后腹腔镜肾囊肿去顶联合经皮肾穿刺碎石术的有效性和安全性分析

目的：对比分析后腹腔镜肾囊肿去顶联合经皮肾穿刺碎石术与开放手术治疗肾囊肿合并肾或输尿管上段结石的效果，探讨后腹腔镜肾囊肿去顶联合经皮肾穿刺碎石术的安全性及有效性。方法：选取2010年1月至2013年12月80例来三家医院就诊的肾囊肿合并肾或输尿管上段结石患者作为研究对象，采用随机数表法随机分为观察组（40例，行后腹腔镜肾囊肿去顶联合经皮肾穿刺碎石术）和对照组（40例，行开放手术治疗）；统计并分析两组手术时间、手术出血量、术后胃肠功能恢复时间、术后下床活动时间、术后住院时间、术后疼痛视觉模拟评分法（ VAS ）评分、结石清除率、囊肿及结石复发率、并发症发生情况，对后腹腔镜肾囊肿去顶联合经皮肾穿刺碎石术的有效性和安全性作出评价。结果：观察组手术时间、手术出血量、术后胃肠功能恢复时间、术后下床活动时间、术后住院时间均明显低于对照组，差异均具有统计学意义（ P＜0．05）。观察组术后VAS评分明显低于对照组，差异具有统计学意义（ P＜0．05）；结石清除率明显高于对照组，差异具有统计学意义（ P＜0．05）；观察组术后3个月囊肿复发率、结石复发率均低于对照组，但差异不具有统计学意义（ P＞0．05）。观察组感染发生率明显低于对照组，差异具有统计学意义（P ＜0．05）；观察组其余各项并发症发生率均低于对照组，但差异不具有统计学意义（ P＞0．05）。结论：腔镜肾囊肿去顶联合经皮肾穿刺碎石术治疗肾囊肿合并肾或输尿管上段结石具有手术出血少、创伤小、术后疼痛轻、结石清除率高和囊肿及结石复发率低等优点，值得临床推广借鉴。

The Safety and Efficacy Analysis of Retroperitoneal Laparoscopic Ren al Cyst Unroofing Combined with Minimally Invasive Percutaneous Nephrolithotomy

Objective： To compare and analyse the clinical efficacy of retroperitoneal laparoscopic renal cyst unroofing combined with minimally invasive percutaneous nephrolithotomy with open surgery in the treatment of renal cyst combined with renal or upper ureteral calculi , to discuss the safety and efficacy of retroperitoneal laparoscopic renal cyst unroofing combined with minimally invasive percutaneous nephrolithotomy .Method：From January 2010 to December 2013, selected 80 cases of re-nal cyst combined with renal or upper ureteral calculi treated in our hospital as study objects .They were randomly divided into observation group and control group by random number table method .The observation group received retroperitoneal laparoscop-ic renal cyst unroofing combined with minimally invasive percutaneous nephrolithotomy treatment , the control group received open surgery treatment .Compared and analysed the efficacy difference between the two groups in operation time , intraoperative blood soss, postoperative gastrointestinal function recovery time , postoperative ambulation time , postoperative hospital stay , postoperative pain visual analog scale（ VAS） score, stone clearance rate , cysts and stone recurrence rate and the occurrence of complications .Evaluated the safety and efficacy of retroperitoneal laparoscopic renal cyst unroofing combined with minimally in -vasive percutaneous nephrolithotomy .Result：The observation group were significantly lower than the control group in operative time, blood loss, postoperative recovery of gastrointestinal function , postoperative ambulation time , postoperative hospital stay , the differences were statistically significant （P 〈0.05）.The observation group was significantly lower than the control group in postoperative VAS score , the difference was statistically significant （ P 〈0.05）; the observation group was significantly higher than the control group in stone clearance rate , the difference was statistically significant （ P 〈0.05）;The observati