双通道经皮肾镜碎石治疗复杂性肾结石的疗效观察

目的：探讨标准通道联合微通道经皮肾镜取石术（ micro channel percutaneous nephrolithotomy ， MPCNL）治疗复杂性肾结石的临床疗效。方法：选择2012年1月至2012年12月我院收治的复杂性肾结石患者76例，随机分为大通道组38例，采用传统大通道经皮肾镜取石术（ percutaneous nephrolithotomy ，PCNL）治疗，双通道组38例，采用标准通道联合MPCNL治疗，比较两组的手术时间、术中出血量、一期结石取净率、术中并发症、下床活动时间、住院时间、伤口愈合时间、肾功能恢复时间。结果：双通道组手术时间、术中出血量明显少于单通道组（P＜0．05）；双通道组一期结石取净率明显高于单通道组（P＜0．05），且并发症明显少于单通道组（ P＜0．05）；双通道组患者下床活动时间、住院时间、伤口愈合时间、肾功能恢复时间均明显短于单通道组（ P＜0．05）。结论：标准通道PCNL联合MPCNL治疗复杂性肾结石效果良好，可有效地处理残留结石，减少了手术创伤，降低了并发症发生风险，提高了结石取净率和手术安全性，值得临床推广。

Curative effect of double-tract percutaneous nephrolithotomy for complex renal calculus

Objective：To investigate the clinical efficacy of treating complex renal calculus by standard channel combined with micro channel percutaneous nephrolithotomy （ MPCNL） .Methods：Seventy-six patients with complex renal calculus in our hospital between January , 2012 to December ,2012 were selected and randomly divided into big-tract group and double-tract group .There were 38 cases in big-tract group , they were treated with traditional big channel percutaneous nephrolithotomy percutaneous nephrolithotomy （ PCNL） .There were 38 cases in double-tract group, they were treated with standard tract combined with MPCNL .Operation time, bleeding during operation,stone clearance rate I phase,complications, ambulation time,hospitalization time, wound healing time, time of renal function recovery of two groups were compared .Results： The operation time, bleeding during operation of double-tract group were significantly less than those of big-tract group （ P〈0 .05 ）;the stone clearance rate I phase of double-tract group was significantly higher than that of big-tract group （ P 〈0.05 ） , and the complications were significantly less than big-tract group （P〈0.05）; the ambulation time, hospitalization time, wound healing time , time of renal function recovery of double-tract group were significantly shorter than those of big-tract group （ P〈0.05） .Conclusion：Treating complex renal calculus by standard-tract PCNL combined with MPCNL has good effect , it can effectively reduce the residual stones and operation trauma , reduce complication risk, improve stone clearance rate and operation safety , it is worth to be spreading .