微创经皮肾镜取石术与ESWL治疗上尿路结石的临床疗效及探讨  

STUDY ON THE ESWL AND PERCUTANEOUS NEPHROLITHOTOMY IN TREATMENT OF URINARY

作　　者：李程[1] 甘宏斌[1] 黄恒海[1] 李仙[1] 

机构地区：[1]广西医科大学第七附属医院泌尿外科,梧州543001

出　　处：《现代预防医学》2011年第14期2848-2850,共3页Modern Preventive Medicine

摘　　要：[目的]探讨微创经皮肾镜取石术(minimally invasive percutanephrolithotomy,MPCNL)和体外震波碎石(extracoporeal shock wave lithotripsy,ESWL)治疗上尿路结石的疗效。[方法]选择我院自2009年12月～2010年6月收治的上尿路结石患者311例,随机分为观察组和对照组,观察组(MPCNL组)156例,对照组(ESWL组)155例,观察组患者在B超引导下经腰背部穿刺建立F16经皮肾通道,经F16皮肾通道将结石击碎取出;对照组采取体外震波碎石(ESWL)治疗,对两组的临床疗效进行对比分析。[结果]观察组患者156例中一期取石成功143例,占91.67%,二期取石成功12例,占7.69%,穿刺失败改开放手术1例;对照组患者155例ESWL治疗,一期结石成功123例,结石清除率为79.35%,二期结石32例,结石清除率为20.65%;MPCNL组累计并发症发生15例,发生率为9.62%,ESWL组并发症发生32例,发生率为20.65%,MPCNL组与对照组相比较,发生率明显降低(P﹤0.05)。[结论]MPCNL治疗上尿路结石较ESWL创伤小,并发症发生率低,临床疗效满意,值得推广和应用。[Objective] To explore extracorporeal shock wave lithotripsy（extracoporeal shock wave lithotripsy,ESWL）and percutaneous nephrolithotomy stone surgery（minimally invasive percutaneous nephrolithotomy,MPCNL）in treatment of urinary tract stones.[Methods]We collected 311 cases of upper urinary tract stones in our hospital from December 2009-June 2010,and randomly divided into two groups and the control group.There were 156 patients in the observation group（MPCNL group）and 155 patients in the control group（ESWL group）.The patients were established percutaneous F16 from puncturing the lower back channels under the B-guided,the F16 crushed stone skin to remove the kidney channel;the control group underwent extracorporeal shock wave lithotripsy（ESWL）treatment.The clinical efficacy of the two groups was compared.[Results]Among 156 cases,143 cases successfully finished the surgery in the I phase,and accounted for 91.67%.In the II phase,12 cases successfully got the stone,accounted for 7.69%.1 case showed puncture failure and converted to open surgery;155 cases in the control group got extracorporeal shock wave lithotripsy（extracoporeal shock wave lithotripsy,ESWL）treatment,123 cases successfully got the stone,and the stone clearance rate was 79.35%.32 cases successful got two phase stone,stone clearance rate was 20.65%;15 patients in the MPCNL group had complications,with the cumulative incidence rate of 9.62%.32 cases in the ESWL group had concurrent diseases,with the incidence rate of 20.65%,showed significantly lower than the control group（P﹤0.05）.[Conclusion]＋＋-MPCNL percutaneous nephrolithotomy had fewer complications release for upper urinary calculi trauma,and the clinical results were satisfactory,which should be promoted and applied.

关 键 词：ESWL MPCNL 上尿路结石 临床疗效 

分 类 号：R695[医药卫生—泌尿科学]