摘要
目的比较微创经皮肾穿刺(mini-percutaneous nephrolithotomy,MPCNL)联合输尿管镜钬激光碎石术和开放性手术治疗鹿角形肾结石的疗效,探讨鹿角形肾结石的最佳治疗方法。方法108例鹿角形肾结石患者按照治疗方法分为两组:MPCNL组60例,开放手术组48例;术后随访并评价1个月结石清除率。结果MPCNL组无一例中转开放手术,手术后血红蛋白下降(11.75±3.79)g/L,输血率为21.67%,术后住院时间平均(5.32±1.63)d,治疗费用平均(9.02±1.40)×103元,均明显低于开放手术组的(18.10±4.66)g/L、41.67%、(13.10±1.64)d及(11.92±1.58)×103元(P<0.05或P<0.01);术后1个月结石清除率为85.00%(51/60),显著高于开放手术组68.75%(33/48)。结论MPCNL具有结石清除率高、出血少、恢复快、治疗费用低的优点,对于较大、开放手术后复发或残留的鹿角形肾结石患者尤为适宜,可作为鹿角形肾结石的首选治疗方法。
Objective To compare the clinical efficacy of the mini-invasive pertutaneous nephrolithotomy（MPCNL） combined with ureteroscopic holmium laser and open surgery for renal staghorn calculi.Method 108 cases of renal staghorn calculi were classified into 2 groups,60 cases of MPCNL and 48 cases of open surgery.Results No case of MPCNL group was conversed to open surgery.The blood loss,blood transfusion rate,postoperative hospital stay,total treatment cost and one month stone clearance rate were（11.75±3.79） g/L vs（18.10±4.66） g/L, 21.67 vs 41.67%,（5.32±1.63）days vs（13.10±1.64）days,（9.02±1.40）×10^3Yuan vs（11.92±1.58）×10^3Yuan,85.00%（51/60） vs 68.75%（33/48）,in the MPCNL group and open group respectively,which showed the statistical advantages of MPCNL group（P〈0.05 or P〈0.01）.Conclusions MPCNL has the advantages of high stone clearance rate,less blood loss,quick resumption,and low medical cost,which is optimally suitable to the large,residual or recrudescent renal staghorn calculi after open operation.So it can be used as the first choice for the renal staghorn calculi.
出处
《中国现代手术学杂志》
2008年第3期171-174,共4页
Chinese Journal of Modern Operative Surgery
关键词
肾结石
肾造口术
经皮
碎石术
激光
kidney calculi,nephrostomy,percutaneous,lithotripsy,laser
