经皮肾镜取石术和开放手术治疗鹿角形肾结石的疗效比较

A comparative study of percutaneous nephrolithotripsy and open operation for staghorn nephrolithiasis

目的:比较经皮肾镜取石术(percutaneous nephrolithotripsy,PNL)和开放手术治疗鹿角形肾结石的疗效。方法:2003年1月-2011年5月我院对102例鹿角形肾结石分别采用开放手术(n=48)和PNL(n=54),比较2组术中、术后情况。结果 :PNL组的手术时间(73.6±14.8)min明显短于开放手术组(146.7±18.2)min(P<0.05);PNL组的术中出血量(84.7±26.7)ml明显少于开放手术组(287.1±48.6)ml(P<0.05);PNL组的下地活动时间(3.2±0.6)d明显短于开放手术组(20.7±1.8)d(P<0.05);PNL组的肠功能恢复时间(6.8±1.1)h明显短于开放手术组(40.5±6.6)h(P<0.05);PNL组的术后住院时间(4.2±1.6)d明显短于开放手术组(14.3±2.8)d(P<0.05)。结论:与开放手术相比,PNL具有创伤小、出血少、恢复快等优点,为鹿角形肾结石提供了微创手术的新方式。

Objective：To investigate the efficacy of percutaneous nephrolithotripsy（PNL） and open surgery for staghorn nephrolithiasis.Methods： From January 2003 to May 2011,we underwent open surgery（n=48） and PNL（n=54） for 102 patients with staghorn nephrolithiasis.The procedure was compared in and after the operation.Results： The operation time in PNL（73.6±14.8） min was obviously shorter than open surgery（146.7±18.2）min（P0.05）;The blood loss in PNL（84.7±26.7） ml was obviously less than that in open surgery（287.1±48.6）ml（P0.05）;The post-operation activities in PNL（3.2±0.6） d was obviously shorter than open surgery（20.7±1.8） d（P0.05）;The recovery time of gastro-intestinal function in PNL（6.8±1.1） h was obviously shorter than open surgery（40.5±6.6） h（P0.05）;The post-operation hospital stay in PNL（4.2±1.6） d was obviously shorter than open surgery（14.3±2.8） d（P0.05）.Conclusion： Comparing with open surgery,PNL has less trauma,less blood loss and quicker recovery.The PNL is a new mini-invasive method to staghorn nephrolithiasis.