference was significant(P<0.01). The intraoperative mucosa and channel damage to obvious bleeding were 18.4% and 40.9%, respectively, and the difference was significant(P<0.01). Conclusion In complex renal calculi percutaneous nephrolithotomy, the F9-F24 telescopic dilator metal sheath is worthy of clinical use.更多还原