体外冲击波碎石术与经皮肾镜碎石取石术治疗上尿路结石疗效对比观察

摘要

Objective:To study the clinical curative effect of renal and ureteral calculi treatment with percutaneous nephroscopic pneumatic lithotripsy and extracorporeal shock wave lithotripsy.Method: 300 cases of renal and ureteral calculi in our hospital from January 2010 to December 2014 were randomly divided into observation group and control group, the observation group taken percutaneous nephroscopic pneumatic lithotripsy, the control group adopted extracorporeal shock wave lithotripsy. The curative effect, complication and operation index of two groups were compared. Result:In the observation group, the clearance rate was 90.0%, was higher than that of the control group 82.0%, the difference was significant (P<0.05). The observation group after two times the removal ,its total cure rate was 96.0%, it was significantly higher than 88.0% compared to the control group, the difference was obviously significant (P<0.05). The incidence of complication, the control group was 8.0% ,which was significantly lower than that in the observation group (17.0%), the difference was obviously significant (P<0.05). The results showed the observation group operation hemorrhage was (203.16±21.34) mL, length of hospital stay was (5.07±1.19) d, were higher than the control group, the operation time was (57.63±13.52) min was significantly lower than the control group, the differences were statistically significant (P<0.05).Conclusion:Percutaneous nephrolithotomy pneumatic lithotripsy under high clearance rate, but more complications than extracorporeal shock wave lithotripsy, and higher treatment costs, so in the choice of mode of operation must be considered the actual situation of patients, select the appropriate type of operation.%目的：比较上尿路结石患者采取经皮肾镜碎石取石术以及体外冲击波碎石术的临床疗效。方法：将2010年1月-2014年12月本院接受肾输尿管结石治疗的300例患者以抽签法随机分为观察组与对照组，观察组采取经皮肾镜碎石取石术，对照组采取体外冲击波碎石术，比较两组患者的疗效、并发症以及手术指标。结果：观察组患者结石一次清除率为90.0%，与对照组的82.0%比较差异有统计学意义（P<0.05）。观察组患者结石二次清除后的总治愈率为96.0%，与对照组的88.0%比较差异有统计学意义（P<0.05）。对照组患者的并发症发生率仅为8.0%，与观察组的17.0%比较差异有统计学意义（P<0.05）。观察组患者手术出血量为（203.16±21.34）mL、住院时间为（5.07±1.19）d，均高于对照组，而手术时间（57.63±13.52）min低于对照组，差异均有统计学意义（P<0.05）。结论：经皮肾镜碎石取石术的结石清除率较高，但是并发症多于体外冲击波碎石术，且治疗费用较高，因此在治疗方式的选择上必须考虑患者的实际情况，选择适当的外科治疗类型。