B超引导下经皮肾镜双导管碎石术与气压弹道联合超声碎石术治疗鹿角形肾结石的疗效比较

目的: 评价B超引导下经皮肾镜Cyberward双导管碎石术和气压弹道联合超声碎石术对于鹿角形肾结石的疗效。方法: 前瞻性地将138例鹿角形肾结石患者随机分成双导管组(A组,n=71)和弹道联合超声组(B组,n=67)。比较两组间术前资料、手术时间、出血量、住院时间、住院费用、并发症。结果: 两组均成功建立通道并且行一期碎石,术前两组间结石大小、年龄构成、合并症等均未见差别。术中碎石时间A组明显短于B组(77.14±21.39)vs(84.25±20.62)mL,P=0.049],术中出血量以及术后诸指标差异无统计学意义。两组一期结石清除率分别为67.6%和70.1%,差别无统计学意义(P=0.854)。结论: 两种碎石方法对于鹿角形肾结石均安全有效。双导管碎石术更加高效,操作更简单。

Comparison of Cyberwand dual probe lithotriptor and Swiss lithoclast master in ultrasonically guided percutaneous nephrolithotomy for renal staghorn calculi

Objective: To evaluate and compare the efficiency and safety of Cyberwand dual probe lithotriptor and Swiss lithoclast master in percutaneous nephrolithotomy for renal staghorn calculi. Methods: A total of 138 patients with renal staghorn calculi were divided randomly into a Cyberwand dual probe lithotripter group (Group A, n=71) and a Swiss lithoclast master group(Group B, n=67). The data for operative time, blood loss volume, one-stage calculus clearance rate, hospitalization time, cost of hospitalization and complication in the two groups were collected and compared. Results: The renal access was established successfully and the one-stage percutaneous nephrolithotomy (PCNL) was performed in the 2 groups. There was no significant difference in the size of stones, the age of patients and the complications between the 2 groups before the operations. Intraoperative gravel time in the Group A was significantly shorter than that in the Group B (77.14±21.39 vs 84.25±20.62, P=0.049). There was no significant difference in the one-staged stone clearance rate, blood loss volume in the operation between the 2 groups. The one-staged stone clearance rate in the 2 groups were 67.6% (48/71) and 70.1% (47/67) respectively, with no significant difference (P=0.854). Conclusion: Two lithotrities were safe and efficient for renal staghorn calculi. But comparing with Swiss lithoclast master, Cyberwand dual probe lithotriptor is more efficient and convenient.