标准通道辅助微通道经皮肾镜取石术在肾铸型结石治疗中的效果与安全性

Evaluation of efficacy and safety of standard channel with a micro-channel in the management of staghorn renal stone

目的评价标准通道辅助微通道经皮肾镜取石术治疗肾铸型结石效果和安全性。方法 78例经皮肾镜取石术患者,分为标准通道辅助微通道组(n=42)和双微通道组(n=36),对比分析两组碎石时间及结石清除率、手术时间、手术并发症。结果患者均Ⅰ期成功建立经皮肾通道,标准通道辅助微通道组手术时间为(71.69±13.83)min,明显短于双微通道组(95.20±14.51)min;结石清除率为90.5%,高于双微通道组69.4%,差异均有统计学意义(P<0.05);而两组术中出血量、术后住院时间比较,差异无统计学意义;标准通道辅助微通道组术后迟发持续性出血1例,术后发热4例;双微通道组术后迟发持续性出血1例,术后发热6例,患者经保守治疗后痊愈。结论与双微通道比较,标准通道辅助微通道缩短了手术时间,提高了结石清除率,治疗肾铸型结石安全有效。

OBJECTIVE To evaluate the efficacy and safety of standard channel with a micro-channel in management of staghorn renal stone. METHODS A total of 115 patients underwent percutaneous nephrolithotomy were divided into two groups ： standard channel with a micro-channel group （n= 42） and dual micro channel group （n=36）. The operation time, stone clearance rate and complications were compared between the two groups. RESULTS Percutaneous renal access was successfully established in all patients. The operation time of the standard channel with a micro-channel group was significar]tly shorter than that of the dual micro-channel group [（7i. 69 ± 13.83） min vs （95.20±14.51）rain, P〈0.05] and the stone free rate of the standard channel＇ with a micro-channel group was significantly higher than that of the dual micro-channel group（90.48% vs 69.44%, ：P〈0. 05）. Two groups showed no difference in amount of blood loss during operation, postoperative hospitalizatibn time. One case demonstrated late continued hemorrhage and six showed postoperative fever in the dual micro-channel group. CONCLUSION The standard channel with a micro-channel has obvious advantage in reducing operation time and improving stone clearance rate over the double micro channel, which is safe in the treatment of staghorn renal calculi.