标准通道与微通道经皮肾镜碎石术治疗上尿路结石的疗效及安全性评价

Curative Effect and Safety Evaluation of Percutaneous Nephroscope for upper urinary tract calculi via Standard Channel and Microchannel

目的:评价标准通道与微通道经皮肾镜碎石取石术(PCNL)治疗上尿路结石的临床效果。方法:A组54例,接受标准通道(24 F)PCNL;B组46例,接受微通道(16 F)PCNL。比较两组手术时间、输血率、住院时间、并发症、结石清除率、肾功能等指标。结果:A组手术时间(94.21±25.62)min少于B组(119.72±29.78)min,差异有统计学意义(P<0.01)。A组术中术后输血率(20.37%)高于B组(2.17%)(P<0.01);两组泌尿系感染率和住院时间比较,差异无统计学意义(均P>0.05)。A组总结石清除率(90.74%)高于B组(73.91%),差异有统计学意义(P<0.05)。两组治疗前后肾功能指标比较,差异均无统计学意义(均P>0.05)。结论:标准通道PCNL治疗上尿路结石具有耗时少、结石清除率高等优势;而微通道PCNL则具有并发症少等优点。标准通道PCNL和微通道PCNL对尿路结石患者肾功能均无明显影响。

Objective：To evaluate the clinical effects of percutaneous nephroscope treating upper urinary tract calculi via standard channel and microchannel.Methods：PCNL via standard channel was employed for Group A （54 cases）;PC-NL via microchannel was used for Group B （46 cases）.Operation time,blood transfusion rate,length of hospital stay, complications,stone clearance rate,renal function of the two groups were compared.Results：Operation time of group A （94.21 ±25.62min）was less than that of group B （119.72 ±29.78 min）,with statistically significant difference （P〈0.01）.Postoperative blood transfusion rate（20.37%）of group A was higher than that of group B （2.17%）（P〈0.01）;The infection rate and length of hospital stay of the two group were compared,and no significant difference was found （P 〉0.05 ）.Summary stone clearance rate （90.74%） of group A was higher than that of control group （73.91%）,and the difference was statistically significant （P〈0.05）.The renal function of two groups before and after the treatment were compared,and there were no statistical differences （all P〉0.05 ）.Conclusion：Standard channel PCNL and MPCNL treating upper urinary calculi have their respective advantages.Standard channel PCNL has advanta-ges of less time-consuming and high calculi clearance rate,while the MPCNL has the advantages of less complications. Standard channel PCNL and MPCNL have no significant effect on renal function in patients with urinary stones.