肾结石患者微创经皮肾镜取石术中碎石方法的选择  

Choice of Lithotripsy Methods in Minimally Invasive Percutaneous Nephrolithotomy Among Patients with Renal Calculus

作　　者：唐黎明[1] 刘猛贤[1] 成校[1] 王艳科[1] 

机构地区：[1]中国人民解放军第一六九中心医院,湖南衡阳421002

出　　处：《实用预防医学》2012年第9期1378-1379,共2页Practical Preventive Medicine

摘　　要：目的探讨气压弹道碎石法与钬激光碎石法在微创经皮肾镜取石术中的应用选择。方法选择128位肾结石患者,根据其易碎性分为易碎结石组60例,不易碎结石组68例。每组又随机分为气压弹道碎石组和钬激光碎石组,比较两种碎石方法的临床疗效。结果在易碎结石组中气压弹道碎石的手术时间(65.2±12.7)min,钬激光碎石的手术时间(85.3±10.4)min,二者差异有统计学意义(P<0.05),两种方法的一期成功率及大出血发生率差异无统计学意义(P>0.05)。在不易碎结石组中气压弹道碎石的手术时间为(125.4±14.5)min,钬激光碎石的手术时间(96.0±12.9)min,二者差异有统计学意义(P<0.05),并且钬激光碎石法大出血发生率低于气压弹道碎石法的发生率(P<0.05),其一期手术成功率高于气压弹道碎石法的一期手术成功率(P<0.05)。结论对易碎结石者宜选择气压弹道碎石法,对不易碎结石者宜选择钬激光碎石法;术中判断结石的易碎性可为合理选择碎石方法提供依据。Objective To explore the application of pneumatic lithotripsy and holmium laser lithotripsy in minimally inva- sive percutaneous nephrolithotomy. Methods According to the fragility of renal calculus （RC）, 128 patients with RC were divided into fragile stone group （n= 60） and non - fragile stone group （n= 68）. The patients in each group were randomly divid- ed into pneumatic lithotripsy group and holmium laser lithotripsy group. The clinical efficacy of the two lithotripsy methods was compared. Results Among fragile stone group, the average time of pneumatic lithotripsy （65.2 ± 12.7 min） was shorter than that of holmium laser lithotripsy （85.3 ± 10.4 rain）, and the difference was statistically significant （P〈0.05）. But no statistically significant difference was found in one stage successful rate and the incidence rate of haemorrhage between the two methods （P〉0.05）. Among non - fragile stone group, the average time of holmium laser lithotripsy （96.0±12.9 rain） was shorter than that of pneumatic lithotripsy （125.4±14.5 rain）, and the difference was statistically significant （P 〈 0.05）. Furthermore, one stage successful rate and the incidence rate of haemorrhage in holmium laser lithotripsy were both better than those in pneu- marie lithotripsy （both P〈 0.05）. Conclusions Pneumatic lithotripsy is suitable for patients with fragile stones, while hol- mium laser lithotripsy is appropriate to non - fragile stone patients. The judgment of stone fragility in the operation can provide the evidence for more reasonable choice of lithotripsy.

关 键 词：肾结石 内窥镜术 碎石术 

分 类 号：R692.4[医药卫生—泌尿科学]