微创和标准通道经皮肾镜取石术治疗复杂性肾结石的疗效比较  

Comparison of MPCNL and PCNL in Complex Renal Calculi

作　　者：余兆雄[1] 廖泽明[1] 王超[1] 张俊杰[1] 蔡勇[1] 杨荣权[1] 李壮志[1] 

机构地区：[1]荆门市第一人民医院泌尿外科,湖北荆门448000

出　　处：《临床泌尿外科杂志》2010年第11期812-814,共3页Journal of Clinical Urology

摘　　要：目的:比较微创经皮肾镜取石术(MPCNL)和标准通道经皮肾镜取石术治疗复杂性肾结石的疗效及安全性。方法:采用MPCNL和标准通道PCNL分别治疗复杂性肾结石患者59例(微创组)和37例(标准组),并对两种方法的手术时间、结石清除率及手术并发症进行对比分析。结果:两组患者均一期成功建立F_(16)和F_(22)皮肾通道。手术时间标准组短于微创组(P<0.05),结石清除率差异两组无统计学意义(P>0.05),穿刺通道的损伤、出血两组差异也无统计学意义(P>0.05),术后发热微创组高于标准组(P<0.05)。结论:MPCNL和标准通道经皮肾镜取石术均是治疗复杂性肾结石的有效方法;采用标准通道能缩短手术时间;随着手术时间的延长,MPCNL因高压冲洗引起的并发症相应增多。Objective： To investigate and evaluate the safety and efficacy of minimally invasive percutaneous nephrolithotomy （MPCNL） and standard percutaneous nephrolithotomy（PCNL） in the treatment of complex kid- ney calculi. Methods： MPCNL and PCNL were performed in 59 and 37 renal stone patients respectively. The oper- ative time, complication and stone-free rate were compared and analyzed. Results：All the cases were punctured sue- cessfully. 59 cases were treated using mini-percutaneous（Ft6 ） renal tract, and 37 cases using standard percutane- ous（Fzz） renal tract. The operative time of stone clearance in MPCNL group was significantly longer than PCNL group （P〈0. 05）. Stone-free rate of two groups was no difference （P〉0.05）. The difference of working channel damage and blood loss in two groups were no difference （P〉0. 05）, and the incidence of postoperative fever in MPCNL group was higher than PCNL group （P〈0. 05 ）. Conclusions： The MPCNL and standard percutaneous nephrolithotomy（PCNL） are both the effective therapeutics for complex kidney calculi. PCNL for kidney calculi has associated with shorter operative time than MPCNL, and the complication of MPCNL would be increased if the operative time was prolonged.

关 键 词：肾结石 经皮肾镜取石术 

分 类 号：R692.4[医药卫生—泌尿科学]