微创经皮肾镜术治疗鹿角形肾结石的临床研究  

Clinical Study of Minimally Invasive Percutaneous Nephrolithotomy in the Treatment of Staghorn Calculi

作　　者：夏宗禹[1] 王琴[1] 刘胜[1] XIA Zong-yu;WANG Qin;LIU Sheng(Department of Urology Surgery,Chongqing Three Gorges Central Hospital,Chongqing 404000,China)

机构地区：[1]重庆三峡中心医院泌尿外科,重庆404000

出　　处：《中国现代手术学杂志》2018年第6期462-465,共4页Chinese Journal of Modern Operative Surgery

摘　　要：目的探讨微创经皮肾镜术治疗鹿角形肾结石的临床疗效。方法选择自2010年1月～2016年1月在重庆三峡中心医院接受治疗的鹿角形肾结石患者100例,根据手术方式的不同分为微创经皮肾镜术治疗组(研究组) 50例、开放性切开手术取石组(开放性手术组) 50例。统计两组患者手术情况、围手术期并发症发生率和预后。结果研究组患者的手术时间、术中出血量及术中输血率均低于开放性手术组患者,P <0. 05;研究组患者并发症发生率低于开放性手术组,P <0. 05;研究组患者术后住院时间比开放性手术组短、术后半年肾结石复发率亦低于开放性手术组,P <0. 05;研究组术后1个月的肾结石清除率明显高于开放性手术组,P <0. 05;研究组术后1周及术后1个月的血肌酐水平显著低于开放性手术组,P <0. 05。结论微创经皮肾镜术治疗鹿角形肾结石可有效降低患手术时间、术中出血量、住院时间、术后肾结石复发率及围手术期的并发症发生率,提高患者肾结石清除率。Objective To explore the clinical efficacy of minimally invasive percutaneous nephrolithotomy for the treatment of staghorn kidney stones. Methods 100 patients with staghorn calculi treated in Chongqing Three Gorges Central Hospital from January 2010 to January 2016 were selected. According to the different surgical methods,50 patients were treated with minimally invasive percutaneous nephrolithotherapy( the study group). And the other 50 patients underwent open pyelolithotomy( the control group). The clinical results such as operation time,intraoperative blood loss,the incidence of perioperative complications,medical cost and the prognosis was recorded and compared between the two groups. Results It showed that operation time,intraoperative blood loss,intraoperative blood complication rate,transfusion rate and postoperative hospital stay of the study group were less than that of the control group( P < 0. 05). The renal stone removal rate was significantly higher in the study group( P < 0. 05). The serum creatinine level in the study group was significantly lower than that of the control group at 1 week and 1 month after operation( P < 0. 05). Conclusions Minimally invasive percutaneous nephrolithotomy for staghorn calculi can effectively reduce operation time,intraoperative blood loss,length of hospital stay,postoperative renal stone recurrence rate and perioperative complication rate,and improve renal stone clearance rate.

关 键 词：微创经皮肾镜术 肾盂切开取石 鹿角形肾结石 

分 类 号：R692.4[医药卫生—泌尿科学]