摘要
①目的对比分析后腹腔镜肾盂切开取石术(retroperitoneal laparoscopic pyelolithotomy,RLP)与经皮肾镜碎石取石术(percutaneous nephrolithotomy,PCNL)治疗单发较大(长泾≥2cm)肾盂结石的应用效果和安全性。②方法回顾性分析2012年3月~2018年10月在我院治疗的单发较大肾盂结石患者90例,按治疗方式分为PCNL组(48例)、RLP组(42例),比较两组患者结石一次清除率、手术时间、术中出血量、术后镇痛时间、术后首次下床时间、术后住院血红蛋白降低值以及术后并发症发生情况。③结果RLP组患者手术时间、术后镇痛时间与PCNL组比较差异无统计学意义( P > 0.05 );术中出血量少于PCNL组,术后首次下床时间短于PCNL组,术后血红蛋白降低值低于PCNL组,差异均有统计学意义( P < 0.05 );RLP组一次结石清除率为97.61%(41/42),PCNL组为85.41%(41/48);差异无统计学意义( P > 0.05 );RLP组并发症发生率为14.28%(6/42),PCNL组的22.91%(11/48),差异无统计学意义( P > 0.05 )。④结论RLP治疗单发较大肾盂结石较PCNL具有一次清石率高、出血小、术后并发症少、术后康复快等优点,在腹腔镜技术成熟条件下应用效果更佳,值得积极应用推广。
Objective To compare the application effect and safety of laparoscopic pyelolithotomy and percutaneous nephrolithotomy foRthe treatment of single large renal pelvic.Methods A retrospective analysis was made of 90 cases with single large renal pelvis calculi treated in ouRhospital from March 2012 to OctobeR2018.According to the treatment method,they were divided into PCNL group(48 cases) and RLP group(42 cases).The stones clearance rate of one time,operation time,intraoperative blood loss, postoperative analgesia time,the time of getting out of bed foRthe first time,postoperative hospital hemoglobin reduction,and postoperative complications were compared between the two groups.Results There was no significant difference in patient operation time and postoperative analgesia time between the PCNL group and the RLP group( P > 0.05 ).The intraoperative blood loss in the RLP group was loweRthan that in the PCNL group,and the time of getting out of bed foRthe first time was shorteRthan that in the PCNL group.The postoperative hemoglobin decrement was loweRthan that in the PCNL group,and the difference was statistically significant( P < 0.05 ).The success rate of stone removal in the RLP group was 97.61%(41/42),which was no significant difference compared with 85.41%(41/48)in the PCNL group( P > 0.05 ).The incidence of complications in the RLP group was 14.28%(6/42)loweRthan the 22.91%(11/48)in the PCNL group,the difference was no statistically significant( P > 0.05 ).Conclusion Compared with PCNL,RLP has the advantages of higheRstone removal rate,less risk of bleeding,less postoperative complications and fasteRpostoperative recovery in the treatment of single large renal pelvis calculi.It has betteRapplication effect undeRthe mature conditions of laparoscopy technology,and is worthy of active application and promotion.
作者
吴俊
吴训
黄群联
姜书传
WU Jun;WU Xun;HUANG Qunlian(Department of Urology,The First Affiliated Hospital of Wannan Medical College,Wuhu 241001,China)
出处
《华北理工大学学报（医学版）》
2019年第5期351-354,共4页
Journal of North China University of Science and Technology：Health Sciences Edition
关键词
肾盂结石
取石术
后腹腔镜
Renal Calculus
Stone removal
Retroperitoneoscopy
