经皮肾镜取石术和开放手术治疗鹿角形肾结石的疗效及安全性比较

Comparison on the Efficacy and Safety of Percutaneous Nephrolithotomy and Open Surgery in Treating Staghorn Calculi

目的比较分析经皮肾静取石术与开放手术治疗鹿角形肾结石的疗效及安全性。方法选取2010年2月至2012年2月新疆医科大学第二附属医院收治的鹿角形肾结石患者86例,按手术方式不同分为两组:开放手术组(40例)行开放手术治疗,经皮肾镜取石术组(46例)行经皮肾镜取石术治疗,对比分析两组患者的临床疗效及安全性。结果经皮肾镜取石术组患者的手术时间、术中出血量、肠功能恢复时间、术后住院时间均明显地低于开放手术组患者(P<0.05);经皮肾镜取石术组结石清除显著地高于开放手术组率(89.13%vs 70.00%),而输血率、并发症发生率则显著地低于开放手术组(2.17%vs 15.00%;4.35%vs 20.00%)(P<0.05)。结论与开放手术相比,采用经皮肾镜取石术治疗鹿角形肾结石疗效佳,安全性好,且对患者的创伤小,术中出血量少,患者恢复较快。

Objective To compare the efficacy and safety of percutaneous nephrolithotomy （PCNL） and open surgery in treating staghorn calculi. Methods A total of 86 cases of patients with staghorn calculi admitted in the Second Affiliated Hospital of Xinjiang Medical University from Feb. 2010 to Feb. 2012 were divided into two groups according to the surgical approaches：patients in the control group （40 cases） were treated with open surgery, patients in the observation group （46 cases） were treated with PCNL, the clinical efficacy and safety were compared between the two groups. Results The operative time, amount of intraoperative blood loss,intestinal function recovery time, andpostoperative hospitalization duration of the observation group were significantly lower than those of the control group （ P 〈 0.05 ） ; the stone clearance rate of the observation group was 89.13% ,significantly higher than 70.00% of the control group ,while the transfusion rate and incidence of complications of the observation group were 2.17% and 4.35% ,significantly lower than 15.00% and 20.00% of the control group （ P 〈 0.05 ）. Conclusion Compared with open surgery, PCNL in the treatment of staghorn calculi has better effect and security, with less intraoperative blood loss and recovery time.