在超重患者中逆行尿道镜手术的挑战
Abdolsalam Ahmadi1, Ahmed A Al Rashed1, Omran Hasan2
1Urology, Salmaniya Medical Complex, Manama, BHR.
Cureus
|November 29, 2023
概括
接受结石逆行性尿路透镜手术的超重患者面临更高的尿路接入失败率. 然而,一旦获得访问,成功率和并发症与正常体重个体相似.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 腎臟病學 (nephrology) 是一種醫學專業.
- 手术创新 在外科创新.
背景情况:
- 肥胖和尿结石 (结石) 是常见的健康问题.
- 肥胖会改变脏和尿道的解剖学,可能会使结石治疗复杂化.
- 了解这些解剖变化是有效的尿病管理的关键.
研究的目的:
- 为了评估在超重与正常体重患者的逆行性尿路透镜手术 (RURS) 期间的手术内挑战.
- 为了比较这两组患者之间程序性困难和并发症的发生率.
- 评估身体质量指数 (BMI) 对 urolithiasis 的 RURS 结果的影响.
主要方法:
- 对146名接受尿病RURS治疗的患者的回顾性审查 (2021年1月至2023年8月).
- 根据BMI分类的患者分为超重 (75) 和正常体重 (71) 组.
- 分析的结果包括尿道接入,石头清除和术后并发症 (克拉维恩-丁多分类).
主要成果:
- 超重患者的尿路接入失败率显著增加 (45%对18%,p=.004).
- 石头清理率是可比的 (91%的超重与95%的正常体重),尽管在统计学上并不显著 (p=.028).
- 并发症的发生率相似,超重患者的II级并发症略高 (8%对1.4%).
结论:
- 逆行性尿路透镜手术是超重和正常体重患者尿病的可行治疗方法.
- 尿道接入是一个主要的挑战,在超重个体中更频繁地遇到.
- 对于接受RURS的超重患者,建议进行手术前咨询和量身定制的手术技术.
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