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重度肾积水对一期扩张法经皮肾镜取石术治疗效果的影响

Effects of severe hydronephrosis on the outcomes of percutaneous nephrolithotomy with one-shot dilation method.

作者信息

Micoogullari Uygar, Yucel Cem, Sueluzgen Tufan, Kisa Erdem, Keskin Mehmet Zeynel, Isoglu Cemal Selcuk, Ilbey Yusuf Ozlem

机构信息

Department of Urology, Tepecik Training and Research Hospital, Izmir, Turkey.

Department of Urology, Hakkari State Hospital, Hakkari, Turkey.

出版信息

Urologia. 2022 May;89(2):221-225. doi: 10.1177/03915603211001175. Epub 2021 Mar 12.

Abstract

OBJECTIVE

To investigate the effect of the presence of severe hydronephrosis on percutaneous nephrolithotomy (PNL) outcome in patients who underwent PNL operation with one-shot dilatation technique.

MATERIALS AND METHODS

Medical data of 989 patients underwent PNL operation in our clinic between 2012 and 2018 were retrospectively reviewed. We included 373 of the patients underwent PNL operation due to renal pelvic stone, who were older than 18 years of age, who did not have any urinary tract abnormality, and had no previous history of open renal stone operation. Patients were divided into two groups according to the presence of severe hydronephrosis and absence of hydronephrosis. These two groups were compared in terms of age, gender, body mass index (BMI), number of stones, stone burden, operation duration, fluoroscopy time, hospitalization time, hemoglobin and creatinine change, complications, and stone free rate.

RESULTS

There was no statistically significant difference between the groups in terms of age, gender, BMI, stone number, stone size, stone density, operation duration, fluoroscopy time, and hospitalization duration. The mean change in hemoglobin was 1.5 g/dL in group 1 and 1.1 g/dL in group 2. This difference was statistically significant ( = 0.006). Postoperative blood transfusion was required for 3 patients (2.1%) in group 1 and 12 patients (5.1%) in group 2. This difference was statistically significant ( < 0.001).

CONCLUSION

Only the presence of severe hydronephrosis was found to be associated with the change in hemoglobin and postoperative blood transfusion.

摘要

目的

探讨重度肾积水的存在对采用一期扩张技术行经皮肾镜取石术(PNL)患者手术结局的影响。

材料与方法

回顾性分析2012年至2018年在我院接受PNL手术的989例患者的医疗资料。我们纳入了373例因肾盂结石接受PNL手术的患者,这些患者年龄大于18岁,无任何尿路异常,且既往无开放性肾结石手术史。根据是否存在重度肾积水将患者分为两组。比较两组患者的年龄、性别、体重指数(BMI)、结石数量、结石负荷、手术时间、透视时间、住院时间、血红蛋白和肌酐变化、并发症及结石清除率。

结果

两组在年龄、性别、BMI、结石数量、结石大小、结石密度、手术时间、透视时间和住院时间方面无统计学显著差异。第1组血红蛋白平均变化为1.5g/dL,第2组为1.1g/dL。这种差异具有统计学显著性(=0.006)。第1组有3例患者(2.1%)需要术后输血,第2组有12例患者(5.1%)需要输血。这种差异具有统计学显著性(<0.001)。

结论

仅发现重度肾积水的存在与血红蛋白变化及术后输血有关。

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