既往结石干预对微创经皮肾镜碎石术的影响

目的：探讨既往开放取石术、经皮。肾镜碎石术和ESWL对微创经皮肾镜碎石术（mini—PcNL）的影响。方法：收集2002年7月～2006年10月收治的885例1156例次接受mini—PCNL术患者的临床资料。将患者分为四组：既往行开放取石术组（A组）、经皮肾镜术组（B组）、单纯ESWL组（C组）、无结石干预史组（D组）。对比分析各组手术时间、结石清除率、出血量、输血率、平均住院日及并发症。结果：各组最终结石清除率未见明显差异（X^2=0．584，p=0．900）。A组的出血量为（10．5±9．3）g／L，明显低于其他各组（F=12．879，P〈0．001）。各组手术时间、平均住院日差别无统计学意义（P〉0．05）。各组输血率、并发症也未见明显差别。结论：有既往结石干预史的患者行miniPCNL是安全、有效的。

The Impact of Previous Intervention of Renal Calculi on Mini-Percutaneous Nephrolithotomy

Objective：To investigate the impact of previous intervention of renal calculi such as open nephrolithotomy, percutaneous nephrolithotomy（PCNL） and ESWL on mini-percutaneous nephrolithotomy. Methods： 1 156 mini-PCNL procedures in 885 patients at our institute from July 2002 to October 2006 were reviewed. Patients were divided into 4 groups, previously undergone open nephrolithotomy （A group）, PCNL （B group）, ESWL （C group） and had no intervention of stone （D group）. The operative time, stone clearance rate, blood loss, transfusion rate, average length of stay and complications were comparatively analyzed. Results： The overall stone-free rates did not differ significantly between 4 groups （X^2=0. 584, P = 0. 900）. The average hemoglobin of group A was （10. 5±9. 3）g/L, was significantly lower than other groups（F=12. 879,P〈0. 001）. The operative time and hospital stay did not differ significantly between 4 groups （P〉0.05）. The blood transfusion rate and complications did not differ significantly between 4 groups （P〉0. 05）. Conclusions：Mini percutaneous nephrolithotomy is effective and safe in patients who have previous intervention of renal calculi.