经皮肾镜钬激光碎石与超声气压弹道碎石清石系统治疗肾结石的临床对比研究

目的 探讨经皮肾镜钬激光与EMS超声气压弹道碎石清石系统治疗肾结石的疗效及并发症.方法 回顾性分析我院2009年2月至2010年8月收治的80例肾结石患者临床资料,其中38例行经钬激光碎石,42例行EMS超声气压弹道碎石治疗,比较经皮肾镜钬激光与EMS超声气压弹道碎石治疗肾结石的疗效及并发症发生情况.结果 钬激光组结石清除率89.5％(34/38)、一期碎石成功率97.4％(37/38),研究组结石清除率为83.3％ (35/42)、一期碎石成功率为95.2％(40/42),组间差异均无统计学意义(P＞0.05)；研究组患者的手术时间为(2.5±1.1)h,明显短于钬激光组[(3.1±0.9)h,P＜0.05].钬激光组有1例合并术后感染,研究组1例术后出血,其余均未发生其他严重并发症.结论 经皮肾镜钬激光治疗肾结石与EMS超声气压弹道碎石清石系统治疗肾结石均具有较好的治疗效果,是治疗肾结石的较好手术方法.

Stone-crushing using YAG Laser and ultrasonic pneumatic lithotripsy under percutaneous nephrolithotomy for the treatment of kid calculi

Objective To discuss the treatment effect of stone-crushing using YAG laser and ultrasonic pneumatic lithotripsy in the treatment of kid calculi. Methods The clinical data of 80 patients with kidney stones who were treated in our hospital from February 2009 to August 20i0 were retrospectively analyzed. 38 cases received holmium laser lithotripsy and the 42 cases received ultrasonic pneumatic lithotripsy therapy. The efficacy and the complications of the two groups were observed. Results The stone clearance rate of holmium laser group was 89. 5% （34/38） and gravel success rate was 97.4% （37/38）. The stone clearance rate of study group was 83.3% （35/42） and gravel success rate was 95.2% （40/42） ; there was no significance difference between the two groups （ P 〉 0. 05）. The treatment time of study group was （2. 5 ＋ 1.1 ） h, which was shorter than that of the holmium laser group （3. 1 ＋0. 9）h（ P 〈0. 05）. One case had postoperative infection in holmium laser group and one case had postoperative hemorrhage in ultrasonic pneumatic lithotripsy group. No other severe complications happened. Conclusion Both YAG laser and ultrasonic pneumatic lithotripsy under percutaneous nephrolithotomy have good treatment effect and they are good operation methods in the treatment of kid calculi.