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预测功能改善的预测因素和PCNL后CKD患者的结果评估
Shivcharan Navriya1, Vikram Singh1, Kartik Sharma1
1All India Institute of Medical Sciences - Jodhpur, Jodhpur, Rajasthan, India.
Urologia
|February 10, 2025
概括
皮肤透神经切除术 (PCNL) 在患有尿路结石的慢性病 (CKD) 患者中改善了54%的功能. 诸如并发症和鹿角石等因素对结果产生了负面影响,突出显示了对CKD中PCNL进行仔细患者选择的必要性.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 外科手术的结果
背景情况:
- 尿路结石病是慢性病 (CKD) 的重要原因之一.
- 在患有结石的患者中,末期病 (ESRD) 的发生率在0.2%至3.2%之间.
- 穿皮瘤切除术 (PCNL) 是一种常见的治疗结石的程序.
研究的目的:
- 评估PCNL在患有CKD的患者的结果.
- 在CKD患者中确定影响PCNL后功能改善的因素.
主要方法:
- 一项前性观察性研究,涉及96名接受标准PCNL的CKD患者.
- 患者进行了36个月的尿液分析,血清肌素和KUB超声波的随访.
- 进行了手术前和36个月随访后估计的球过率 (eGFR) 的比较.
主要成果:
- 在PCNL后的患者中,54%的功能得到改善 (I组),而46%的功能稳定或下降 (II组).
- 第一个组的平均eGFR从41.13升至46.91毫升/分钟/平方米,第二组的平均eGFR从37.14降至33.17毫升/分钟/平方米.
- 影响PCNL疗效的因素包括并发症,鹿角石,先前的脏手术,长时间的手术时间 (>100分钟),不完全的石头清除和并发症.
结论:
- 在大量慢性病患者中,PCNL可以改善功能.
- 并发症,鹿角结石,先前的手术,手术时间和术后并发症是影响CKDPCNL结果的关键因素.
- 谨慎的患者选择和手术规划对于优化CKD和尿路结石患者的PCNL结果至关重要.
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