微通道钬激光与标准通道气压弹道联合超声碎石治疗肾结石的疗效比较

目的：评价微通道（F16～18）钬激光与标准通道（F22）气压弹道联合超声碎石治疗肾结石的疗效.方法：用临床对照研究分析2003年3月～2009年6月经微通道钬激光与标准通道气压弹道联合超声碎石治疗1120例肾、肾输尿管结石患者的临床资料,分析比较两组的疗效及并发症.结果：微通道经皮肾镜钬激光碎石取石术治疗组710例,标准通道经皮肾镜气压弹道联合超声碎石取石术治疗组410例.结石清除率分别为：94.6%与95.9%,差异无统计学意义（P〉0.05）,并发症发生率分别为：32%与33.2%,差异无统计学意义（P〉0.05）,平均碎石取石时间分别为（84±43）min与（56±21）min,差异有统计学意义（P〈0.01）.结论：两种方法的结石清除率、并发症发生率无显著性差异,均是微创、高效的碎石方法.两种通道严重出血、感染发生率无显著性差异.标准通道气压弹道联合超声碎石清石效率优于微通道钬激光碎石.

Comparison of Percutaneous Nephrostolithotomy Curative Effect Between Microchannel and Normochannel

Objective： Evaluation the efficacy of micro-channel （F16-18 ） holmium laser and standard channel （F22） pneumatic and ultrasonic lithotripsy for kidney stones. Methods： 1 120 patients （710 microehannel F16-18 by holmium laser and 410 normochannel F22 by Swiss Litho Clast Master） were treated with percutaneous nephrolithotomy. Clinical data including curative effect and complication were retrospective analyzed between 2003 and 2009. Results： Microchannel percutaneous nephroscopic lithotripsy with holmium laser group had 710 cases , standard channel percutaneous nephroscopic lithotripsy pressure ballistic combined treatment group had 410 cases . The total stone clearance rate was 94.6%0 and 95.9% in the two groups respectively,and the rate of complication was 32 % and 33.2% respectively between microchannel and normochannel, both were insignificant difference between microchannel and normochannel （P〉0.05）, the operation time of calculi clearance was 84±43 min and（56 ±21） rain respectively,and there is significant difference between microchannel and normochannet （P〈0. 01）. Conclusions： Less invasiveness and high-performance were proved in PNL between microchannel and normoehannel, normochannel PNL by Swiss Litho Clast Master have an advantage in efficiency of calculi clearance.