经皮肾穿刺输尿管镜碎石术治疗无积水型肾鹿角形结石  

MPCNL in the treatment of staghorn calculi without hydronephrosis

作　　者：廖尚范[1] 卢东明[1] 吴宗强[1] 吴用样[1] 

机构地区：[1]福建医科大学附属三明第一医院泌尿外科,福建三明365000

出　　处：《中国现代医生》2016年第18期49-52,共4页China Modern Doctor

摘　　要：目的探讨经皮肾穿刺输尿管镜碎石术治疗无积水型肾鹿角形结石的疗效及安全性。方法回顾性分析2010年7月~2014年7月期间我科诊治120例无积水型肾鹿角形结石患者,随机分为实验组58例(经皮肾穿刺输尿管镜碎石手术)和对照组62例(传统开放手术),比较两组的手术时间、出血量、一期无石率、术后并发症及住院时间等。结果实验组患者均成功建立穿刺通道后行一期碎石,平均手术时间(97.0±8.6)min,术中出血量(154±24)m L,一期无石率84.48%(49/58),术后并发症12.07%(7/58),住院时间(8.3±0.5)d。对照组62例,平均手术时间(143.0±10.3)min,术中出血量(415±37)m L,一期无石率82.26%(51/62),术后并发症27.42%(17/62),住院时间(13.5±0.8)d,两组平均手术时间、出血量、术后并发症及住院时间比较,差异有统计学意义(P<0.05),两组一期无石率比较,差异无统计学意义(P>0.05)。结论 MPCNL治疗无积水型肾鹿角形结石具有微创、出血少、结石清除率高、住院时间短等优点,值得临床推广。Objective To evaluate the efficacy and safety of minimally invasive percutaneous nephrolithotripsy （MPC- NL） for staghorn calculi without hydronephrosis. Methods A retrospective analysis of 120 cases of staghorn calculi without hydronephrosis .admitted in our department from July 2010 to July 2014,were randomly divided into experimen- tal group of 58 patients（minimally invasive percutaneous renal puncture ureteroscopy lithotripsy, MPCNL surgery under the guidance of the ultrasonic and X-ray） and control group of 62 patients （traditional open surgery）, the clinical data of average operation tirre,the blood loss,stone-free rate after one-stage operation, postoperative complication and hos- pital stay were compared and analyzed between the two groups. Results In the experimental group, all patients who were carried out one-stage operation after the percutaneous renal access were successfully established,the average op- eration time was（97.0±8.6） min,the blood loss was（154＋24） mL,the stone-free rate after one-stage surgery was 84.48% （49/58）, the postoperal：ive complication rate was 12.07%（7/58）,the hospital stay were（8.3＋0.5）d. In the control group of 62 patients, the average operation time was（143.0±10.3）min, the blood loss was（415＋37）mL,the stone-free rate after one-stage surgery was 82.26%（51/62）, the postoperative complication rate was 27.42% （17/62）, hospitalization days were（13.5±0.8）d. The differences of the clinical data of operation time, the blood loss, postoperative complication and hospital stay between the two groups were statistically significant（P〈0.05）. The difference of stone-free rate after one-stage operation bel^ween the two groups was not significant（P〉0.05）. Conclusion The MPCNL for renal staghorn calculi with non-dilated collecting system has the advantages of minimally invasive, safe, less bleeding and high stone-free rate,it shoul,：t be worthy of promotion.

关 键 词：经皮肾穿刺术 输尿管镜 肾鹿角形结石 一期无石率 开放手术 

分 类 号：R699[医药卫生—泌尿科学]