【摘要】 目的:探讨精准穿刺双通道期经皮肾镜取石术对鹿角形肾结石患者肾血流动力学的影响。方法:选取90例鹿角形肾结石患者为研究对象,采用随机数字法将其分为对照组(n=45)和观察组(n=45)。对照组采用标准单通道经皮肾镜取石术,观察组采用精准穿刺双通道经皮肾镜取石术,比较两组手术相关指标、结石清除率及肾血流动力学指标。结果:观察组手术时间长于对照组(P<0.05);两组术中出血量比较,差异无统计学意义(P>0.05)。术后1 d,两组肾主动脉、段间动脉、叶间动脉的Vmax、S/D均低于术前(P<0.05),但观察组高于对照组(P<0.05);术后1 d,两组肾主动脉、段间动脉、叶间动脉的RI均高于术前,且观察组低于对照组(P<0.05)。观察组一期结石清除率高于对照组(P<0.05),并发症发生率高于对照组,差异无统计学意义(P>0.05)。结论:精准穿刺双通道经皮肾镜取石术治疗鹿角形肾结石,可有效改善肾血流动力学指标,一期结石清除率高,但手术时间相对延长。更多还原

【Abstract】 Objective:To investigate the effect of pinpoint attack double channel percutaneous nephrolithotomy on renal hemodynamics in patients with renal staghorn calculi.Methods:90 patients with renal staghorn calculi were selected as the research objects.They were randomly divided into two groups:control group(n=45) and observation group(n=45).The control group was treated with standard single channel percutaneous nephroscopy,and the observation group was treated with pinpoint attack double channel percutaneous nephroscopy.The operation related indexes,stone removal rate and renal hemodynamics were compared between the two groups.Results:The operation time of the observation group was longer than that of the control group(P<0.05).There was no significant difference in the amount of bleeding between the two groups(P>0.05).1 day after operation,the Vmax and S/D of renal aorta,segmental artery and interlobar artery in the two groups were lower than those before operation(P<0.05),and those in the observation group were higher than those in the control group(P<0.05).The RI of renal aorta,segmental artery and interlobar artery in the two groups were higher than those before operation(P<0.05),and the observation group was lower than that in the control group(P<0.05).The first stage stone clearance rate of the observation group was higher than that of the control group(P<0.05),and the incidence of complications was higher than that of the control group,there was no significant difference between the two groups(P>0.05).Conclusion:Using pinpoint attack double channel percutaneous nephrolithotomy for renal staghorn calculi can effectively improve renal hemodynamic indexes,the first stage stone clearance rate is high,but the operation time is longer.更多还原