梁华良 陈云清 杨大富

【中图分类号】R691.4 【文献标识码】A 【文章编号】1672－3783(2011)07－0044－02

【摘要】目的：探讨经皮肾微造瘘输尿管镜下碎石取石术的临床治疗效果。方法：将60例上尿路结石患者随机分为AB两组，A组应用经皮肾微造瘘输尿管镜下碎石取石术治疗，B组应用传统的开放手术治疗，对照两组结石清除率、平均手术时间、出血量、肾造瘘管平均留置时间、住院时间、并发症等指标，分析两组治疗效果。结果：A组一期结石取净率为90.4%，较B组91.2%两者无显著差异，但A组在平均手术时间、出血量、住院时间、并发症发生率等均较B组减少，有统计学差异。结论：经皮肾微造瘘输尿管镜下碎石取石术具有创伤小，并发症少，恢复快等特点，临床应用效果明显，应首推为治疗上尿路结石的最佳选择。但对于初学者来说，严格掌握适应症及细致谨慎的手术操作才是手术成功的关键。

【关键词】上尿路结石 经皮肾微造瘘取石术 外科开放手术

The clinical effect analysis of the treatment of ureteral calculi by mini percutaneous nephrolithotomy

Liang Hua liangChen Yun qing Yang Da fu

【Summary】Objective：Discuss the clinical effect of the treatment of ureteral calculi by mini percutaneous nephrolithotomy. Method：Take 60 upper-urinary surgery calculi patients divides into AB two teams stochastically, A team apply the treatment of ureteral calculi by mini percutaneous nephrolithotomy operation,B team apply the treatment of the traditional operative method, contrast the data of the two teams as: cleared rate of calculi、the average operation time、bleeding volume、the average stopover time of kidney stomapipe、hospitalization time、complications, analysis the treatment effect of the two teams. Result：A team in phase I : calculi clear rate was 90.4%, no marked difference compare to B team with 91.2%,but there are statistical differences between the A and B team in below items as: the average operation time、bleeding volume、hospitalization time、complications rate ,A team is much less than B team,Conclusion：The operation of ureteral calculi by mini percutaneous nephrolithotomy with the characteristics such as little hurt,less complications，quick recover, clinic apply effect evidence, so it should be regarded the best choice for the treatment for upper-urinary surgery calculi. But for a abecedarian,grasps strictly the indications and the careful discrete surgery operates is the surgery successful key.

【Key words】 Upper-urinary surgery calculiUreteral calculi by mini percutaneous nephrolithotomyOpen surgery

上尿路结石是泌尿外科常见病、多发病。近年来，随着居住环境以及人民生活水平提高，上尿路结石的发病率有逐年提高趋势，且再发率高，容易引起并发症，轻者疼痛、血尿、尿路感染，重者肾功能损害。而我市又属于贫困山区，多半患者起病已多年，但因经济困难忽视有效及时的早期治疗，为提高上尿路结石病人科学治疗的依从性，改善结石病人的生活质量，本组研究通过观察PCNL治疗泌尿系结石的效果及并发症，取得较为满意效果，报告如下。

1资料与方法