经皮肾镜钬激光治疗复杂性肾结石疗效观察

目的探讨经皮肾镜钬激光治疗复杂性肾结石的临床疗效。方法 80例复杂性肾结石患者分为2组,观察组40例给予经皮肾镜钬激光治疗,对照组40例给予传统开放性肾切开取石术治疗。观察比较2组的排石效果、手术情况及肾功能变化情况。结果观察组患者清石次数显著少于对照组(P<0.05),术后1、4、12周的结石清除率显著高于对照组(P<0.05);观察组患者术中出血量显著少于对照组(P<0.05),手术时间和住院时间显著短于对照组(P<0.05);观察组患者术后并发症发生率显著低于对照组(P<0.05);2组患者手术前血肌酐(SCr)和血尿素氮(BUN)水平比较差异无统计学意义(P>0.05),观察组患者术后1、7、14、21 d的SCr和BUN水平显著低于对照组(P<0.05)。结论经皮肾镜钬激光治疗复杂性肾结石排石彻底,手术创伤小,肾功能恢复快。

Effect of percutaneous nephrolithotomy with holmium laser on patients with complicated renal calculus

Objective To investigate the clinical effect of percutaneous nephrolithotomy with holmium laser for the treatment of complicated renal calculi.Methods Eighty patients with complicated renal calculi were divided into two groups,the patients in observation group were treated with percutaneous nephrolithotomy with holmium laser,and the patients in control group were treated with traditional nephrolithotomy.The effect of renal calculus excretion,the situation of operation and renal function were observed and compared between the two groups.Results The time of stone clearance in observation group was significantly less than that in control group(P<0.05),the rates of calculus excretion 1 week and 4,12 weeks after surgery in observation group were significantly higher than those in control group(P<0.05).The blood loss in observation group was significantly less than that in control group(P<0.05),the operative time and the length of hospital stay in observation group were significantly shorter than those in control group(P<0.05).The incidence of postoperative complications in observation group was significantly lower than that in control group(P<0.05).There was no significant difference in the levels of serum creatinine(SCr) and blood urea nitrogen(BUN) between the two groups before treatment(P>0.05).The levels of SCr and BUN 1 day and 7,14,21 days after surgery in observation group were significantly lower than those in control group(P<0.05).Conclusion The clinical application of percutaneous nephrolithotomy with holmium laser for complicated renal calculi can clear renal calculus completely,reduce surgical trauma,and promote the recovery of renal function.