Stoller M L, Bolton D, St Lezin M, Lawrence M
Department of Urology, University of California School of Medicine, San Francisco.
Urology. 1994 Nov;44(5):651-4. doi: 10.1016/s0090-4295(94)80198-3.
To evaluate the success and morbidity of percutaneous nephrolithotomy (PNL) performed in patients aged 65 years and older.
A retrospective review of 42 PNLs performed on 33 patients aged 65 years and older was compared with a cohort of 160 PNLs performed on younger patients over the same time period.
The presence of complete staghorn calculi (17 of 36 renal units [47%] versus 88 of 160 renal units [55%], p = 0.46) and average stone size (3.8 cm versus 4.3 cm, p = 0.2) were similar for the 2 groups. Eighty-two percent of patients (27 of 33) were stone-free or left with fragments < 5 mm at 3 months after surgery. Elderly patients had a higher transfusion rate after PNL despite similar preoperative hemoglobin levels (11 of 42 PNLs [26%] versus 22 of 160 PNLs [14%], p < 0.01). Serious complications were infrequent and there were no deaths.
Percutaneous nephrolithotomy is a safe and effective therapy for elderly patients with complex stone disease; however, awareness of an apparent increased requirement for blood transfusion is warranted.
评估在65岁及以上患者中进行经皮肾镜取石术（PNL）的成功率和发病率。
对33例65岁及以上患者实施的42例经皮肾镜取石术进行回顾性分析，并与同期对年轻患者实施的160例经皮肾镜取石术进行队列比较。
两组患者完全鹿角形结石的发生率（36个肾单位中的17个[47%] 对比160个肾单位中的88个[55%]，p = 0.46）和平均结石大小（3.8厘米对比4.3厘米，p = 0.2）相似。82%的患者（33例中的27例）在术后3个月结石清除或残留碎片<5毫米。尽管术前血红蛋白水平相似，但老年患者经皮肾镜取石术后输血率更高（42例经皮肾镜取石术中的11例[26%] 对比160例经皮肾镜取石术中的22例[14%]，p < 0.01）。严重并发症少见，无死亡病例。
经皮肾镜取石术是治疗老年复杂性结石疾病的一种安全有效的方法；然而，有必要意识到明显增加的输血需求。
