[1]景中民,卢学仁,徐海亮,等.经皮肾镜取石术与后腹腔镜肾盂切开取石术治疗肾盂结石疗效比较[J].新乡医学院学报,2018,35(2):133-135.[doi:10.7683/xxyxyxb.2018.02.013]
　JING Zhong-min,LU Xue-ren,XU Hai-liang,et al.Comparison of the effect between percutaneous nephrolithotomy and retroperitoneal laparoscopic pyelolithotomy in the treatment of renal pelvis calculus[J].Journal of Xinxiang Medical University,2018,35(2):133-135.[doi:10.7683/xxyxyxb.2018.02.013]
点击复制

经皮肾镜取石术与后腹腔镜肾盂切开取石术治疗肾盂结石疗效比较
分享到：

《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
35
期数:
2018年2
页码:
133-135
栏目:
临床研究
出版日期:
2018-02-05

文章信息/Info

Title:
Comparison of the effect between percutaneous nephrolithotomy and retroperitoneal laparoscopic pyelolithotomy in the treatment of renal pelvis calculus
作者:
景中民1; 卢学仁1; 徐海亮1; 夏明亮1; 张雪培2
（1.驻马店市中心医院泌尿外科，河南　驻马店　463000；2.郑州大学第一附属医院泌尿外科，河南　郑州　450003）
Author(s):
JING Zhong-min1; LU Xue-ren1; XU Hai-liang1; XIA Ming-liang1; ZHANG Xue-pei2
（1.Department of Urology，Zhumadian Central Hospital，Zhumadian 463000，Henan Province，China；2.Department of Urology，the First Affiliated Hospital of Zhengzhou University，Zhengzhou 450003，Henan Province，China）
关键词:
肾盂结石; 后腹腔镜肾盂切开取石术; 经皮肾镜取石术
Keywords:
renal pelvis calculus; retroperitoneal laparoscopic pyelolithotomy; percutaneous nephrolithotomy
分类号:
R692.4
DOI:
10.7683/xxyxyxb.2018.02.013
文献标志码:
A
摘要:
目的　比较经皮肾镜取石术（PCNL）和后腹腔镜肾盂切开取石术（RLP）治疗肾盂结石的临床效果，为选择肾盂结石治疗方法提供依据。方法　选取2012年1月至2016年12月驻马店市中心医院收治的肾盂结石患者108例，根据治疗方法将患者分为PCNL组（n=59）和RLP组（n=49），对2组患者的手术时间、术中失血量、术中输血率、手术成功率、结石清除率、术后血红蛋白降低值、术后镇痛时间、术后住院时间及并发症发生率进行比较。结果　PCNL组和RLP组患者手术成功率分别为94.9%（56/59）、100.0%（49/49），2组患者手术成功率比较差异无统计学意义（χ2=1.026，P>0.05）。PCNL组和RLP组患者结石完全清除率分别为94.9%（56/59）、98.0%（48/49），2组患者结石完全清除率比较差异无统计学意义（χ2=0.140，P>0.05）。PCNL组和RLP组患者术中输血率分别为5.1%（3/59）、2.0%（1/49），2组患者术中输血率比较差异无统计学意义（χ2=0.105，P>0.05）。2组患者手术时间、术后镇痛时间比较差异均无统计学意义（P>0.05）。与PCNL组比较，RLP组患者术中失血量及术后血红蛋白水平降低少，术后住院时间短（P<0.05）。PCNL组患者术后尿漏、泌尿系统感染及继发性出血发生率分别为3.4%（2/59）、8.5%（5/59）、6.8%（4/59），RLP组患者术后尿漏、泌尿系统感染及继发性出血发生率分别为8.2%（4/49）、4.1%（2/49）、4.1%（2/49），2组患者术后尿漏、泌尿系统感染及继发性出血发生率比较差异均无统计学意义（χ2=2.975、1.064、1.811，P>0.05）。结论　PCNL和RLP治疗肾盂结石的临床效果相当，且安全性较高；但RLP术中出血量少，患者术后恢复快、住院时间短。
Abstract:
Objective　To compare the clinical effect between percutaneous nephrolithotomy （PCNL） and retroperitoneal laparoscopic pyelolithotomy （RLP） in the treatment of renal pelvis calculus，so as to provide evidence for the treatment of renal pelvis calculus.Methods　A total of 108 patients with renal pelvis calculus were selected from January 2012 to December 2016 in Zhumadian Central Hospital.The patients were divided into PCNL group （n=59） and RLP group （n=49） according to the therapeutic method.The operation time，intraoperative blood loss，intraoperative blood transfusion rate，operative success rate，stone clearance rate，postoperative hemoglobin reduction，postoperative analgesia time，postoperative hospitalization time and the incidence of complications were compared between the two groups.Results　The success rate of operation in PCNL group and RLP group was 94.9% （56/59） and 100.0% （49/49） respectively，there was no significant difference in the success rate of operation between the two groups （χ2=1.026，P>0.05）.The stone clearance rate in PCNL group and RLP group was 94.9% （56/59） and 98.0% （48/49） respectively，there was no significant difference in the stone clearance rate between the two groups （χ2=0.140，P>0.05）.The intraoperative blood transfusion rate in PCNL group and RLP group was 5.1% （3/59） and 2.0% （1/49） respectively，there was no significant difference in the intraoperative blood transfusion rate between the two groups （χ2=0.105，P>0.05）.There was no significant difference in operation time and postoperative analgesia time between the two groups （P>0.05）.Compared with the PCNL group，the blood loss and postoperative hemoglobin reduction were less，and the postoperative hospitalization time was shorter in the RLP group （P<0.05）.The incidence of postoperative urinary leakage，urinary tract infection and secondary hemorrhage in PCNL group was 3.4% （2/59），8.5% （5/59） and 6.8% （4/59） respectively；the incidence of postoperative urinary leakage，urinary tract infection and secondary hemorrhage in RLP group was 8.2% （4/49），4.1% （2/49） and 4.1% （2/49） respectively；there was no significant difference in the incidence of postoperative urinary leakage，urinary tract infection and secondary hemorrhage between the two groups （χ2=2.975，1.064，1.811；P>0.05）.Conclusion　The clinical effect of PCNL and RLP in the treatment of renal pelvis calculus is fairly，and their safety is high.However，RLP has the advantages of less intraoperative bleeding，quick postoperative recovery and short hospitalization time.

参考文献/References:

［1］　DE CASTRO S M，REEKERS J A，DWARS B J，et al.Delayed intrahepatic subcapsular hematoma after laparoscopic cholecystectomy［J］.Clin Imaging，2012，36（5）： 629-631.
［2］　石奇刚，孙永恒，任艳胜.微创经皮肾镜取石术治疗输尿管上段结石合并轻度肾积水疗效观察［J］.新乡医学院学报，2017，34（3）：235-237，240.
［3］　张道秀，乔保平，文思态，等.输尿管软镜在小儿上尿路结石治疗中的应用及并发症分析［J］.中华实用儿科临床杂志，2017，32（5）：377-379.
［4］　LEE J W，CHO S Y，JEONG C W，et al.Comparison of surgical outcomes between laparoscopic pyelolithotomy and percutaneous nephrolithotomy in patients with multiple renal stones in various parts of the pelvocalyceal system［J］.J Laparoendosc Adv Surg Tech A，2014，24（9）： 634-639.

更新日期/Last Update: 2018-02-05