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目的:探讨微创经皮肾取石术(MPCNL)治疗上尿路结石的效果。方法:分别应用激光碎石术和气压弹道超声碎石术通过经皮肾镜通道治疗76例、82例上尿路结石,分析比较其结石清除率、出血量、手术时间等指标。结果:①微创经皮肾镜气压弹道超声碎石术I期结石清除率为95.12%,高于激光碎石术的88.16%I期结石清除率,差异具有显著性(P<0.05)。②气压弹道超声碎石术平均手术时间(74min)和平均出血量(35ml),显著少于激光碎石术的平均手术时间(92min)和平均出血量(65ml),差异具有显著性(P<0.05)。③两种治疗方法在造瘘管置留时间、平均住院时间、积水好转率、术后复发率上差异无统计学意义(P>0.05)。结论:微创经皮肾镜气压弹道超声碎石术相较于微创经激光碎石术在上尿路结石治疗中更为安全有效。
Objective: To investigate the effect of minimally invasive percutaneous nephrolithotomy (MPCNL) in the treatment of upper urinary tract calculi. Methods: Laser lithotripsy and pneumatic lithotripsy were used to treat 76 cases and 82 cases of upper urinary tract stones through percutaneous nephrolithotomy. The indexes of stone clearance rate, blood loss, operation time and so on were analyzed. Results ① The clearance rate of stage I stone was 95.12% in the minimally invasive percutaneous nephroscope pneumatic lithotripsy, which was higher than 88.16% stage I stone clearance in laser lithotripsy, the difference was significant (P <0.05). ② The mean operative time (74min) and mean blood loss (35ml) of pneumatic lithotripsy were significantly less than those of laser lithotripsy (92mm) and mean bleeding volume (65ml) (P < 0.05). ③ There was no significant difference between the two treatment methods in the duration of fistula catheterization, average length of hospital stay, rate of improvement of hydrops and recurrence rate (P> 0.05). Conclusion: The minimally invasive percutaneous nephrolithotomy is more safe and effective than the minimally invasive laser lithotripsy in the treatment of upper urinary tract stones.