经皮肾镜超声弹道碎石清石系统与气压弹道治疗肾结石效果比较

Comparative study of third generation Swiss LithoClast Master and pneumatic lithotripsy with percutaneous nephroscope in renal calculi

目的比较经皮肾镜超声弹道碎石清石系统与气压弹道治疗肾结石的临床疗效。方法回顾性分析2007年9月～2008年2月经皮肾镜(PCNL)联合第3代超声弹道碎石清石系统治疗肾结石36例的临床资料,并对照2006年1月～2007年8月微创经皮肾穿刺(MPCNL)气压弹道治疗肾结石41例的临床资料,比较两组患者的平均手术失血量、平均手术时间、平均结石处理时间及结石清除率的差异。结果两组的手术失血量分别为(89.5±13.4)mL和(104.2±15.1)mL,P>0.05;平均手术时间分别为(82.6±12.8)min和(136.7±15.3)min,P<0.05;平均结石处理时间分别为(51.5±10.6)min和(101.7±8.9)min,P<0.05;一期结石清除率分别为86.4%(38/44)和66.1%(34/52),P<0.05。结论两种方法治疗肾结石具有同等安全性,但PCNL超声弹道碎石清石系统明显减少手术时间和提高结石清除率,临床效果优于气压弹道。

[Objective] To compare the clinical efficacy of percutaneous nephrolithotomy （PCNL） using third gen, eration Swiss LithoClast Master and minimally invasive pereutaneous nephrolithotomy （MPCNL） with pneumatic lithotripsy in renal calculi. [Methods] From Sep 2007 to Feb 2008,36 patients who underwent PCNL by using third generation Swiss LithoClast Master for renal calculi （EMS group） were analyzed retrospectively. As a contrast, 41 patients performed by MPCNL with pneumatic lithotripsy for renal calculi （pneumatic lithotripsy group） were investigated from Jan 2006 to Aug 2007. Clinical data including the average blood loss volume, the average time for whole surgery, the average time for stone management, and the phase I stone-free rate were made comparisons in the two groups,respectively. [Results] The average blood loss volume was （89.5±13.4） mL and （104.2±15.1） mL （P 〉0.05）, the average time for whole surgery was （82.6±12.8） min and （136.7±15.3） min （P 〈0.05）, the average time for stone management was （51.5±10.6） min and （101.7±8.9） rain （P 〈0.05）, and the phase I stone-free rate was 86.4% and 66.1% （P 〈0.05） in the EMS group and pneumatic lithotripsy group, respectively. [Conclusion] PCNL by using third generation Swiss Litho Clast Master is as a safe procedure as MPCNL with pneumatic lithotripsy for the treatment of renal calculi, and the former is more effective in both saving the surgical time and increasing the stone-free rate than the latter.