微创经皮肾镜治疗孤立肾与非孤立肾结石的比较  

Comparison of the stones with solitary kidney and without solitary kidney treated by minimally invasive percutaneous nephrolithotomy

作　　者：雷光远[1] 雷鸣[1] 刘永达[1] 罗金泰[1] 张泽[1] 袁坚[1] 黄泽瑞 

机构地区：[1]广州医科大学第一附属医院微创外科中心泌尿外科,广东省泌尿外科重点实验室,广东510230 [2]澧县人民医院泌尿外科,湖南415500

出　　处：《中华腔镜泌尿外科杂志（电子版）》2016年第2期30-33,共4页Chinese Journal of Endourology(Electronic Edition)

基　　金：广东省科技厅项目(2013B021800190)

摘　　要：目的比较微创经皮肾镜碎石取石术(MPCNL)治疗孤立肾与非孤立肾肾结石的安全性和有效性。方法回顾性收集广州医科大学第一附属医院2011年9月至2014年6月采用MPCNL治疗孤立肾与非孤立肾结石患者一期手术的资料。孤立肾组128例,非孤立肾单侧肾结石组530例。依据年龄、体质量指数、合并症、手术史、结石大小、结石位置、肾积水成功匹配94对,比较两组的手术时间、血红蛋白下降值、结石清除率、并发症。结果孤立肾组及非孤立肾组在年龄、体质量指数、合并症、手术史、结石大小、结石位置、肾积水方面差异无统计学意义。平均手术时间为(60.7±33.8)min和(56.3±31.2)min,差异无统计学意义(P=0.381)。术后48 h平均血红蛋白下降值为(12.7±11.3)g/L和(11.8±9.9)g/L,差异无统计学意义(P=0.588)。一期术后48 h结石清除率为55.3%(52例)和62.8%(59例),差异无统计学意义(P=0.299)。术后并发症发生率分别为20.2%(19例)和17%(16例),差异无统计学意义(P=0.55)。结论 MPCNL治疗孤立肾结石与非孤立肾结石一期手术的安全性和有效性相似。Objective To compare the safety and efficacy of minimally invasive percutaneous nephrolithotomy（MPCNL） in the treatment of renal calculi with solitary kidney and without solitary kidney.Methods The data of patients with solitary kidney and without solitary kidney who underwent MPCNL between Septemter 2011 and June 2014 in the First Affiliated Hospital of Guangzhou Medical University were collected. 128 cases of patients with solitary kidney and 530 cases of patients with non solitary kidney were collected. 94 pairs of patients were matched by applying the following criteria： age, body mass index,complications, surgical history, stone size, stone location and hydronephrosis. The operative time,postoperative hemoglobin decreased value, postoperative 48 h stone free rate and complications were compared between the two groups. Results There were no significant differences between the two groups in age, body mass index, complications, surgical history, stone size, stone location and hydronephrosis. The mean operation time was（60.7 ±33.8） min vs（56.3 ±31.2） min, the difference was not statistically significant（ P=0. 381）. The mean hemoglobin drop value was（12.7±11.3） g/l vs（11.8±9.9） g/l, the difference was not statistically significant（P=0.588）. The stone clearance rate was 55.3%（52 cases） vs62.8%（59 cases）, the difference was not statistically significant（P=0.299）. The postoperative complications was 20.2% vs 17.0%, the difference was not statistically significant（P=0.55）. Conclusion MPCNL is safe and effective for renal stones in the patients with or without soltitary kidney.

关 键 词：肾造口术 经皮 微创 孤立肾 肾结石 

分 类 号：R699.2[医药卫生—泌尿科学]