无管化经皮肾镜取石术治疗上尿路结石的疗效观察

目的探讨无管化经皮肾镜取石术（MPCNL）治疗上尿路结石的疗效观察。方法上尿路结石患者92例随机分为MPcNL组与PCNL组，各46例。MPCNL组采取无管化经皮肾镜碎石术治疗，PCNL组采取传统经皮肾镜碎石术治疗。观察两组患者手术时间、术中出血量、术后留置尿管时间、术后第1天疼痛情况、使用镇痛药剂量、术后并发症发生率、住院时间及住院费用。结果两组患者手术时间、术中出血量、术后留置尿管时间比较差异无统计学意义（P〉0．05）；MPCNL组术后第l天疼痛VAS评分及使用镇痛药物剂量均明显少于对照组（P〈0．05）；两组患者术后并发症发生率比较差异无统计学意义（P〉0．05）；MPCNL组住院天数及住院费用明显少于PCNL组（P〈0．05）。结论MPCNL治疗上尿路结石与PCNL比较具有术后疼痛轻、恢复快、医疗费用低等优势，建议在严格掌握适应证的基础上推广应用。

Objective To explore curative effect observation of the treatment of upper urinary stones with tubeless percutaneous nephrolithotomy （PCNL）. Methods 92 cases of patients with upper urinary stones were randomly divided into MPCNL group and PCNL group, each group 46 cases. MPCNL group took tubeless percutaneous nephrolithotomy to treat, and PCNL group took traditional pereutaneous nephrolithotomy as treatment. Both groups of patients were observed in operation time intraoperatve blood soss, indwelling catheter time after operation, pain situation on the first postoperative day, dosage of analgesic, postoperative complication rate, hospital stays and hospitalization costs. Results Comparative difference of operation time, intraoperative blood soss, and indwelling catheter time after operation between the two groups of patients had no statistical significance（P〉0.05）; Score of VAS in pain situation on the first postoperative day and dosage of analgesic in MPCNL group were obviously less than those in control group（P〈0.05）; Comparative Difference of the postoperative complication rate between the two groups has no statistical significance（P〉0.05）; The hospital stays and hospitalization costs in MPCNL group are obviously less than those in PCNL group（P〈0.05）. Conclusion Compared with traditional percutaneous nephrolithotomy, MPCNL has some advantages of light operative pain, fast recovery, low medical costs, and so on. It is suggested to popularize and apply on the basis of strictly mastering the indications.