微创钬激光碎石术治疗复杂性肾结石的疗效及安全性

Efficacy and Safety of Minimally Invasive Holmium Laser Lithotripsy for Complex Renal Calculi Patients

目的探讨微创钬激光碎石术治疗复杂性肾结石的疗效和安全性。方法选取2010年1月至2015年1月北京市仁和医院收治的200例复杂性肾结石患者,根据随机数字表法分为观察组和对照组,各100例。对照组采取开放性肾切开取石术,观察组应用微创钬激光碎石术。比较两组患者的临床改善效果、治疗情况、并发症发生率。结果观察组结石清除率显著高于对照组[98.0%(98/100)比82.0%(82/100)](P<0.01)。观察组手术时间、术中出血量、下床活动时间及住院时间显著少于对照组[(53±9)min比(95±13)min、(64±13)mL比(124±17)mL、(6.2±1.2)d比(12.5±2.4)d、(13.2±2.1)d比(19.2±4.4)d](P<0.01)。观察组总并发症发生率显著低于对照组[12.0%(12/100)比35.0%(35/100)](P<0.01)。结论复杂性肾结石患者应用微创钬激光碎石术治疗,结石清除率较高,结石残留率较低,术中出血量少、术后并发症较少,安全性较高,其临床疗效良好。

Objective To study efficacy and safety of minimally invasive holmium laser lithotripsy in complex renal calculi patients. Methods Total of 200 patients with complicated renal calculi patients in Beijing Renhe Hospital from Jan. 2010 to Jan. 2015 were included in the study, according to the random number table method all patients were divided into an observation group and a control group, 100 cases in each group. The control group received open renal lithotomy, and the observation group was given minimally invasive holmium laser lithotripsy. The clinical improvement effect, treatment condition, complication rates of the two groups were compared. Results Stone clearance rate of observation group was significantly higher than the control group[ 98.0% （98/100） vs 82. 0% （82/100） ] （P 〈0. 01 ）. The observation group＇s operative time, intraoperative blood loss, ambulation time and hospitalization time was significantly less than the control group[（53±9） min vs （95 ±13） min,（64 ±15） mLvs （124 ±17） mL,（6.2 ±1.2） d vs （ 12. 5 ±2.4） d, （ 13.2 ± 2. 1 ） d vs （ 19.2 ± 4. 4 ） d ] （ P 〈 0.01 ）. The overall complication rate of the observation group was significantly lower than the control group[ 12.0% （ 12/100 ） vs 35.0% （ 35/100 ） ] （ P 〈 0. 01 ）. Conclusion Minimally invasive holmium laser lithotripsy for patients with complex renal calculi, has higher stone clearance rate, lower residual stone rate, less blood loss, fewer complications, and higher safety, thus can be concluded as good clinical efficacy.