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经皮肾镜取石术治疗合并代谢综合征的上尿路结石患者的临床疗效及安全性

[Clinical efficacy and safety of percutaneous nephrolithotomy for upper urinary tract calculi patients with metabolic syndrome].

作者信息

Wang Tian, Huang Xiao-bo, Xu Qing-quan, Ye Hai-yun, Ma Kai, Wang Xiao-feng

机构信息

Department of Urology, Peking University People's Hospital, Beijing 100044, China.

出版信息

Beijing Da Xue Xue Bao Yi Xue Ban. 2011 Aug 18;43(4):556-8.

Abstract

OBJECTIVE

To investigate the efficacy and safety of percutaneous nephrolithotomy (PCNL) for upper urinary tract calculi patients complicated with metabolic syndrome (MS).

METHODS

The clinical data of 66 PCNL cases with upper urinary tract calculi from March 2010 to February 2011 were retrospectively reviewed. Patients were divided into two groups according to 2004 Diagnostic Criteria of Metabolic Syndrome by the Chinese Diabetes Society (CDS). Twenty six upper urinary tract calculi patients complicated with metabolic syndrome were defined as case group (average aged 52.4 years, 16 males and 10 females). The other 40 cases without MS served as control group (average aged 45.9 years, 21 males and 19 females). The stone burden was (7.2 ± 1.8) cm(3) in case group and (6.4 ± 1.3) cm(3) in control group (P=0.712). The stone free rate, operative time, drop in hemoglobin level and fever were compared between the two groups.

RESULTS

The operation time was (87.1 ± 9.0) min in case group and (87.6 ± 6.0) min in control group (P=0.963). The stone free rate was 76.9% (20/26) vs. 75.0% (30/40), P=0.859. The drop in hemoglobin level was (8.4 ± 1.6) g/L vs. (9.1 ± 1.4) g/L, P=0.739. The incidence of post-operative fever was 38.5% (10/26) vs. 45.0% (18/40), P=0.599.

CONCLUSION

MS will neither increase the difficulty of surgery, nor reduce the stone free rate of PCNL for upper urinary tract calculi. And it will not raise the incidence of postoperative complications.

摘要

目的

探讨经皮肾镜取石术(PCNL)治疗合并代谢综合征(MS)的上尿路结石患者的疗效及安全性。

方法

回顾性分析2010年3月至2011年2月期间66例行PCNL治疗上尿路结石患者的临床资料。根据中华医学会糖尿病分会(CDS)2004年代谢综合征诊断标准将患者分为两组。26例合并代谢综合征的上尿路结石患者为病例组(平均年龄52.4岁,男16例,女10例)。另外40例无MS的患者作为对照组(平均年龄45.9岁,男21例,女19例)。病例组结石负荷为(7.2±1.8)cm³,对照组为(6.4±1.3)cm³(P=0.712)。比较两组的结石清除率、手术时间、血红蛋白水平下降情况及发热情况。

结果

病例组手术时间为(87.1±9.0)分钟,对照组为(87.6±6.0)分钟(P=0.963)。结石清除率分别为76.9%(20/26)和75.0%(30/40),P=0.859。血红蛋白水平下降值分别为(8.4±1.6)g/L和(9.1±1.4)g/L,P=0.739。术后发热发生率分别为38.5%(10/26)和45.0%(18/40),P=0.599。

结论

MS既不会增加手术难度,也不会降低PCNL治疗上尿路结石的结石清除率,且不会增加术后并发症的发生率。

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