不同通道建立方式在经皮肾镜碎石术患者中的应用价值比较

A comparison of application value of different channel setup ways in percutaneous nephroscope lithotripsy

目的探讨不同通道建立方式经皮肾镜碎石术治疗肾结石的安全性及有效性。方法选取2011年1月—2013年1月该院收治的80例肾结石患者为研究对象,随机分为观察组和对照组各40例,对照组采用微通道经皮肾镜碎石术进行治疗(MPCNL),观察组采用标准通道经皮肾镜碎石术进行治疗(PCNL),比较两组患者的手术时间、结石清除率、住院时间、并发症等。结果观察组和对照组的一期结石清除率分别为92.5%和90.0%、住院天数分别为(5.7±1.3)d和(5.3+1.1)d、血红蛋白下降值分别为(9.5±3.2)g·L-1和(10.5±3.3)g·L-1、灌注液用量分别为(18.7±1.7)L和(17.9±1.3)L,两组比较差异均并无统计学意义(P>0.05);观察组和对照组的平均手术时间分别为(112.5±13.5)min和(90.3±15.6)min、出血量分别为(54.3±14.7)mL和(103.1±64.7)mL,并发症发生率分别为5.0%和12.5%,两组比较差异显著(P<0.05)。结论微通道及标准通道经皮肾镜碎石术在治疗肾结石中各有优势,均具有较好的临床疗效,而微通道出血少、并发症发生率低,更为安全,值得在临床上推广应用。

Objective To explore the safety and efficacy of different channels setup ways of percutaneous nephroscope lithotripsy in treatment of kidney stones. Methods Eighty cases of kidney stones patients in our hospital from January 2011 to January 2013 were selected as the research object. They were divided into observation group and control group randomly with 40 cases in each group. Patients in control group were given the treatment of the microchannel percutaneous nephroscope lithotripsy（ MPCNL）. while patients in observation group were given the treatment of the standard channel percutaneous nephroscope lithotripsy（ PCNL）. The operation time, stone clearance rate,length of hospital stay,complications of patients in two groups were compared. Results The first stone clearance rate of observation group and control group were 77. 5% and 75. 0% respectively. The hospitalization days were（ 5. 7 ± 1. 3） d and（ 5. 3 ± 1. 1） d respectively. The decreased hemoglobin values were（ 9. 5 ± 3. 2） g·L-1and（ 10. 5 ± 3. 3） g·L-1respectively. The dosage of perfusion fluid were（ 18. 7 ± 1. 7） L and（ 17. 9 ± 1. 3） L respectively. There was no statistically significant difference between 2 groups（ P ＆gt; 0. 05）. The average operation time of observation group and control group were（ 112. 5 ± 13. 5） min and（ 90. 3 ± 15. 6） min respectively. The blood loss were（ 54. 3 ± 14. 7） mL and（ 103. 1 ± 64. 7） mL respectively,yhe complication rates were 5. 0% and 12. 5% respectively. There was a significant difference（ P ＆lt; 0. 05） between two groups. Conclusions The microchannel and the standard channel percutaneous nephroscope lithotripsy in the treatment of kidney stones each has advantages,and both have a good clinical efficacy,but the microchannel leads to less bleeding,low complication rate and more safety,which is worthy of popularization and application in clinic.