标准通道经皮肾弹道超声碎石取石与微通道经皮肾气压弹道碎石取石术治疗肾鹿角形结石的疗效比较

目的比较标准通道弹道超声碎石取石与微通道经皮肾气压弹道碎石取石术治疗鹿角形肾结石的疗效。方法2004年6月～2010年6月，对129例肾鹿角形结石分别采用标准通道弹道超声碎石取石与微通道经皮肾气压弹道碎石取石术治疗，标准通道组61例，微通道组68例，比较2组手术时间、一期结石清除率和手术并发症等指标。结果标准通道组手术时间（92±22）min，显著少于微通道组（139±23）min（t=11．828，P=0．000）；标准通道组术后发热率为8．2％，显著低于微通道组26．5％（，=11．828，P=0．007）；标准通道组一期结石取净率52．5％（32／61），与微通道组51．5％（35／68）比较无统计学差异（X^2=0．013，P=0．911）。结论与微通道相比，标准通道治疗肾鹿角形结石具有手术时间短和术后发热率低等优点，有条件者可作为首选的治疗方法。

Comparison of Standard Channel Percutaneous Nephrolithotomy with Ultrasonic and Pneumatic Lithotripsy and Microchannel Percutaneous Nephrolithotomy with Pneumatic Lithotripsy in the Treatment of Staghorn Calculi

Objective To investigate the effect of ultrasonic and pneumatic lithotripsy through standard channel on staghorn calculi, as compared to pneumatic lithotripsy through microchannel. Methods From June 2004 to June 2010, a total of 129 patients suffering from staghorn calculi were treated in our hospital. Sixty one patients received standard channel procedure（ standard channel group） , while the other sixty eight patients received microchannel procedure （microchannel group）. Clinical data including operation time, first-stage stone clearance rate, and complications were compared. Results The operating time in standard channel group was （92±22） min, significantly less than that of microchannel group （139 ±23） min （t = 11. 828, P =0.000）; the postoperative fever rate in standard channel group was 8.2% , significantly less than that of microchannel group （26. 5% , X^2 = 11. 828 ,P = 0. 007 ） ; the first-stage stone clearance rate in standard channel group and microchannel group was 52.5 % （32/61） and 51.5% （35/68） respectively, and no statistical difference was observed between the two groups （X^2 = 0. 013, P = 0. 911 ）. Conclusions Compared with microchannel, standard channel procedure for staghorn calculi has shorter operation time, higher lithotripsy efficiency, and lower postoperative fever rate. Therefore, standard channel procedure is a priority for staghorn calculi.