经皮肾镜取石术与开放性手术治疗肾结石的疗效比较分析

The comparative analysis of the efficacy of percutaneous nephrolithotomy with open surgery in the treatment of kidney stones

目的：比较经皮肾镜取石术与开放性手术治疗肾结石的临床效果。方法回顾性分析2010-01～2012-01该院肾结石患者的临床资料，将行经皮肾镜取石术的30例患者作为观察组，其余行开放性手术治疗的30例患者作为对照组，比较两组的结石清除率、手术时间、下床活动时间、术中出血量、并发症等疗效指标。结果观察组结石清除率为90.0％（27/30），对照组为66.7％（20/30），观察组结石清除率明显高于对照组（P＜0.05），术后两组患者恢复均较好。观察组术中出血量显著少于对照组（P＜0.01），术后下床活动时间亦明显快于对照组（P＜0.01），但观察组的手术时间明显长于对照组（P＜0.01）。两组并发症发生率分别为10.0％和33.3％，差异有统计学意义（ P＜0.05）。结论经皮肾镜取石术与开放性手术治疗肾结石的疗效比较具有较大的优势，可以减少出血量，降低并发症的发生率，有利于提高治疗效果，值得临床推广应用。

Objective To compare the clinical outcome of percutaneous nephrolithotomy （ PCNL） and open surgery in the treatment of kidney stones .Methods A retrospective analysis was performed of the clinical data in pa-tients with kidney stones in the hospital from January 2011 to January 2012 .Among them , 30 patients in the observa-tion group underwent PCNL;30 patients in the control group underwent open surgery for removing kidney stones .The stone clearance rate, operative time, ambulation time, blood loss, complications were compared between two groups . Results The stone clearance rate of the observation group was 90.0%（27/30）.The stone clearance rate of the con-trol group were 66.7%（20/30）, postoperative patients in both groups had better recovery , but the observation group were significantly superior to the group in stone clearance rate , the difference was statistically significant （ P〈0.05 ） . The blood loss of the observation group was significantly less than that of the control group , postoperative ambulation time of observation group was significantly shorter than that of the control group , the difference was significant （ P〈0.05 ） , but the operative time of observation group was significantly longer than that of control group （ P〈0.05 ） .The complication rate of observation group and the control group was 10.0%, 33.3%respectively , the difference was sig-nificant（P 〈0.05）.Conclusion Compared with open surgery, PCNL have greater advantages, can reduce the a-mount of bleeding , reduce the incidence of complications , improve the therapeutic effect , and it is an ideal treatment for kidney surgical stones , should be popularized and applied .