| Objective:To investigate the clinical efficacy of modified percutaneous nephrolithotomy.Methods:Eighty patients with kidney stones who underwent percutaneous nephrolithotomy at the First Affiliated Hospital of Fujian Medical University from May 2016 to December 2016 were selected.The stone size was 2-4cm and the STONE score was within 10 minutes(including 10 points).The patients were randomly divided into three groups: 18 F,20F,24 F different puncture channels.The patients were divided into two groups.The patients were divided into two groups: sex,age,BMI,stone size,STONE score,preoperative leukocyte count,preoperative hemoglobin,preoperative creatinine,preoperative CRP,preoperative urine culture,operation time,postoperative leukocyte count,postoperative hemoglobin reduction,postoperative creatinine,postoperative CRP,SFR,town Pain application,postoperative Clavien classification,hospitalization time for statistical analysis.Results:80 cases of patients,including 50 males and 30 females,aged 24-70 years,mean age 49.85;47 cases of left calculi,33 cases of right calculus;BMI15.4-35.8,an average of 24.4;stone size of 2.0-4.0cm,mean 2.71cm;CT value of preoperative stone is 600-2000 Hu,average 1318Hu;STONE score 5-10 points,an average of 7.23 points;preoperative white blood cell count 3.31-11.26 × 10 ^ 9 / L,an average of 6.48 × 10 ^ 9 / L,preoperative HB11.2-17.8g / dl,an average of 14.3g / dl,preoperative creatinine 28.0-99.0umol / L,an average of 65.44 umol / L,preoperative CRP1.0-49.6mg / L,An average of 6.44 mg / L,12 cases of preoperative urine culture positive,mainly Escherichia coli,Klebsiella pneumoniae,Enterococcus faecalis.There were no significant differences in the operation time between the two groups(23.9 ± 8.1min,22.6 ± 10.8min,25.0 ± 12.6min),and there was no significant difference between the two groups.The The reduction rate of hemoglobin after operation was 0.98 ± 0.67 g / dl,0.99 ± 0.81 g / dl,1.58 ± 1.25 g / dl,respectively.The postoperative hospitalization was 96.2%,96.9% and 95.5%(P = 0.038)and hospitalization time(P = 0.044)were statistically significant,and the other groups were between the two groups(P> 0.05)The difference was not statistically significant.Postoperative complications were based on Clavien grade,grade ? 3 cases,grade ? 3 cases,grade ? 1 case,? grade,grade ? were 0 cases.The overall incidence of postoperative complications was 8.75%.Class I fever with pain in 1 case,1 case of pain alone,pain with vomiting in 1 case.2 cases of infectious shock in 2 cases,1 case of blood transfusion.Grade ? Bank of DSA.Conclusion:For the stones with stone size of 2-4cm,average 2.71 cm,STONE score of 5-10 points,an average of 7.23 points of kidney stones,modified percutaneous nephrolithotomy is a safe and effective method,using three different sizes of channels,24 channel compared to 18,20,the incidence of postoperative complications is high,the operation time of each group is similar to the case,the incidence of micro-channel complications is lower,so the size of 2.0-4.0cm,STONE score Less than 10 points of kidney stones,improved percutaneous nephrolithotomy,surgical channel 18-20,to ensure the safety of surgery at the same time,to maintain a high frying stone efficiency. |
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