To investigate the clinical efficacy for minimally invasive percutaneous nephrolithotomy lithotomy in the kidney stones after open surgery. Methods 48 patients of hospitalized open surgery with a history of kidney stones from February 2010 to June 2011 were randomly divided into the MPCNL group and PCNL group, and they were taken with minimally invasive percutaneous nephrolithotomy stone surgery (with MPCNL) and percutaneous nephrolithotomy lithotomy (PCNL), of which 31 cases were in left and right side was in 17 cases, 25 cases were of single stones, and multiple stones were in 18 patients, five cases were of staghom calculi, and calculus volume was 4.0～25.0cm3. The postoperative clinical results and complications were compared. Results The hospitalized time in MPCNL group of patients was significantly shorter than PCNL group (P < 0.05), and the average operative time and average cost of hospitalization were no statistically significant ( P > 0.05 ). The average of stones cleared in the MPCNL group of patients was 81. 8% , significantly higher than in the PCNL group with 64. 4%. The recurrence rate of the MPCNL group was 4.0% , significantly lower than the the PCNL group of 13. 1% (P<0.05). The post-operative complications in the MPCNL group of patients was 8.0% , significantly lower than PCNL group of 26.1 % (P < 0.05). Conclusion The clinical efficacy for MPCNL in the treatment of kidney stones or recurrent aspects with open surgery is good, with tissue trauma and low complication rate.%目的 探讨微创经皮肾镜取石术(MPCNL)在开放手术后治疗肾结石的临床疗效.方法 将2010年2月～2011年6月入院的有开放手术病史的肾结石患者48例随机分成MPCNL组和PCNL组,分别行微创经皮肾镜取石术(MPCNL)和经皮肾镜取石术(PCNL),其中左侧31例,右侧17例,单发性结石25例,多发性结石18例,鹿角形结石5例,结石体积4.0～25.0cm3,比较术后临床效果、并发症等.结果 MPCNL组患者的住院时间较PCNL组显著缩短(P＜0.05),但平均手术时间平均住院费用无统计学意义(P＞0.05)；MPCNL组患者的平均结石清除率为81.8％,显著高于PCNL组患者64.4％；MPCNL组术后复发率为4.0％,显著低于PCNL组13.1％,(P＜0.05)；MPCNL组患者手术后并发症的出现率为8.0％,显著低于PCNL组患者的26.1％,(P＜0.05).结论 MPCNL在治疗开放手术后肾结石残留或复发方面临床疗效良好,组织创伤小,并发症发生率低.
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