在超声波导向的上皮层髓切割术中,下极的进入更安全吗?
Ziv Savin1, Linda Dayan Rahmani1, Eve Frangopoulos1
1Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY.
Urology practice
|January 12, 2026
概括
在超声波导向的卧式皮穿性瘤切除术 (PCNL) 中,下极接入提供了更好的安全性. 这种方法导致较少的重大和总并发症相比,在结石去除期间非下极接入.
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
- 最少侵入性的手术
背景情况:
- 超声 (美国) 导向的卧底皮肤透神经切除术 (PCNL) 是结石治疗的新兴技术.
- 选择的接入点 (例如,较低的杆与其他杯子) 可能会影响卧床PCNL的安全性和有效性.
研究的目的:
- 为了比较下极接入 (LPa) 与非下极接入 (非LPa) 的安全性和有效性,在卧卧美国指导的PCNL中.
- 评估与不同接入点相关的并发症率和疼痛评分.
主要方法:
- 对228名接受单次接入美国指导的卧床PCNL的患者进行了回顾性队列分析.
- 患者被分为下极 (n=162),中极 (n=42) 和上极 (n=21) 接入组.
- 基线人口统计数据,石头特征,手术内细节和手术后30天并发症的比较 (克拉维恩-丁多分类).
主要成果:
- 与上极接入 (14%) 相比,下极接入 (LPa) 的重大并发症率显著降低 (2%) (p=0.03).
- 此外,LPa的整体并发症率也较低 (11%),相比于跨极 (22%) 和上极 (19%) 接入.
- 两种内脏损伤在极地间组中被发现;所有组的疼痛得分都是可比的.
结论:
- 在美国指导的卧式PCNL中,下极接入与更高的安全性相关.
- 这种方法导致较少的重大和总并发症,而不是较低的极点访问.
相关概念视频
Imaging Studies II: Ultrasonography
344
IntroductionUltrasonography, or renal ultrasound, is a noninvasive medical imaging technique that uses high-frequency sound waves to visualize the kidneys, ureters, bladder, and surrounding tissues.Indications for Urinary System UltrasonographyUrinary system ultrasonography is indicated in various clinical scenarios, such as:Kidney Stones (Urolithiasis): To detect and monitor the size and presence of kidney or urinary tract stones.Hydronephrosis: To assess the dilation of the renal pelvis and...
344
Urinary Tract Calculi VI: Surgical Management
361
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...
361
Imaging Studies V: Intravenous Urography and Retrograde Pyelography
1.0K
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...
1.0K
Imaging Studies I: Kidney, Ureter, and Bladder Studies
260
Kidney, Ureter, and Bladder (KUB) StudiesKidney, Ureter, and Bladder (KUB) studies are standard diagnostic imaging procedures used to assess the anatomy of the urinary system. They are commonly utilized for patients experiencing abdominal pain or urinary symptoms. By using a simple X-ray of the abdomen, KUB studies can reveal structural and pathological abnormalities within the kidneys, ureters, and bladder. These studies are particularly valuable in diagnosing kidney stones, urinary...
260
Cardiac Catheterization IV: Nursing Management
634
Nursing responsibilities before cardiac catheterization include:Assess for allergies and establish baseline health status.Before cardiac catheterization, assess the patient for allergies to contrast dye. Perform a comprehensive baseline assessment, including vital signs, heart and breath sounds, and a neurovascular assessment of the extremities, noting distal pulses, skin color, and temperature. Instruct the patient to fast for 8-12 hours before the procedure. Evaluate baseline laboratory...
634
Imaging Studies VII: Vascular Imaging
303
DefinitionRenal angiography, also known as renal arteriography, is an imaging technique used to obtain a comprehensive view of blood flow and the vascular structure of blood vessels in the kidneys and surrounding areas.PurposeRenal angiography detects blood vessel abnormalities in the kidneys, such as aneurysms, stenosis, thrombosis, vascular tumors, and renal artery stenosis. It evaluates kidney function and guides interventional treatments like angioplasty or stent placement.Pre-Procedure...
303


