微创经皮肾镜取石术治疗泌尿系统结石的临床疗效及安全性分析

Effects and safety of minimally invasive percutaneous nephrolithotomy lithotomy in the treatment for urinary stones

目的观察微创经皮肾镜取石术治疗泌尿系统结石的效果及安全性。方法选择我院2009年3月至2011年5月泌尿科的泌尿系结石患者200例,随机分为2组。观察组采用微创经皮肾镜取石术治疗,对照组采用传统开腹手术治疗。对比两组术中出血量、手术时间、住院时间与术后恢复情况(首次如厕时间、首次下床时间)、结石取净率以及术后并发症发生率。结果两组患者的术中出血量、手术时间、住院时间与术后恢复情况比较,差异有统计学意义(P<0.05);观察组结石取净率明显高于对照组,术后并发症发生率明显低于对照组(P<0.05)。结论微创经皮肾镜取石术具有创伤小、出血少、恢复快、取石率高等优点,值得泌尿科广泛应用。术前积极控制原发病,积极抗感染治疗,术中注意降低肾盂内压,预防细菌逆行,术后严密观察引流管的通畅与脱落等情况,可以有效降低微创经皮肾镜取石术并发症发生率。

Objective To observe the clinical effects and safety of minimally invasive percutaneous nephrolithotomy lithotomy in the treatment for urinary stones.Methods 200 cases of urinary stones patients in the urology oepartment of our hospital from March 2009 to May 2011 were selected and randomly divided into 2 groups.Observation group was given minimally invasive percutaneous nephrolithotomy lithotomy treatment; control group was given conventional laparotomy treatment.Blood loss,operative time,hospital stay and postoperative recovery （the first time going to the toilet in time,get out of bed time for the first time）,stones removal rate as well as the incidence of postoperative complications of the two groups were compared.Results There were significant differences in the blood loss,operative time,hospital stay and postoperative recovery between the two groups（P ＜ 0.05）.The stone removal rate of observation group were significantly higher than that of control group,and the incidents of postoperative complications were significantly lower than those of control group （P ＜ 0.05）.Conclusion The minimally invasive percutaneous nephrolithotomy lithotomy has the advantages of less trauma and bleeding,faster recovery,higher stone removal rate,and it is worthy of clinical promote application.The preoperative active control of the primary disease,positive anti-infection treatment,intraoperative attention to reduce the intrapelvic pressure,prevention of bacterial retrograde drainage tube patency and shedding after close observation,can effectively reduce the minimally invasive percutaneous nephrolithotomy lithotomy concurrent disease incidence.