经11肋间微通道经皮肾镜碎石术在复杂肾结石中的应用

The application of supra-12 costal mini-PCNL in patients with complex renal calculi

目的评估经11肋间微通道经皮肾镜碎石术(PCNL)在治疗复杂肾结石中的临床效果。方法收集复杂肾结石且已行PCNL治疗的100例患者临床资料进行回顾性分析,根据不同的工作通道分为经11肋间微通道PCNL组和经12肋下微通道PCNL组。比较两组患者手术时间、住院时间、术后结石清除率、出血等并发症,并行统计学分析。结果经11肋间微通道PCNL组45例,经12肋下微通道PCNL组55例。经11肋间微通道PCNL组手术时间要短于经12肋下微通道PCNL组[(96.8±19.84)min vs.(111.21±16.62)min],两组间在住院天数[(10.75±1.86)d vs.(13.50±3.74)d]、血红蛋白下降值[(3.95±2.56)g/L vs.(6.04±2.59)g/L]、一期结石清除率(80%vs.70.9%)有统计学差异(P<0.05)。结论经11肋间微通道PCNL能缩短复杂肾结石的手术时间、住院时间,减少出血,提高一期清石率,在复杂性肾结石的治疗中具有明显有效性及安全性。

Objective To evaluate the efficacy and safety of supra-12 costal mini-percutaneous nephrolithotripsy （PCNL） for complex renal calculi. Methods The clinical data of 100 patients with complex renal calculi treated with PCNL during Feb. 2014 and Jun. 2016 were retrospectively analyzed. The patients were divided into 2 groups： supra-12 costal mini-PCNL group （n=45） and subcostal mini-PCNL group （n=55）. The efficacy and complications of the 2 groups were compared. Results The operation time, hospital stay, hemoglobin drop, one stage stone clearance rate of the supra-12 costal mini-PCNL group and subcostal mini-PCNL group were （96.8±19.84） vs. （111.21± 16.62） min, （10.75±1.86） vs. （13.50±3.74） d, （3.95±2.56） vs. （6.04±2.59） g/Land 80% vs. 70.9% respectively, showing significant difference （P〈0.05）. Conclusiorl Supra-12 costal mini-PCNL is safe and effective to treat complex renal calculi by reducing the operation time, hospital stay, amount of bleeding, and improving one-stage stone clearance rate.