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鹿角形结石患者结石体积评估及其与手术结果的关系。

Evaluation of stone volume and its relationship with surgical outcomes in patients with staghorn calculi.

作者信息

Mulay Abhirudra, Satav Vikram, Kandari Ashwani, Sharma Sonu, Mane Deepak, Sabale Vilas

机构信息

Department of Urology, Dr. D. Y. Patil Medical College, Pune, Maharashtra, India.

出版信息

Urol Ann. 2019 Jan-Mar;11(1):53-57. doi: 10.4103/UA.UA_65_18.

Abstract

INTRODUCTION

Urolithiasis is one of the most common renal diseases with a significant burden on health-care system worldwide. Here, we evaluated the stone volume and its relationship with duration of operation, blood loss, and total stone clearance in patients with staghorn calculi.

MATERIALS AND METHODS

This was a prospective, single-center study conducted from October 2015 to September 2017. Patients of either sex aged more than 18 years of age with a confirmed diagnosis of staghorn calculus were eligible to participate in the study. Eligible patients were divided into three groups based on stone volume (assessed by three-dimensional computed tomography): Group 1 (≤5000 mm), Group 2 (>5000 to ≤20,000 mm), and Group 3 (>20,000 mm).

RESULTS

A total of 85 patients were enrolled in the study (Group 1, = 9; Group 2, = 66; and Group 3, = 10). The mean age was 43.68 years, and 62.4% of patients were male. The mean operative time increased significantly from Groups 1-3, (31.67, 60.14, and 92.30 min, respectively). The mean pre- and postoperative hematocrit was highest in Group 3 (2.82%) ( < 0.0001). Overall, the correlation between stone volume and operative time and difference in hematocrit showed a positive relationship. A total of five patients had residual calculus, and only four patients reported complications.

CONCLUSIONS

The results showed that patients with larger stone volume need more operative time and may have more blood loss.

摘要

引言

尿石症是最常见的肾脏疾病之一,给全球医疗保健系统带来了沉重负担。在此,我们评估了鹿角形结石患者的结石体积及其与手术时间、失血量和结石完全清除率的关系。

材料与方法

这是一项于2015年10月至2017年9月进行的前瞻性单中心研究。确诊为鹿角形结石、年龄超过18岁的男女患者均有资格参与本研究。符合条件的患者根据结石体积(通过三维计算机断层扫描评估)分为三组:第1组(≤5000立方毫米)、第2组(>5000至≤20000立方毫米)和第3组(>20000立方毫米)。

结果

本研究共纳入85例患者(第1组9例;第2组66例;第3组10例)。平均年龄为43.68岁,62.4%的患者为男性。第1组至第3组的平均手术时间显著增加(分别为31.67、60.14和92.30分钟)。第3组术前和术后平均血细胞比容最高(2.82%)(P<0.0001)。总体而言,结石体积与手术时间及血细胞比容差异之间呈正相关。共有5例患者有残余结石,仅4例患者报告有并发症。

结论

结果表明,结石体积较大的患者需要更长的手术时间,且可能失血更多。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4a7b/6362778/2f2dcc34b9e1/UA-11-53-g001.jpg

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