在管理大型结石中,微型皮肤利切除术和标准皮肤利切除术之间的比较:一项随机对照临床试验
Karim Omar ElSaeed1, Mohammed Metwally Sadeq2, Karim Meslhy Hassan2
1Department of Urology, Ain Shams University, Cairo, Egypt.
Journal of endourology
|October 6, 2023
概括
迷你透皮骨切除术 (PNL) 与结石的标准PNL相比,可以减少住院和疼痛. 标准PNL提供了更高的无结石率,但需要更长的恢复时间和更多的并发症.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 最少侵入性的手术
背景情况:
- 结石 (20-40毫米) 的管理往往涉及皮肤透过的腎石切除术 (PNL).
- 迷你PNL是一种不那么侵入性的标准PNL替代品.
研究的目的:
- 为了比较小PNL和标准PNL对于结石 (20-40毫米).
- 评估手术时间,光镜,血液流失,无石头率和并发症.
主要方法:
- 预期的,随机的比较研究.
- 93名患者分为标准PNL (44) 和迷你PNL (49) 组.
主要成果:
- 迷你PNL显示血红蛋白下降显著降低,住院时间缩短,术后疼痛减少.
- 标准PNL的操作时间较短,但导管注射和瘤切除时间较长.
- 没有石头的比率在1周后是可比的,但标准PNL在4周后更好.
结论:
- 标准PNL提供了更高的无结石率和更短的操作时间.
- 迷你PNL在减少住院,疼痛和并发症方面表现出优势.
- 这两种技术都适用于结石 (20-40毫米),具有明显的益处概况.
相关概念视频
Urinary Tract Calculi VI: Surgical Management
8
Procedures for Kidney StonesMedical intervention is necessary when kidney stones or renal calculi are too large to pass spontaneously (typically greater than 5 millimeters) when stones are accompanied by symptomatic infection (such as fever or pyelonephritis), when they impair kidney function, or when they cause persistent symptoms like severe pain, nausea, or urinary retention. Additionally, patients with only one kidney or those who cannot be treated with medical management also require...
8
Urinary Tract Calculi III: Medical Management
9
The diagnosis of renal calculi involves several imaging techniques, including non-contrast CT scans and ultrasound. These methods help visualize kidney stones, assess their size and location, and detect possible obstructions. Additionally, Measuring urine pH is useful for diagnosing specific stone types, such as struvite (alkaline pH) and uric acid stones (acidic pH). Cystine stones are primarily linked to cystinuria, a genetic condition. A urinalysis helps detect blood in the urine (hematuria)...
9
Imaging Studies V: Intravenous Urography and Retrograde Pyelography
38
IntroductionIntravenous Urography (IVU) and Retrograde Pyelography (RP) are important diagnostic imaging techniques used to evaluate the urinary system. These methods help identify structural abnormalities, obstructions, and functional issues in the kidneys, ureters, and bladder. Both procedures use iodine-based contrast media to enhance the visibility of urinary tract structures on X-ray images, though they differ in their methods and indications.1. Intravenous Urography (IVU)Intravenous...
38
Urinary Tract Calculi V: Nursing Management
13
AssessmentSubjective Data: Obtain a detailed health history, including any recent or chronic urinary tract infections, periods of immobilization, previous episodes of renal calculi, and medical conditions such as gout, benign prostatic hyperplasia, or hyperparathyroidism. Review the medication history for drugs that may influence stone formation, including allopurinol, analgesics, loop diuretics, or thiazide diuretics. Document the use of long-term indwelling catheters and any past surgical...
13
Urinary Tract Calculi IV: Nutrition Therapy and Prevention
11
Management of renal calculi focuses on effective strategies like tailored nutrition and hydration therapy. Adjusting diet and fluid intake reduces stone formation and recurrence, making these interventions simple yet powerful in kidney stone prevention and management.Understanding Kidney StonesKidney stones form when calcium, oxalate, uric acid, and cystine concentrate and crystallize in urine. Factors contributing to their formation include genetic predisposition, certain medical conditions,...
11
Kidney Transplant II: Surgical Procedure
22
Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living...
22


