标准通道与微通道经皮肾镜取石术治疗肾结石的疗效对比

目的:探讨标准通道与微通道经皮肾镜取石(PCNL)对肾结石的疗效。方法:选择2010年1月～2011年12月,在钦州市第二人民医院泌尿外科治疗的肾结石患者176例,按随机数字表将其分为两组,两组均为88例。第一组(标准通道组)行经标准通道皮肾镜取石(SPCNL),第二组(微通道组)行微通道经皮肾镜取石(MPCNL)。比较和分析两组的手术时间和出血量、结石清除率、术后恢复及不良反应情况等。结果:MPCNL的平均手术时间和出血量分别为76.26±13.44min、和63.31±8.0 9ml,显著低于SPCNL组(P<0.05);SPCNL一次结石总清除率和单发结石清除率分别为77.27%和79.63%,与MPCNL组差异未达到显著水平(P>0.05),多发结石清除率和显鹿角结石清除率分别达到73.52%和62.50%显著高于MPCNL组(P<0.05);MPCNL组术后可下次活动和住院时间分别为(33.10±5.90)h和(4.00±1.40)d显著短于MPCNL组(P<0.05),而术后24h小时Hb和Scr水平分别为132.25±7.30(g/L)和95.67±16.49(umol/L),且显著高于MPCNL组(P<0.05);SPCNL和MPCNL术后总并发症率分别为31.82%和29.55%,两组差异未达到显著水平(P>0.05)。结论:标准通道与微通道经皮肾镜取石疗效显著,且各有优势,应根据患者和结石的具体综合考虑选择合适的通道经皮肾镜取石。

Clinical efficacy comparison of micro-channel and standard channel percutaneous nephrolithotomy in treatment of kidney calcui

Objective: To compare the clinical efficacy of micro-channel and standard channel percutaneous nephrolithotomy in the treatment of kidney calcui.Methods:A total of 176 kidney calcui patients hospitalized in our hospital from January 2010 to December 2011 were randomly selected and divided into two groups,each group had 88 cases.The first group(the standard channel group) underwent standard channel percutaneous nephrolithotomy(SPCNL),while the second group(the micro channel group) had micro channel percutaneous nephrolithotomy(MPCNL).Length of operation time and the bleeding volume,stone-free rate,postoperative recovery and the adverse reactions were compared and analyzed after treatment.Results:The average length of operation time and bleeding volume of the MPCNL group was(76.26 ± 13.44) min and(63.31±8.09) mL,significant lower than that of the SPCNL group(P<0.05).The total stone clearance and solitary stone clearance rates of the SPCNL group was 77.27% and 79.63%,the differences between two group did not achieve a significant level(P>0.05).while the multiple stones clearance rate and staghorn stone clearance rate of the SPCNL group was73.52% and 62.50%,both were significant higher than those of the MPCNL group(P<0.05).Length of hospital stay and mobility time of the MPCNL group was(33.10±5.90) h and(4.00±1.40) d,significantly shorter than that in the SPCNL group(P<0.05).The 24h hours Hb and Scr levels of the MPCNL group after treatment were(132.25±7.30) g/L and(95.67±16.49) umol/L,significant higher than that in the SPCNL group(P<0.05).The total postoperative complication rates of the SPCNL and MPCNL group was 31.82% and 29.55%,respectively,showing no significant difference(P>0.05).Conclusions: Both standard channel and micro channel percutaneous nephrolithotomy shows good effects in the treatment of kidney calcui with its own advantages,thus choice of the two should be based on status of patients and symptoms.