标准通道与微通道经皮肾镜取石在肾结石患者中应用疗效的对照研究

Comparative study on micro-channel percutaneous nephrolithotomy and standard channel percutaneous nephrolithotomy on renal calculus

目的探究并分析微通道经皮肾镜取石术和标准通道皮肾镜取石术在肾结石患者中应用及效果。方法选择2010年12月～2011年12月陕西西电集团医院泌尿外科收治的肾结石患者100例,随机分为A组(50例)和B组(50例),A组患者给予微通道经皮肾镜取石术治疗,B组患者给予标准通道经皮肾镜取石术治疗。比较两组患者手术时间、术中出血量、下床活动时间、术后住院时间、术后住院费用、结石清除率和并发症发生率等临床指标。结果 B组患者手术时间[(60.47±8.64)min]和术中出血量[(73.36±12.27)mL]明显少于A组[(73.71±8.87)min、(95.94±15.63)mL],差异有统计学意义(P<0.05)。B组患者下床活动时间[(33.46±3.67)d]、术后住院时间[(2.26±0.28)d]、术后住院费用[(1837.26±225.65)元]明显少于A组[(51.71±3.81)d、(4.94±0.23)d、(2125.67±338.44)元],差异有统计学意义(P<0.05)。两组患者单发结石、多发结石清除率比较差异无统计学意义(P>0.05)。两组患者并发症发生率差异无统计学意义(χ2=0.543,P>0.05)。结论微通道经皮肾镜取石术治疗较小肾结石临床疗效确切,优于标准通道经皮肾镜取石术,具有手术所需时间短、术后住院时间和术后住院费用少等优点。

Objective To investigate the application effect on micro-channel percutaneous nephrolithotomy and standard channel percutaneous nephrolithotomy on renal calculus. Methods 100 patients with renal calculus treated in the Department of Urinary Surgery in Xidian Group Hospital in Shaanxi Province from December 2010 to December 2011 were collected and divided into group A （n = 50） and group B （n = 50）. Patients in group A were given micro- channel pereutaneous nephrolithotomy percutaneous nephrolithotomy, patients in group B were given standard channel percutaneous nephrolithotomy. The blood loss, the operation time, the bed activity time, the postoperative hospital stay, the postoperative hospitalization costs, the stone-free rate and complications were evaluated. Results The operation time, blood loss in group B [（60.47＋8.64） min, （73.36_＋12.27） mL] were lower than those in group A [（73.71_＋8.87） min, （95.94_＋15.63） mL], the differences were statistically significant （P 〈 0.05）. The bed activity time, the postoperative hospital stay, the postoperative hospitalization costs in group B [（33.46~3.67） d, （2.26i-0.28） d, （1837.26~225.65） yuan] were lower than those in group A [（51.71~3.81）d, （4.94＋0.23） d, （2125.67~338.44） yuan], the differences were statistically significant （P 〈 0.05）. The differences of clearance rate of single stone, multiple stones in the two groups were not statistically significant （P 〉 0.05）. The difference of complication occurrence rate in the two groups was not statistically significant （Xz = 0.543, P〉 0.05）. Conclusion The micrcv--channel pereutaneous nephrolithotomy percutaneous nephrolithotomy on the renal calculus can obtain satisfactory curative effect for patients with one renal calculus, and it has less operation time, less postoperative hospital stay and less postoperative hospitalization costs.