Khorrami Mohammad Hatef, Izadpanahi Mohammad Hossein, Mohammadi Mehrdad, Alizadeh Farshid, Zargham Mahtab, Khorrami Farbod, Isfahani Felora Farahini
Department of Urology, Isfahan University of Medical Sciences, Isfahan, Iran.
Department of Biology, A. Y. Jackson Secondary School, Toronto, Ontario, Canada.
Adv Biomed Res. 2017 Jul 14;6:84. doi: 10.4103/2277-9175.210661. eCollection 2017.
Access dilation is the most important part of percutaneous nephrolithotripsy (PCNL) that is done by different methods, especially metal telescoping and one shot. In this study, two different methods of access dilation one shot and telescoping were compared.
In observational cross-sectional study, 240 patients who were a candidate for PCNL were selected and randomly divided into two groups. The first group was undergone one-shot method and the second group was undergone telescoping method. The decrease in hemoglobin (Hb), duration of hospitalization and the time of radiation exposure during access dilation was compared in two groups by SPSS software version 21, (SPSS Inc., Chicago, IL, USA).
The decrease of Hb level after intervention in one-shot group was 1.08 ± 1.23 g/dl and in telescoping, group was 1.51 ± 1.08 g/dl with no difference statistically ( = 0.37). The mean duration of hospitalization in one shot and telescoping group were 2.36 ± 0.67 and 2.28 ± 0.61 days, respectively. According to -test, there was no significant difference between the two groups ( = 0.37). Average radiation exposure in one shot group was 7.13 s and in telescoping, group was 35.75 s, and there was a significant difference between the two groups ( < 0.001).
One-shot method is superior to telescoping method due to less time for radiation exposure and no more blood loss and other complications during PCNL.
通道扩张是经皮肾镜取石术(PCNL)最重要的部分,可通过不同方法完成,尤其是金属套管扩张法和一次穿刺法。在本研究中,比较了两种不同的通道扩张方法,即一次穿刺法和套管扩张法。
在观察性横断面研究中,选取240例适合PCNL的患者并随机分为两组。第一组采用一次穿刺法,第二组采用套管扩张法。使用SPSS 21软件(美国伊利诺伊州芝加哥市SPSS公司)比较两组在通道扩张过程中血红蛋白(Hb)的下降情况、住院时间及辐射暴露时间。
一次穿刺组干预后Hb水平下降为1.08±1.23 g/dl,套管扩张组为1.51±1.08 g/dl,差异无统计学意义(P = 0.37)。一次穿刺组和套管扩张组的平均住院时间分别为2.36±0.67天和2.28±0.61天。根据t检验,两组之间无显著差异(P = 0.37)。一次穿刺组的平均辐射暴露时间为7.13秒,套管扩张组为35.75秒,两组之间存在显著差异(P<0.001)。
在PCNL中,一次穿刺法由于辐射暴露时间更短且无更多失血及其他并发症,优于套管扩张法。