清石汤联合经皮肾镜取石术对肾脏铸形结石碎石术后残石排出情况及1年复发率的影响

Effect of Stone-Clearance Decoction Combined with PCNL on Residual Stone and One-Year Recurrence Rate After Lithotripsy of Kidney Staghorn Calculi

目的:探讨清石汤联合经皮肾镜取石术(percutaneous nephrolithotomy,PCNL)治疗肾铸型结石的临床疗效及1年复发情况。方法:按随机数字表法将100例肾铸型结石(碎石术前/后结石残留)患者分为观察组与对照组,各50例,观察组采取清石汤联合PCNL治疗,对照组则行单纯PCNL治疗,比较两组临床疗效、并发症及随访1年后两组的复发率。结果:观察组治疗有效率98.00%,显著高于对照组的86.00%,两组比较,差异有统计学意义(P<0.05);观察组结石排净时间、疼痛完全消失时间、住院时间分别为(5.68±1.31)d、(3.45±1.00)d、(5.72±1.22)d,均显著短于对照组的(8.50±2.04)d、(6.20±1.48)d、(9.00±1.46)d,两组比较,差异有统计学意义(P<0.05);两组并发症发生率比较差异无统计学意义(P>0.05);观察组随访6个月、12个月结石复发率分别为2.00%、4.00%,显著低于对照组的14.00%、18.00%,差异有统计学意义(P<0.05)。结论:清石汤联合PCNL治疗肾铸型结石疗效明确,结石排净时间显著短,同时能明显减少术后1年结石复发率。

Objective： To investigate the clinical effect of stone-clearance decoction combined with percutaneous nephrolithotomy（ PCNL） in treating kidney staghorn calculi and the status of 1-year recurrence. Methods： One hundred patients with kidney staghorn calculi（ residual stone before/after lithotripsy） were divided into the observation group and the control group by the random number table method,50 cases in each group. The observation group was treated with stone-clearance decoction and PCNL,and the control group was treated with PCNL alone. The clinical efficacy,complications and 1-year recurrence rate were compared between the two groups. Results： The effective rate of the observation group（ 98. 00%） was significantly higher than that of the control group（ 86. 00%）（ P 〈0. 05）; The time to complete clearance of stones and pain disappearing completely and the reserve time in hospital in observation group [（ 5. 68 ± 1. 31） d,（ 3. 45 ± 1. 00） d,（ 5. 72 ± 1. 33） d] were significantly shorter than those in control group [（ 8. 50 ± 2. 04） d,（ 6. 20 ± 1. 48） d,（ 9. 00 ± 1. 46） d]（ P 〈0. 05）. There was no significant difference in the incidence of complications between the two groups（ P 〉0. 05）. The recurrence rates in the observation group during 6 months and 12 months of follow-up（ 2. 00%,4. 00%） were significantly lower than those in control group（ 14. 00%,18. 00%）（ P 〈0. 05）.Conclusion： The effect of stone-clearance decoction combined with combined with PCNL in the treatment of kidney staghorn calculi is clear. The time to complete clearance of stones is significantly shorter,and it can significantly reduce 1-year recurrence.