多通道微通道与标准单通道经皮肾镜取石术治疗复杂性肾结石的对比研究

A comparative study of multiple-tract mini and standard single-tract percutaneous nephrolithotomy in the treatment of complex renal calculi

摘要:

目的：探讨多通道微通道与标准单通道经皮肾镜取石术治疗复杂性肾结石的有效性与安全性。方法：回顾分析2006年12月至2011年12月我院收治的复杂性肾结石共78例，其中40例采用多通道微通道经皮肾镜取石术治疗，38例采用标准单通道经皮肾镜取石术治疗。比较２组的手术时间、住院时间、一期术后结石清除率、辅助治疗、二期术后结石清除率、术中出血量。结果：多通道组和单通道组的手术时间分别为（132.11±12.54） min和（137.85±16.52） min（P=0.09）；两组的住院时间分别为（12.32±2.15） d和（11.45±1.92） d（P=0.06）；一期经皮肾术后结石清除率，多通道组和单通道组分别为77.5%（31/40）和52.63%（20/38）（P=0.02）；术后辅助治疗，多通道组为20.0%（8/40），单通道组为44.74%（17/38）（P=0.02）；多通道组和单通道组二期术后结石清除率分别为92.5%（37/40）以及71.05%（27/38）（P=0.01）；多通道组和单通道组的术中出血量分别为（88.3±7.5） ml和（85.6±8.2） ml（P=0.13）。结论：多通道微通道经皮肾镜取石术治疗复杂性肾结石较标准单通道结石清除率高，更加有效。

Abstract:

Objective：To assess the safety and feasibility of multiple-tract mini and standard single-tract percutaneous nephrolithoto－my in the treatment of complex renal calculi. Methods：Totally 78 cases of complex renal calculi were treated in our hospital from De－cember 2006 to December 2011. Forty cases were treated with multiple-tract mini percutaneous nephrolithotomy and 38 cases were treated with standard single-tract percutaneous nephrolithotomy. Operative time，hospital stay，one phase stone-free rate，postoperative adjuvant therapy，two phase stone-free rate，amount of bleeding were analyzed and compared. Results：In multi-tract group，operative time was （132.11±12.54） min and hospital stay was （12.32±2.15） d and in single-tract group，operative time was （137.85±16.52） min and hospital stay was （11.45±1.92） d （P=0.09 and P=0.06）. One phase stone-free rates in multi-tract group and in single-tract group were 77.5%（31/40） and 52.63%（20/38）（P=0.02）. Rate of adjuvant therapy was 20.0%（8/40）in multi-tract group，significantly lower than 44.74%（17/38） in single-tract group（P=0.02）. Two phase stone-free rates in multi-tract group and in single-tract group were 92.5%（37/40） and 71.05%（27/38）（P=0.01）. Amount of bleeding of two group was （88.3±7.5） ml and （85.6±8.2） ml （P=0.13）. Conclusions：Higher successful rate and stone-free rate can be achieved in patients with complex renal calculi treated by mul－tiple-tract mini percutaneous nephrolithotomy than by standard single-tract percutaneous nephrolithotomy.