结石管理方面的创新:在资源有限的环境中,小型PCNL用于雄鹿角结石
An Minh Nguyen1,2,3, Hung Hai Do4, Duc Van Nguyen2
1Department of Surgery, Hanoi Medical College, Hanoi, Vietnam.
Frontiers in urology
|August 8, 2025
概括
在越南,微型穿皮腎石切開術 (mini-PCNL) 使用高功率激光光治療是安全有效的治療石. 这种先进的泌尿外科手术提供了良好的石头清除和恢复,即使在资源有限的环境中.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 腎石病的管理方法
- 最少侵入性的手术
背景情况:
- 鹿角带来了复杂的管理挑战,特别是在资源有限的环境中.
- 迷你透皮骨切除术 (迷你PCNL) 提供了一种不那么侵入性的结石去除方法.
- 评估新的技术,如使用18F金属接入的迷你PCNL,对于改善患者的治疗结果至关重要.
研究的目的:
- 评估小型PCNL使用18F金属接入在越南患者的初始经验和结果.
- 在资源有限的环境中确定该技术的安全性和有效性.
- 评估与迷你PCNL相关的石头清除率和术后并发症.
主要方法:
- 进行了一项多中心回顾性审查,涉及236名患有鹿角结石的患者.
- 患者接受了小型PCNL,使用高功率Ho激光石术 (Lumenis 100 W).
- 从2020年1月至2023年12月期间,从越南北部的四家省级医院收集了数据.
主要成果:
- 该研究包括236名患者,平均年龄为54.88岁;13.56%的患者先前接受过开放性手术,3.81%的患者先前接受过PCNL.
- 平均石头大小为28.05毫米,其中53.81%的石头尺寸为20-30毫米,38.56%的石头尺寸超过30毫米.
- 手术后并发症包括出血 (13.14%) 和发烧 (9.75%). 三天后石头清除率为67.37%,一个月后为80.91%.
结论:
- 迷你PCNL结合高功率Ho激光光是一种安全有效的治疗鹿角结石.
- 该技术实现了有利的石头清除和回收结果.
- 这种方法为资源有限的环境中先进的泌尿器科护理提供了可行的,具有成本效益的解决方案.
相关概念视频
01:25Urinary Tract Calculi VI: Surgical Management
27
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...
27
01:30Urinary Tract Calculi III: Medical Management
23
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)...
23
01:28Urinary Tract Calculi V: Nursing Management
28
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...
28
01:27Urinary Tract Calculi IV: Nutrition Therapy and Prevention
32
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,...
32
01:26Kidney Transplant II: Surgical Procedure
76
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...
76
01:28Urinary Tract Calculi I: Introduction
44
Renal calculi, or kidney stones, are solid deposits of minerals and salts formed inside the kidneys. In medical terminology, "calculus" refers to the stone itself, while "lithiasis" describes the process of stone formation. Depending on their location within the urinary system, these stones may be classified as either urolithiasis, when situated within the urinary tract, or nephrolithiasis, when located within the kidneys. Each term signifies the specific impact of the stone.Predisposition...
44