2种手术方法治疗上尿路结石的效果对比研究

The study of two surgical methods in the treatment of upper urinary calculi

目的探讨微创经皮肾镜气压弹道碎石取石术(MPCNL)与体外冲击波碎石术(ESEL)治疗上尿路结石的临床应用效果。方法选取2012年9月至2016年5月海南省第二人民院收治的上尿路结石患者188例,采用抽签法均分为观察组和对照组各94例,对照组采用ESEL,观察组使用MPCNL,比较2组患者的术中出血量、手术时间、住院时间、结石第1次和第2次的清除率及并发症。结果观察组患者住院时间、术中出血量明显高于对照组,差异有统计学意义(P<0.05);观察组手术时间明显少于对照组,观察组第1次手术清除率为93.62%,明显高于对照组(81.91%),第2次清除率为95.74%,高于对照组(87.23%),差异均有统计学意义(P<0.05);但2组患者的并发症发生率比较,差异无统计学意义(P>0.05)。结论 MPCNL与ESEL比较,具有较高的结石清除率,手术时间短及无重大并发症等优点,但术中出血量多,住院时间长,应根据患者实际情况进行手术选择。

Objective To investigate the effect of minimally invasive percutaneous nephrolithotomy lithotripsy lithotripsy and extracorporeal shock wave lithotripsy for upper urinary calculi.Methods 188 patients with upper urinary calculi from September 2012 and May 2016,admitted in our hospital were divided into observation group and control group.The observation group was treated with minimally invasive percutaneous erythrocyte pressure The patients in the control group were treated with extracorporeal shock wave lithotripsy,and the intraoperative blood loss,operation time,hospitalization time,stone primary and secondary clearance rate and complication were compared between the two groups.Results The hospitalization time and intraoperative blood loss were significantly higher in the observation group than in those the control group（P〈0.05）,the operation time of the patients was significantly less than that in the control group.The rate of primary operation was 93.62% in the observation group,which was significantly higher than that in the control group（81.91%）and the secondary clearance rate was 95.74%,which was significantly higher than that of the control group（87.23%）,the differences were statistically significant（P〈0.05）,there was no significant difference in the incidence of adverse reactions between the two groups（P〉0.05）.Conclusion In the treatment of patients with upper urinary calculi,minimally invasive percutaneous nephrolithotomy lithotripsy lithotripsy has the advantages of high stone clearance,short operation time and no major complication compared with extracorporeal shock wave lithotripsy intraoperative bleeding,hospital stay a long time.Clinical operation should be based on the actual situation of patients to choose.