mPCNL双通道和单通道两期取石治疗复杂性肾结石的疗效比较

Comparison the Efficacy of Bi-channel in One-stage and Single Channel in Two-stage of Minimally Invasive Percutaneous Nephrolithotomy for Complicated Renal Calculi

目的:比较微创经皮肾镜取石术(mPCNL)双通道取石和单通道两期取石治疗复杂性肾结石的疗效和安全性。方法:对57例复杂性结石患者,31例行双通道一期取石(双通道组),26例行单通道两期取石(单通道组)。结果:双通道组术中出血75～262.5 ml,平均146.4 ml;单通道组75～300ml,平均154.3 ml,差异无统计学意义。双通道组手术时间65～136 min,平均88.4 min;单通道组70～180 min,平均123.1 min,差异有统计学意义(P<0.05)。双通道组净石率为83.9%(26/31);单通道组为57.8%(15/26),差异有统计学意义(P<0.05)。结论:经双通道取石较单通道两期取石手术时间短,结石取净率高,患者住院时间短,治疗费用低,是治疗复杂性肾结石的一种理想方法。

Objective：To investigate the effect and safety of the bi channel in one-stage of minimally invasive pereutaneous nephrolithotomy （mPCNL） in management of complicated renal calculi, compared with single channel in two-stage of mPCNL. Methods： 57 patients underwent mPCNL in treatment of complicated renal calculi were retrospectively reviewed. 31 cases in group A underwent bi channel in one-stage of mPCNL; 26 cases in group B underwent single channel in two stage of mPCNL. Results：The mean bleeding in the group A was 146.4 ml（75- 262.5 ml）, compared with the group B 154.3 mi（75-300 ml）, there was no statistically difference between the two groups （P〉0.05）. The mean operation time in the group A was 88.4 rain（65-136 min）, compared with the group B 123. 1 min（70 180 min）, there was statistically difference between them（P〈0.05）. Compared of the clearance rate of stone in the group A 83.9%（26/31） and B 57.8%（15/26）, there was statistically difference between them （P〈0.05）. Conclusions： According the treatment of complicated renal calculi, the hi-channel in onestage of mPCNL has shorter operation time, higher clearance rate of stone, compared with single channel in twostage of mPCNL. The patients need less expenses and shorter time staying in hospital. It is an ideal method.