经皮肾镜下两种碎石术治疗巨大肾结石的疗效比较

The comparison of curative effect of minimally invasive percutaneous nephrolithotomy in two lithotripsy

目的 比较经皮肾镜下超声碎石清石术与钬激光碎石术治疗巨大肾结石的临床疗效.方法 120例巨大肾结石按治疗方法 不同,分为超声碎石清石术组（A组）60例、钬激光碎石术组（B组）60例,观察两组手术时间、血红蛋白下降、输血率、术后住院时间、结石清除率等差异.结果 A组手术时间（60.8±16.4）min、术后住院时间（7.5±2.0）d均低于B组[（80.5±18.5）min、（9.5±2.5）d]（t=2.328、2.240,均P＜0.05）;A组血红蛋白下降发生率（5.0%）低于B组（9.0%）（x2=3.89,P＜0.05）,结石清除率（81.7%）高于B组（61.6%）（x2=3.98,P＜0.05）;两组输血率差异无统计学意义（x2=1.86,P＞0.05）;A组术后并发症发生率（10.0%）与B组（13.3%）差异无统计学意义（x2=1.56,P＞0.05）.结论 经皮肾镜下超声碎石清石术具有手术时间短、术中出血少、清石效率高等优点.

Objective To compare the efficacy of minimally invasive pereutaneous nephrosomy for complicated renal calculi between holimium laser hthotfipsy and ultrasonic lithotripsy.Methods 120 patients with renal calculi according to the different treatment methods,were divided into holimium laser lithotfipsy group 60 cases（group A）and tdtrasonic lithotripsy group 60 cases（group B）.The index of operative time、hemoglobin drop blood transfusion rate、postoperative hospital stay、stone clearance rate were observed.Results Operative time（60.8±16.4）min,postoperative hospital stay（7.5±2.0）d in group A were shorter than[（80.5±18.5）min,（9.5±2.5）d]in group B （t=2.328,2.240,all P＜O.05）;Hemoglobin decline（5.0%）in group A was lower than the（9.0%）in group B （x2=3.89,P＜0.05）;Calculi clearance rate（81.7%）in the B group was highter than that（61.6%）in group B （x2=3.98,P＜0.05）;Complication incidence of postoperative 10.O%in group A compared with group B 13.3%had no significant difference（x2=1.56,P＞0.05）.Conclusion Percutaneous nephrostomy with ultrasonic lithotripter for complicated renal calculi had the advantages of mini-invasion,less operative time,less bleeding,and faster clearance calculi efficiency compared with laser lithotripsy.