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| 标准通道与微通道经皮肾镜碎石术治疗上尿路结石的疗效比较 |
| Analysis of standard channel percutaneous nephrolithotomy and micro channel percutaneous nephrolithotomy in treatment of renal and upper ureteral calculus |
| 投稿时间：2016-11-12 |
| DOI：10.3969/j.issn.1000-0399.2017.04.008 |
| 中文关键词: 上尿路结石 经皮肾镜 微通道 标准通道 |
| 英文关键词: Renal and upper ureteral calculus Percutaneousnephrolithotomy Mini-invasive Stand-invasive |
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| 中文摘要: |
| 目的 比较标准通道经皮肾镜碎石术（sPCNL）与微通道经皮肾镜碎石术（mPCNL）治疗上尿路结石的疗效。方法 2015年10月至2016年10月安庆市石化医院收治的62例上尿路结石患者，30例采用sPCNL治疗，32例采用mPCNL治疗。记录并比较两组患者手术时间、结石清除率、血红蛋白下降值、总并发症发生率、高选择性肾动脉栓塞概率和住院时间。结果 sPCNL组手术时间（113.2±49.8）min，mPCNL组手术时间（108.2±41.4）min，差异无统计学意义（P>0.05）；sPCNL、mPCNL两组总结石清除率分别为86.7%（26/30）、87.5%（28/32），差异无统计学意义（P>0.05）；术前术后血红蛋白下降值sPCNL、mPCNL两组分别为（2.15±1.10）、（1.20±1.26）g/L，差异有统计学意义（P<0.05）；总并发症发生率sPCNL、mPCNL两组分别为16.7%（5/30）、15.6%（5/32），差异无统计学意义（P>0.05）；高选择性肾动脉栓塞概率sPCNL、mPCNL两组分别为3.3%（1/30）、3.1%（1/32），差异无统计学意义（P>0.05）；住院时间sPCNL、mPCNL两组分别为（10.3±0.9）、（9.2±0.7）d，差异无统计学意义（P>0.05）。结论 sPCNL与mPCNL均为上尿路结石的理想治疗方法。mPCNL创伤更小，出血量少，对输尿管上段结石患者优势明显。 |
| 英文摘要: |
| Objective To compare the curative effect of standard channel percutaneous nephrolithotomy(sPCNL) and micro channel percutaneous nephrolithotomy(mPCNL) on renal and upper ureteral calculus.Methods A total of 62 patients with renal and upper ureteral calculus were treated in PCNL and divided into sPCNL group(30 cases) and mPCNL group(32 cases) from October 2015 to October 2016 in our hospital. Operation time, stones clearance rate, hemorrhage, postoperative complications, and postoperative length of stay were compared between two groups. Results The average operation time of mPCNL group [(108.2±41.4) min] showed no significant differences compared with that in sPCNL group[(113.2±49.8) min] (P>0.05); the total stone clearance rate of mPCNL group was 87.5%,which of sPCNL group was 86.7%, and there were no significant differences between the two groups(P>0.05); the decreased level of Hb of mPCNL group was (1.20±1.26)g/L, which was significantly lower than that of control group[(2.15±1.10)g/L](P<0.05); the total surgical complication rate of mPCNL group and sPCNL group was 15.6% and 16.7% respectively, and there was no significant difference between the two groups(P>0.05). The superselective renal artery embolization rate of mPCNL group was 3.1%,which of sPCNL group was 3.3% with no significant differences between the two groups(P>0.05); the postoperative hospitalization time of mPCNL group was(9.2±0.7) days, which of sPCNL group was (10.3±0.9) days without any significant differences between the two groups(P>0.05). Conclusion The curative effect of standard channel and micro channel through the percutaneous renal and upper ureteral calculus gravel take stone are all remarkable. mPCNL is less invasivewith less bleeding. Hence, mPCNL has more clinical advantage in treating upper ureteral calculus. |
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