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外科研究与新技术 ›› 2015, Vol. 4 ›› Issue (3): 149-152.

• 论著 • 上一篇    下一篇

微创经皮肾联合钬激光碎石治疗复杂性肾结石的疗效及并发症分析

乐有为   

  1. 广东省深圳市龙岗中心医院泌尿外科
  • 收稿日期:2015-07-20 修回日期:2015-07-27 出版日期:2015-09-28 发布日期:2015-10-08
  • 通讯作者: 乐有为 E-mail:yywlg68@126.com

Analysis on the clinical effect and complications of minimally percutaneous nephrolithotomy with holmium laser on the treatment of complex nephritic stone

  • Received:2015-07-20 Revised:2015-07-27 Online:2015-09-28 Published:2015-10-08

摘要: 【摘要】目的 分析微创经皮肾取石术(mPCNL)联合钬激光碎石治疗复杂性肾结石的疗效及并发症。方法 将320例复杂性肾结石患者随机分为A组和B组,各160例,分别采用mPCNL联合钬激光碎石取石术、开放性肾切开取石术进行治疗,比较分析两组手术相关指标、结石清除率、术后疼痛程度及并发症情况。结果 与B组比较,A组的手术时间、术后下床活动时间及住院时间明显缩短,术中出血量减少(P<0.05);A组结石的清除率为92.5%,显著高于B组80.6%(P<0.05);A组患者术后的Ⅱ、Ⅲ级疼痛程度占20.6%,显著低于B组38.1%(P<0.05);A组出血、切口感染、尿瘘及肾绞痛的发生率显著均低于B组(P<0.05)。结论 MPCNL钬激光碎石治疗复杂性肾结石,可有效缩短手术时间,减轻术后疼痛,减少并发症,提高结石清除率。

关键词: 复杂性肾结石, 微创经皮肾镜取石术, 钬激光, 开放性肾切开取石术, 并发症

Abstract: Abstract Objective:To explore the clinical effect and complications of minimally percutaneous nephrolithotomy(mPCNL) with holmium laser on the treatment of complex nephritic stone. Methods:320 patients with complex nephritic stone were treated by mPCNL with holmium laser (Group A, n=160) and open renal lithotomy(Group B, n=160). The operation related indicators, stone clearance rate, degree of postoperative pain and complications between two groups were comparatively analyzed. Result:Compared with Group B, group A, the operation time, postoperative activity time and hospitalization time in Group A were significantly shortened, the intraoperative blood loss was also reduced(P<0.05). The stone clearance rate in Group A were 92.5% and 80.6% in Group B , respectively (P<0.05). The proportion of Ⅱ,Ⅲ pain was 20.6% in Group A, which was significantly lower than 38.1% in Group B(P<0.05). The incidence of bleeding, incision infection, urinary fistula and renal colic in Group A were significantly lower than those in Group B(P<0.05). Conclusions: mPCNL with holmium laser for the treatment of complex nephritic stone can effectively shorten the operation time, reduce postoperative pain and complications, improve the stone clearance rate.

Key words: Complex nephritic stone, Percutaneous nephrolithotomy, Holmium laser, Open renal lithotomy, Complications