针、水、导丝辅助技术在复杂性肾结石经皮肾镜取石术中的临床研究

The Clinical Study of Needle, Water and Guide Wire Assisted Technique in Complex Renal Calculi Percutaneous Nephrolithotomy

摘要: 目的：探讨针、水、导丝辅助技术在复杂性肾结石的经皮肾镜取石术(percutaneous nephrolithotomy, PCNL)中的临床应用价值。方法：将复杂性肾结石患者随机分为实验组与对照组，其中实验组使用针、水、导丝辅助PCNL术，对照组使用标准通道PCNL术，收集并对比两组手术患者的经皮肾通道数量、手术时间、术中失血量、I期结石清除率、术后并发症发生率、住院天数以及住院费用等资料，以评估针、水、导丝辅助技术在复杂性肾结石的PCNL术中应用的可行性。结果：实验组患者在I期经皮肾通道数量、手术时间、术中出血量、I期清石率、术后并发症发生率、住院时间以及住院费用方面均明显优于对照组。结论：针、水、导丝辅助技术在复杂性肾结石的PCNL术中的应用，可以提高复杂性肾结石I期结石清除率，缩短手术时间并降低出血量的同时，避免多通道碎石引起大出血、感染及尿瘘等并发症的发生。

Abstract: Objective: To explore the clinical value of needle, water, and guide wire assisted techniques in the percutaneous nephrolithotomy (PCNL) for complex renal calculi. Methods: Patients with complex renal calculi were randomly divided into an experimental group and a control group. The experimental group underwent PCNL assisted by needle, water, and guide wire, while the control group underwent standard tract PCNL. The clinical data, included the number of percutaneous renal tracts, operative time, intraoperative blood loss, stage I stone clearance rate, postoperative complication rate, length of hospital stay, and hospitalization costs, was collected and compared between two groups to evaluate the feasibility of needle, water, and guide wire assisted techniques in PCNL for complex renal calculi. Results: The experimental group showed significant improvements over the control group in terms of the number of stage I percutaneous renal tracts, operative time, intraoperative blood loss, stage I stone clearance rate, postoperative complication rate, length of hospital stay, and hospitalization costs. Conclusion: The application of needle, water, and guide wire assisted techniques in PCNL for complex renal calculi can improve the stage I stone clearance rate, shorten the operative time, and reduce blood loss. The new technique also helps to avoid complications such as major hemorrhage, infection, and urinary fistula that can arise from multi-tract stone removal.