B超与X线定位微创经皮肾取石术治疗上尿路结石的随机对照研究

The Randomized Controlled Study of B-ultrasound and X-ray Locating Minimally Invasive Percutaneous Nephrolithotomy in Treatment of Urinary Tract Stones

目的:比较B超与X线定位微创经皮肾取石术治疗上尿路结石的临床疗效。方法:选取2010年3月到2012年9月我院收治的上尿路结石患者190例,按照随机数字表法将患者分为研究组和对照组,每组95例;对照组给予X线定位微创经皮肾取石术,研究组给予B超定位微创经皮肾取石术治疗,两组再分为肥胖组和正常体型组;比较各组结石清除率、手术时间、术中出血量、住院时间、并发症发生率及穿刺定位时间。结果:研究组一期结石清除率高于对照组,两组比较差异具有统计学意义(X2=10.751,P=0.024);研究组手术时间、术中出血量、住院时间均显著优于对照组,两组比较差异具有统计学意义(t=9.214,9.013,10.012,P=0.012,0.015,0.009);两组均无严重并发症发生,并发症发生率比较无统计学意义(X2=3.120,P=0.120),研究组中肥胖组定位时间明显长于正常体型组,差异有统计学意义(t=22.939,P=0.003),也长于对照组的肥胖组,差异有统计学意义(t=10.979,P=0.009)。结论:B超定位微创经皮肾取石术治疗上尿路结石具有较好的效果,结石的清除率高,对患者危害小,有利于患者康复。对于肥胖患者,B超定位相对于X线定位无优势。

Objective： To compare the clinical effect of B-ultrasound and X-ray locating minimally invasive percutaneous nephrolithotomy in treatment of urinary tract stones. Methods： 190 cases with urinary tract stones were selected from our hospital from March 2010 to September 2012, and they were divided into the study group and the control group according to a random number table,with 95 cases in each group. The patients of the control group were treated with X-ray locating minimally invasive percutaneous nephrolithotomy, while the patients of the study group were treated with B-ultrasound locating minimally invasive percutaneous nephrolithotomy, and the two groups were each subdivided into obesity group and normal group, the stone clearance rate, the operative time, blood loss, length of stay, incidence of complications and puncture positioning time of the two groups were compared. Results： The stone clearance rate of the study group were significantly higher than that of the control group, the difference was statistically significant（X2=10.751, P=0.024）; The operative time, blood loss, length of stay of the study group were significantly better than that of the control group, the difference was statistically significant（t=9.214, 9.013, 10.012, P=0.012, 0.015, 0.009）; There were no serious complications,the complication rate of the two groups was not statistically significant（χ^2=3.120, P=0.120）. The puncture locating time of obesity group of study group was significantly longer than the normal group, and the difference was statistically significant（t=22.939, P=0.003）, and also longer than that of the obesity group of control group, and the difference was statistically significant（t=10.979, P=0.009）. Conclusion：B-ultrasound locating minimally invasive percutaneous nephrolithotomy has better effect, with high clearance rate and little harm to patients, and it is conducive to the rehabilitation of patients. For obese patients, ultrasound locating shows no advantage over the X-ray method.