单通道与双通道经皮肾镜取石术治疗复杂性肾结石的疗效对比

目的：对比单通道与一期双通道行经皮肾镜取石术（PCNL）治疗复杂性肾结石的安全性及治疗效果。方法：将我院在2014年7月～2015年7月收治的肾结石患者进行筛查，共获得84例复杂性肾结石患者，按编号依次归入单通道组、双通道组。所有患者均在彩超引导下行 PCNL，将两组患者的手术时间、结石清除率、术后住院时间进行对比，比较治疗效果的差异；将两组患者术中及术后并发症发生率、出血量进行对比，比较安全性的差异。结果：84例患者均顺利完成手术，并发症发生率均为9.52%。双通道组术后结石清除率88.10%明显高于单通道组66.67%，而手术时间、术中出血量、术后住院时间二组无明显差异。结论：单通道 PCNL 治疗复杂性肾铸型结石术后残石率较双通道高，往往需要二期手术。双通道治疗复杂性肾结石能明显提高结石清除率，出血量及术后并发症并没有增加，可作为复杂性结石、特别是结石长径大于等于5cm 的全铸型结石的首选治疗方式。

Single and dual channel percutaneous nephrolithotomy compare the efficacy of the treatment of complex renal calculi

Objective To compare the single and a dual-channel downstream of percutaneous nephrolithotomy lithotripsy(PCNL)safety and therapeutic effect of the treatment of complex renal calculi. Methods July 2014 - July 2015, the kidney stone patients in our hospital, screening, received a total of 84 cases of patients with complex renal calculi, classified by number followed by a single channel group, dual-channel group. All patients underwent PCNL under ultrasound guidance, the two groups were operative time, stone clearance rate, postoperative hospital stay were compared difference, compare the therapeutic effect; the two groups of patients intraoperative and postoperative complications, hemorrhage comparing the amount, comparing security differences. Results 84 patients were successfully operated, the complication rate was 9.52%. Postoperative stone clearance rate of dual-channel group is 88.10%, it exceeds Single channel group(66.67%). Operation time blood loss of two groups is No obvious difference. Conclusion Single channel PCNL treatment of complicated renal calculi mold postopera-tive residual stone rate higher dual channel often required two surgeries. Dual Treatment of complex renal stone clearance rate can significantly increase the amount of bleeding and postoperative complications did not increase, as the complexity of the stones, especially stones long diameter greater than the preferred treatment equal to the full casting stones of 5cm.