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目的:对比分析后腹腔镜肾囊肿去顶联合经皮肾穿刺碎石术与开放手术治疗肾囊肿合并肾或输尿管上段结石的效果,探讨后腹腔镜肾囊肿去顶联合经皮肾穿刺碎石术的安全性及有效性。方法:选取2010年1月至2013年12月80例来三家医院就诊的肾囊肿合并肾或输尿管上段结石患者作为研究对象,采用随机数表法随机分为观察组(40例,行后腹腔镜肾囊肿去顶联合经皮肾穿刺碎石术)和对照组(40例,行开放手术治疗);统计并分析两组手术时间、手术出血量、术后胃肠功能恢复时间、术后下床活动时间、术后住院时间、术后疼痛视觉模拟评分法(VAS)评分、结石清除率、囊肿及结石复发率、并发症发生情况,对后腹腔镜肾囊肿去顶联合经皮肾穿刺碎石术的有效性和安全性作出评价。结果:观察组手术时间、手术出血量、术后胃肠功能恢复时间、术后下床活动时间、术后住院时间均明显低于对照组,差异均具有统计学意义(P<0.05)。观察组术后VAS评分明显低于对照组,差异具有统计学意义(P<0.05);结石清除率明显高于对照组,差异具有统计学意义(P<0.05);观察组术后3个月囊肿复发率、结石复发率均低于对照组,但差异不具有统计学意义(P>0.05)。观察组感染发生率明显低于对照组,差异具有统计学意义(P<0.05);观察组其余各项并发症发生率均低于对照组,但差异不具有统计学意义(P>0.05)。结论:腔镜肾囊肿去顶联合经皮肾穿刺碎石术治疗肾囊肿合并肾或输尿管上段结石具有手术出血少、创伤小、术后疼痛轻、结石清除率高和囊肿及结石复发率低等优点,值得临床推广借鉴。
OBJECTIVE: To compare and analyze the effect of retroperitoneal laparoscopic renal cyst de-crease combined with percutaneous nephrolithotomy and open surgery in the treatment of renal cysts or upper ureteral calculi, and to explore the effect of retroperitoneal laparoscopic renal cyst debridement combined with percutaneous nephrolithotomy The safety and effectiveness. Methods: From January 2010 to December 2013, 80 patients with renal cysts and upper ureteral calculi who were treated in three hospitals were enrolled. The patients were randomly divided into observation group (n = 40), retroperitoneal laparoscopy Renal cysts to the top combined with percutaneous nephrolithotomy) and control group (40 cases, open surgery); statistics and analysis of two groups of operation time, surgical bleeding, postoperative gastrointestinal function recovery time, Activity time, postoperative hospital stay, postoperative visual analog scale pain score (VAS) score, stone removal rate, cyst and stone recurrence rate, complications, retroperitoneal laparoscopic renal cyst descending percutaneous nephrolithotomy The effectiveness and safety of surgery were evaluated. Results: The operation time, operation bleeding, postoperative gastrointestinal function recovery time, postoperative ambulation time, postoperative hospital stay were significantly lower in the observation group, the difference was statistically significant (P <0.05). The postoperative VAS score of the observation group was significantly lower than that of the control group (P <0.05), and the stone clearance rate was significantly higher than that of the control group (P <0.05) Cyst recurrence rate and recurrence rate of stone were lower than those in control group, but the difference was not statistically significant (P> 0.05). The incidence of infection in the observation group was significantly lower than that in the control group (P <0.05). The incidence of other complications in the observation group was lower than that in the control group, but the difference was not statistically significant (P> 0.05). Conclusions: Endoscopic renal cyst debridement combined with percutaneous nephrolithotripsy for the treatment of renal cyst with renal or upper ureteral calculi has the advantages of less bleeding, less trauma, less postoperative pain, high rate of stone removal, lower recurrence rate of cysts and stones Advantages, it is worth clinical promotion.