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目的肾窦内肾盂及肾后唇实质弧形切开取石术与经皮肾镜取石术治疗复杂性鹿角形肾结石的效果比较。方法将87例复杂性鹿角形肾结石患者随机分成两组,采用肾窦内肾盂及肾后唇实质弧形切开取石术(开放组)与经皮肾镜取石术(PCNL组)分别治疗46例和41例,观察血BUN、Scr、胱抑素C(cystatin C,Cys C)、β2-MG和尿β2-MG手术前后变化,对手术时间、出血量、输血率、结石取净率和并发症作比较。结果两组手术均获成功。两组术前、术后血BUN、Scr、CysC、β2-MG、尿β2-MG相比差异无显著性(P>0.05),并发症相比亦差异无显著性(P>0.05),手术时间、出血量、输血率和结石取净率相比差异有显著性(P<0.05)。PCNL组一期术后结石取净率为82.9%,开放组结石取净率达97.8%。结论 PCNL对患者损伤轻,一期单通道结石取净率低,常需一期多通道或二期多通道或多期多通道取石,开放组结石取净率高,对腰部切口各层损伤大,外观手术疤痕长,恢复较慢,但仍是部分患者选择的较理想术式。
Objective To compare the effect of the renal pelvis and renal posterior lip real arc incision lithotomy and percutaneous nephrolithotomy for the treatment of complex antler kidney stones. Methods Eighty-seven patients with complicated antler kidney stones were randomly divided into two groups. The renal pelvis and renal posterior lip parenchyma (open group) and percutaneous nephrolithotomy (PCNL group) Cases and 41 cases. The changes of blood BUN, Scr, cystatin C (Cys C), β2-MG and urinary β2-MG before and after operation were observed. The operation time, blood loss, blood transfusion rate, Complications were compared. Results Both procedures were successful. There were no significant differences in BUN, Scr, CysC, β2-MG, urinary β2-MG between the two groups (P> 0.05) Time, blood loss, blood transfusion rate and stone removal rate was significantly different (P <0.05). The stone removal rate in the PCNL group after operation was 82.9% and that in the open group was 97.8%. Conclusions PCNL has the advantages of less damage to patients, lower incidence of single-stage single-stage calculi, and often requires one-stage multi-channel or multi-channel multi-channel or multi-channel multi-channel stone removal. The open rate of PCL in open group is high, , The appearance of surgical scars long, slow recovery, but still some of the more ideal choice of patients surgery.