经皮肾取石术中钬激光与气压弹道的疗效比较

A comparative study of pneumatic lithotripsy and holmium laser lithotripsy in percutaneous nephrolithotomy

目的 比较钬激光碎石术（LL）与气压弹道碎石术（PL）在经皮肾穿刺取石术（PCNL）中的疗效和安全性.方法 128例肾结石患者,其中采用PL治疗49例,采用LL治疗79例.结果 LL组在手术时间、术中出血量、术后住院时间和并发症发生率方面均低于PL组（P〈0.05）,分别为（72.4±2.3）min与（100.5±1.9）min,（75.8±5.3）ml与（91.4±4.3）ml,（5.1±1.2）d与vs（8.2±1.1）d,1.3% 与10.2%；LL组一次碎石成功率则高于PL组,LL为92.1%,PL为71.2%（P〈0.05）.结论 LL的疗效和安全性优于PL,在PCNL中更适合,更安全和高效.

Objective To compare the efficacy and safety of pnumatic lithotripsy（PL） and laser iithotripsy（LL） in percutaneous nephrolithotomy （PCNL）. Methods From Feb. 2006 to Dec. 2008,128 consecutive patients underwent PCNL either with the Swiss Lithoclast PL（49 cases）or with Ho：YAG LL （79 cases）for the treatment of renal stones in our hospital. Results The average operative time and postoperative stay of LL were shorter than those of Pl,（ 82.4 ±2.3 ） rain vs （94.5 ±1.9） rain, （5. 1±1.2） d vs （8.2 ±1. 1 ） d, P 〈 0.05 ）. The average operative blood loss and complication incidence were lower in LL（75.8±5.3）ml vs（91.4±4.3）ml,1. 3% vs 7.4% ,P 〈0.05）. The average successful rate of stone fragmentation was higher in PL （92. 1% vs 71.2% , P 〈 0.05 ）. Conclusions LL is superior to PL in terms of high efficiency of stone fragmentation and low complication rate and is an effective and safe treatment modality in PCNI,.