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目的比较微创经皮肾镜取石术与大通道经皮肾镜取石术治疗肾结石的临床疗效及安全性。方法选取2013年2月至2015年2月永州市第四人民医院收治的肾结石患者120例,将其随机分为微创经皮肾镜碎石取石(MPCNL)组及大通道经皮肾镜碎石取石(PCNL)组,每组60例,分别以MPCNL及PCNL方式治疗,对比两组患者结石大小、手术时间、手术出血量、术后血红蛋白下降情况、结石取石率,手术中有无腹腔脏器、肾蒂血管损伤等不良反应。结果手术后血红蛋白下降值PCNL组为(14.28±3.91)g/L,MPCNL组为(11.48±1.94)g/L,差异有统计学意义(P<0.05);PCNL组患者手术时间为(112.49±22.14)min,MPCNL组为(128.52±28.15)min,差异未见统计学意义(P<0.05);术中出血量PCNL组为(116.98±32.76)ml,MPCNL组为(54.18±15.22)ml,差异有统计学意义(P<0.05);PCNL组一期结石取尽率为75.34%,MPCNL组为90.15%,差异未见统计学意义(P<0.05)。120例患者均手术成功,无穿刺失败患者,且均无胸膜、腹腔脏器及肾蒂血管损伤等不良反应。结论 MPCNL组患者具有较低的手术出血量、血红蛋白下降值、较高的一期结石清除率,但手术时间延长。两组患者均无手术不良反应,安全性良好。
Objective To compare the clinical efficacy and safety of minimally invasive percutaneous nephrolithotomy with large percutaneous nephrolithotomy in the treatment of kidney stones. Methods One hundred and twenty patients with nephrolithiasis who were admitted to the Fourth People’s Hospital of Yongzhou from February 2013 to February 2015 were randomly divided into minimally invasive percutaneous nephrolithotomy (MPCNL) group and percutaneous nephrolithotomy The patients in each group were treated with MPCNL and PCNL respectively. The stone size, operation time, blood loss, postoperative hemoglobin drop, stone extraction rate, intraoperative abdomen Organ, renal pedicle vascular injury and other adverse reactions. Results The decrease of hemoglobin after operation was (14.28 ± 3.91) g / L in PCNL group and (11.48 ± 1.94) g / L in MPCNL group, the difference was statistically significant (P <0.05); the operation time in PCNL group was (112.49 ± 22.14) min in MPCNL group and (128.52 ± 28.15) min in MPCNL group, the difference was not statistically significant (P <0.05); the amount of bleeding in PCNL group was (116.98 ± 32.76) ml and that in MPCNL group was (54.18 ± 15.22) The difference was statistically significant (P <0.05). The rate of primary stone in PCNL group was 75.34% and that in MPCNL group was 90.15%. There was no significant difference between the two groups (P <0.05). All of the 120 patients were successfully operated without any puncture failure, and no adverse reactions such as pleural injury, abdominal viscera and renal pedicle vascular injury were found. Conclusions Patients in MPCNL group have lower operative blood loss, hemoglobin decrease and higher rate of primary stone removal, but the operation time is prolonged. Two groups of patients without adverse reactions, safety is good.