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目的:比较经皮肾镜取石术(PCNL)和经皮肾微造瘘取石术(MPCNL)两种手术方法的疗效及安全性。方法:采用F_(20.8)肾镜、超声联合气压弹道碎石系统行PCNL治疗肾结石患者155例,同期采用F_(8/9. 8)输尿管镜、气压弹道碎石系统行MPCNL治疗肾结石患者150例,并对两种方法的手术时间、结石清除率及并发症发生率进行比较分析。结果:伴有中等以下肾积水的肾结石患者采用两种方法在手术时间、结石清除率方面的差异无统计学意义(P>0.05);伴有重度肾积水的肾结石患者采用两种方法,MPCNL的手术时间长于PCNL(P<0.01),结石清除率方面差异无统计学意义(P>0.05)。两种方法穿刺通道的损伤、出血差异无统计学意义(P>0.05),术后发热方面MPCNL高于PCNL(P<0.05)。结论:PCNL与MPCNL均为肾结石的高效治疗方法,但采用F_(8/9.8)输尿管镜、气压弹道碎石系统的MPCNL效率与肾积水程度有关,而采用F_(20.8)肾镜、超声联合气压弹道碎石系统的PCNL效率与肾积水程度无关。制作皮肾通道的相关并发症两组差异无统计学意义,但随着手术时间的延长,采用高压水流冲洗碎石片的MPCNL相关并发症增多。
Objective: To compare the efficacy and safety of two methods of percutaneous nephrolithotomy (PCNL) and percutaneous nephrostomy (MPCNL). Methods: 155 cases of renal calculi were treated with F (20.8) nephrolithotomy and ultrasound combined with pneumatic lithotripsy. PCNL was used to treat 155 cases of renal calculi in the same period. The patients were treated with F_ (8/9. 8) ureteroscopy and pneumatic lithotripsy. 150 cases, and the two methods of operation time, stone clearance rate and complication rate were analyzed. Results: There was no significant difference in operation time and stone clearance rate between the two methods (P> 0.05). Nephrolithiasis patients with severe hydronephrosis were treated with two methods Methods: The operation time of MPCNL was longer than that of PCNL (P <0.01). There was no significant difference in stone clearance (P> 0.05). There was no significant difference between the two methods in terms of the puncture channel injury and bleeding (P> 0.05). The postoperative fever was higher in MPCNL than in PCNL (P <0.05). Conclusions: Both PCNL and MPCNL are effective treatments for renal calculus. However, the MPCNL efficiency of pneumatic pneumatic lithotripsy with F_ (8 / 9.8) ureteroscopy is related to the degree of hydronephrosis. F_ (20.8) The PCNL efficiency of the combined pneumatic lithotripsy system has nothing to do with the degree of hydronephrosis. There were no significant differences between the two groups in the complications related to the production of the renal access, but with the prolongation of the operation time, MPCNL-related complications of using high-pressure water-flow lithotripsy were increased.