【摘要】 目的比较和评价PCNL碎石与开放性手术在治疗复杂性肾结石的临床价值。方法回顾分析20例经皮肾穿刺碎石术和15例肾切开取石及肾盏成形术的临床资料,统计分析两种术式在手术时间、术中出血量、结石清除情况、术后住院时间及并发症发生率等差异。结果两组平均手术时间、平均出血量、术后住院时间分别为300min(180～540min)和150min(120～240min);150mL(80～250mL)和300mL(150～600mL);14d(5～18d)和10d(8～14d)。20例PCNL中一次取净结石5例,Ⅰ期结石取净率25.00%,二次取净结石11例,三次取净结石2例,四次取净结石2例。15例肾切开取石及肾盏成形术中全部一次取净结石,结石取净率100.00%。术中并发症:PCNL组有3例,占手术的15.00%;开放手术组有5例,占手术的33.33%。结论PCNL在出血量及并发症发生优于开放手术组,但手术时间及术后住院时间较开放手术长,结石一次清除率低。对复杂性巨大鹿角肾结石较适合用开放性手术治疗。更多还原

【Abstract】 Objective To compare and evaluate the clinical value between PCNL and surgical intervention for the treatment of complicated renal stone. Methods The clinical data of 20 cases of patients underwent PCNL and 18 cases of patients underwent surgical intervention were analyzed retrospectively.The differences in operating time,average bleeding volume during operation,stone clearance,hospitalization stay after operation and occurrence of complication of the two procedures were compared. Results In PCNL,5 of 20 patients were treated successfully in the first one session,the tonal stone clearance rate was 25.00%. In open surgery,15 patients were treated successfully in first session,the tonal stone clearance rate was 100.00%.The mean operation time,average bleeding volume during operation,hospitalization stay after operation of the PCNL and surgery group were 300 min (range 180～540)vs 150 min (range 120～240); 150 mL(range 80～250) vs 300 mL(range 150～600); 14 days (range 5～18) vs 10 days (range 8～14),respectively. In the PCNL,the hemorrhage occurred in 3 cases,the complication rate was 15.00%. In open surgery,the hemorrhage in 3 cases,pleural injury occurred in 2 cases,the complication rate was 33.33%. Conclusion In open surgery group,the operation time during operation,hospitalization stay after operation,stone clearance rate were superior to those in PCNL group. Open surgery would become the first choice of complicated renal stone.更多还原