【摘要】 目的探讨日间模式下经皮肾镜碎石术治疗肾和输尿管上段结石的手术策略及临床疗效观察。方法回顾性分析2018年12月至2019年6月在华中科技大学同济医学院附属同济医院中法新城院区成功开展的32例日间经皮肾镜碎石术治疗的肾及输尿管上段结石患者的临床资料,包括一般信息、住院时间、术后并发症、再入院情况以及术后1个月结石清除率、患者治疗满意度等。结果 32例结石患者平均手术时间(109.6±28.2)min,失血量(53.5±23.8)mL;6例给予无管化处理,术后疼痛评分1分(轻度疼痛)20例(62.5%);住院时间(1.5±0.6)d;延迟出院7例(21.9%),出现术后并发症4例(12.5%);1个月内非计划再入院1人(3.1%);术后1个月结石清除率100%,患者治疗满意度96.9%。结论对于符合筛选标准的肾和输尿管上段结石患者,接受日间经皮肾镜碎石术治疗安全有效,结石清除率高,并发症发生率低;术后疼痛轻微,住院时间短,治疗满意度高。更多还原

【Abstract】 Objective To evaluate the surgical strategy and clinical efficacy of percutaneous nephrolithotomy(PCNL)under ambulatory surgery(AS)mode in the treatment of renal/upper ureteral calculi.Methods Clinical data of 32 patients with renal/upper ureteral calculi treated with PCNL under AS mode during Dec.2018 and Jun.2019 were retrospectively analyzed,including general information,length of hospital stay,postoperative complications,readmission,1-month stone-free rate,patients’satisfaction,and so on.Results The mean operation time was(109.6±28.2)min,and blood loss was(53.5±23.8)mL.Tubeless PCNL was performed in6 patients,and20 patients(62.5%)had a postoperative pain score of 1.The mean hospital stay was(1.5±0.6)days,and 7 patients(21.9%)delayed discharge.Postoperative complications occurred in 4 patients(12.5%),and 1 patient(3.1%)was readmitted within 1 month after operation.The 1-month stone-free rate was 100% and patients’satisfaction rate was 96.9%.Conclusion PCNL under AS mode is safe and effective in the treatment of renal/upper ureteral calculi with high removal rate and low incidence of complications.Patients have high satisfaction,mild postoperative pain and short hospital stay.更多还原