双通道经皮肾镜碎石治疗复杂性肾结石的疗效观察

Curative effect of double-tract percutaneous nephrolithotomy for complex renal calculus

目的:探讨标准通道联合微通道经皮肾镜取石术(micro channel percutaneous nephrolithotomy,MPCNL)治疗复杂性肾结石的临床疗效。方法:选择2012年1月至2012年12月我院收治的复杂性肾结石患者76例,随机分为大通道组38例,采用传统大通道经皮肾镜取石术(percutaneous nephrolithotomy,PCNL)治疗,双通道组38例,采用标准通道联合MPCNL治疗,比较两组的手术时间、术中出血量、一期结石取净率、术中并发症、下床活动时间、住院时间、伤口愈合时间、肾功能恢复时间。结果:双通道组手术时间、术中出血量明显少于单通道组(P<0.05);双通道组一期结石取净率明显高于单通道组(P<0.05),且并发症明显少于单通道组(P<0.05);双通道组患者下床活动时间、住院时间、伤口愈合时间、肾功能恢复时间均明显短于单通道组(P<0.05)。结论:标准通道PCNL联合MPCNL治疗复杂性肾结石效果良好,可有效地处理残留结石,减少了手术创伤,降低了并发症发生风险,提高了结石取净率和手术安全性,值得临床推广。

Objective：To investigate the clinical efficacy of treating complex renal calculus by standard channel combined with micro channel percutaneous nephrolithotomy （ MPCNL） .Methods：Seventy-six patients with complex renal calculus in our hospital between January , 2012 to December ,2012 were selected and randomly divided into big-tract group and double-tract group .There were 38 cases in big-tract group , they were treated with traditional big channel percutaneous nephrolithotomy percutaneous nephrolithotomy （ PCNL） .There were 38 cases in double-tract group, they were treated with standard tract combined with MPCNL .Operation time, bleeding during operation,stone clearance rate I phase,complications, ambulation time,hospitalization time, wound healing time, time of renal function recovery of two groups were compared .Results： The operation time, bleeding during operation of double-tract group were significantly less than those of big-tract group （ P〈0 .05 ）;the stone clearance rate I phase of double-tract group was significantly higher than that of big-tract group （ P 〈0.05 ） , and the complications were significantly less than big-tract group （P〈0.05）; the ambulation time, hospitalization time, wound healing time , time of renal function recovery of double-tract group were significantly shorter than those of big-tract group （ P〈0.05） .Conclusion：Treating complex renal calculus by standard-tract PCNL combined with MPCNL has good effect , it can effectively reduce the residual stones and operation trauma , reduce complication risk, improve stone clearance rate and operation safety , it is worth to be spreading .