多通道微创经皮肾镜取石术治疗复杂性肾结石的可行性

摘要

Objective To analyze the feasibility and safety of minimally invasive percutaneous nephrolithotomy in treat-ing complex renal calculi. Methods From September 2013 to September 2014, 88 patients with complicated renal cal-culus treated in the Affiliated Hospital of Jinlin Medical College were selected and divided into control group and ob-servation group, patients of two groups were given implemented micro fistula (18F) single channel of minimally invasive percutaneous nephrolithotomy and minimally invasive percutaneous nephrolithotomy stone surgery respectively. The clinical effect of two groups was compared andanalyzed. Results The operation time, intraoperative bleeding, hospital-ization time of two groups were compared, the differences were not statistically significant (P> 0.05). The one and two stage postoperative stone clearance rates in the control group were 50.00%, 68.18%, and one stage and two stage post-operative stone clearance rates in the observation group were 72.73%, 88.64%, the differences were statistically signifi-cant (P< 0.05);The auxiliary treated in control group rate was 43.18%, The auxiliary treated in observe group patients was only 18.18%, the difference was statistically significant (P< 0.05); the complication rates after surgery in the con-trol group were significantly lower than those in the observation group, the differences were statistically significant (P<0.05). Conclusion In the clinical treatment of complicated renal calculi, the implementation of multi channel minimally invasive percutaneous nephrolithotomy treatment can improve the removal rate in patients with gallstone, obtain good clinical outcomes, and it is worth popularizing and applying in clinic.%目的：分析多通道微创经皮肾镜取石术在复杂性肾结石治疗中的应用可行性和安全性。方法选取2013年9月~2014年9月在吉林医药学院附属医院治疗的88例复杂性肾结石患者，将其分为对照组和观察组，分别实施微造瘘(18F)单通道微创经皮肾镜取石术和多通道微创经皮肾镜取石术治疗。比较分析两组患者的临床治疗效果。结果两组患者的手术时间、术中出血量、住院时间之间的差异无统计学意义(P>0.05)；对照组患者的一期、二期术后结石清除率分别为50.00%、68.18%，观察组患者的一期、二期术后结石清除率分别为72.73%、88.64%，两组比较差异有统计学意义(P<0.05)；对照组患者的辅助治疗率达到43.18%，观察组患者的辅助治疗率仅为18.18%，两组比较差异有统计学意义(P<0.05)；观察组患者的术后各并发症发生率明显低于对照组，差异有统计学意义(P<0.05)。结论在复杂性肾结石临床治疗中，实施多通道微创经皮肾镜取石术治疗，能够提高患者的结石清除率，取得良好的临床治疗效果，值得在临床加大推广应用。