不同微创手术方案治疗肾结石的疗效和安全.docVIP

不同微创手术方案治疗肾结石的疗效和安全性比较 ［ ］H的探讨经皮肾镜碎石取石术（PCNL）和输尿管硬镜钬激 光碎石术治疗直径〉2 cm肾结石的疗效和安全性。方法回顾性分析 2011年2月?2013年2月收治2 cm的70例肾结石患者的临床资料 及其治疗方法，A组30例采用经皮肾镜碎石取石术（PCNL），B组40 例采用输尿管硬镜钬激光碎石术治疗〉2 cm肾结石。比较并分析两组 治疗方法的一期手术结石清除率、手术时间、手术中出血量、手术并 发症、总结石的清除率、住院天数及住院费用。结果A组和B组一 期手术结石清除率分别为86. 67%和60. 00% （P0. 05）； A组手术时间、 术中出血量、输血率、住院时间、住院费用与并发症率明显低于B组， 差异有统计学意义（P〈0.05）。结论对于直径〉2 cm肾结石，经皮肾 镜碎石取石术与输尿管硬镜钬激光碎石术疗效相近，但经皮肾镜碎石 取石术还具有创伤性小、住院天数短及住院费用低的优势。 和著作权归原 所有， 己 如果需耍分享， 请保留本段说明。 ［关键词］肾结石；经皮肾镜碎石术；输尿管硬镜激光碎石术；安全 ［ ］R692.4 ［ ］B ［ ］1673-9701 (2017) 17-0036-03 ［Abstract］ Objective To discuss the effect and safety of percutaneous nephrolithotomy (PCNL) and ureteroscope holmium laser lithotripsy (HLL) in treatment of renal calculus 2 cm in diameter. Methods A total of 70 patients with renal calculus treated in our hospital from February 2011 to February 2013 were reviewed. 30 patients in group A were treated by PCNL, and 40 patients in group B were treated by ureteroscope HLL. The clearance rate of calculus at first stage of surgery, operation duration, blood loss during operation, complications after operation, overall clearance rate of calculus, hospital stay duration, and hospitalization cost were compared between two groups. Results The clearance rates of calculus at first stage of surgery were 86. 67% and 60. 00% in group A and group B (P0. 05). The operation duration, blood loss during operation, rate of blood transfusion, hospital stay duration, hospitalization cost, and incidence rate of complications were significantly lower in group A than those in group B (P0. 05) . Conclusion For renal calculus 2 cm in diameter, the clinical effects are similar between PCNL and HLL, but PCNL shows smaller invasion, shorter hospital stay, and lower cost. [Keywords] Renal calculus； Percutaneous nephrolithotomy； Urctcroscopc holmium laser lithotripsy； Safety 中华医学会泌尿外科分会认为经皮肾镜碎石取石术（PCNL）可推 荐为治疗直径＞2 cm肾结石的首选方案[1]。目前，随着近年来临床上 输尿管镜设备和技术的不断进步，输尿管硬镜钦激光碎石术也常用来 治疗〉2 cm的肾结石，本次调查系统性回顾了 2011年2月?2013年2 月运用PCNL与同期输尿管硬镜