B超定位微创经皮肾镜取石术治疗上尿路结石229例效果观察  

Clinical effect of mPCNL with ultrasound guidance in the treatment of 229 cases of upper urinary calculi.

作　　者：张鹏舒[1] 

机构地区：[1]桃江县人民医院泌尿外科,湖南桃江413400

出　　处：《海南医学》2012年第24期55-57,共3页Hainan Medical Journal

摘　　要：目的探讨超声定位微创经皮肾镜取石术(mPCNL)在上尿路结石治疗中的临床疗效。方法将2007年1月至2010年10月我院收治的429例上尿路结石患者按治疗方法不同分为mPCNL组和PCNL组,所有患者均随访1年,分析术后结石清除情况及临床疗效。结果 mPCNL组229例患者一期取净结石194例,占84.7%。手术平均时间(78.3±33.2)min;肾造瘘管平均留置时间(6.2±2.4)d;术后平均住院时间(6.8±2.4)d。PCNL组200例患者一期取净结石178例,占89.0%。手术平均时间(88.8±35.5)min;肾造瘘管平均留置时间(7.8±2.8)d;术后平均住院时间(9.6±3.5)d。两组一期取净结石率比较差异无统计学意义(P>0.05),但mPCNL组在造瘘时间和住院时间上均明显少于PCNL组,两组比较差异有统计学意义(P<0.05)。结论超声定位行mPCNL治疗上尿路结石具有高效、微创、安全和并发症少等优势,具有临床推广应用价值。Objective To evaluate the effect of Minimally Invasive PereutaneousNephrolithotomy （mPCNL） with ultrasound guidance in the treatment of upper urinary calculi. Methods Four hundred and twen- ty-nine patients with upper urinary calculi admitted from January 2007 to October 2010 were treated by mPCNL （the mPCNL group, n=229） and mPCNL （the PCNL group, n=200）. All the patients were followed up for one year. The clinical effect and the calculi clearance rate were compared between the two groups. Results In mPCNL group, 194 of the 229 patients had calculi cleared away with one-stage, with a clearance rate of 84.7%. The mean operation duration, the remain time of nephrostomy, and the mean length of hospital stay were （78.3±33.2） rain, （6.2±2.4） d, （6.8±2.4） d, respectively. In PCNL group, 178 of the 200 patients had calculi cleared away with one-stage, with a clearance rate of 89.0%. The mean oper- ation duration, the remain time of nephrostomy, and the mean length of hospital stay were （88.8±35.5） rain, （7.8±2.8） d, （9.6±3.5） d, respectively. The clearance rote showed no statistically significant difference between the two groups （P〉0.05）. The operation duration and the remain time of nephrostomy in the mPCNL group were significantly less than those in the PCNL group （P〈0.05）. Conclusion mPCNL has the advantages of high success rate, less trauma, higher safety and reduced complica- tions, which is worthwhile to be widely used in clinic.

关 键 词：B超定位 微创经皮肾镜取石术 经皮肾镜 上尿路结石 

分 类 号：R691.4[医药卫生—泌尿科学]