沈进　周东言　姜心

[摘要] 目的 比较分析经皮肾镜取石术与传统开放性手术治疗肾结石的疗效。 方法 将2014年12月～2016年12月我院收治的60例肾结石患者作为研究对象，将其中采用经皮肾镜取石术的30例肾结石患者作为观察组，其余采取开放性手术的30例肾结石患者作为对照组，比较两组患者的手术时间、术中出血量、术后住院时间及结石碎石成功率、并发症情况。 结果 两组患者的手术时间、术中出血量、平均住院时间比较，差异具有统计学意义（P<0.05），与对照组行开放性手术比较，观察组行经皮肾镜取石术的手术时间短、术中出血少、术后住院时间短。与对照组行开放性手术比较，观察组行经皮肾镜取石术碎石成功率高，两组患者一期碎石成功率比较差异无统计学意义（P>0.05），而两组患者并发症发生率比较差异具有统计学意义（P<0.05），与对照组行开放性手术比较，观察组行经皮肾镜取石术并发症发生率低。 结论 经皮肾镜取石术较传统开放性手术治疗肾结石效果显著，具有手术时间短、术中出血少、术后并发症少、术后恢复快等优点，值得广泛推广和应用。

[关键词] 经皮肾镜取石术；传统开放性手术；肾结石；并发症

[中图分类号] R699 [文献标识码] B [文章编号] 1673-9701（2017）23-0045-03

[Abstract] Objective To compare and analyze the efficacy of percutaneous nephrolithotomy and conventional open surgery in the treatment of renal calculi. Methods 60 cases of patients with kidney stones from December 2014 to December 2016 in our hospital were selected as the research objects， 30 cases of renal calculi treated with percutaneous nephrolithotomy as the observation group， 30 cases of renal calculi patients remaining with open surgery as the control group， the operation time， the amount of intraoperative bleeding， postoperative hospitalization time and lithotripsy success rate， complications were compared between two groups. Results The operation time， bleeding volume and hospitalization time between two groups were statistically significant（P<0.05）， compared with the control group underwent open surgery， operation time of percutaneous nephrolithotomy in observation group was shorter， with less bleeding and shorter hospitalization time. Compared with the control group underwent open surgery， observation group underwent percutaneous nephrolithotomy lithotripsy success rate was higher， there was no statistically significant difference between the two groups in success rate of lithotripsy（P>0.05）， and the complications were statistically significant between two groups（P<0.05）， and compared the control group underwent open surgery， observation group had less complications. Conclusion The percutaneous nephrolithotomy compared with traditional open surgery in the treatment of kidney stones has significant effect， short operation time， less bleeding， less postoperative complications and quick postoperative recovery， is worthy of extensive promotion and application.

[Key words] Percutaneous nephrolithotomy； Conventional open surgery； Renal calculi； Complications

腎结石是泌尿系统常见疾病之一，结石嵌顿易出现肾积水、尿毒症等并发症[1]。手术为治疗肾结石的常用方法，包括传统开放手术、经皮肾镜取石术。传统开放手术虽然能达到取石的目的，但具有创伤大、术中出血多、并发症多等缺点。随着微创外科技术的不断发展，肾结石的治疗方法由开放手术转为微创手术，其中，经皮肾镜取石术（PCNL）作为一种现代微创碎石术，主要适用于2 cm以上的肾结石，或部分输尿管上段结石及体外碎石无效或伴有明显肾积水的2 cm 以下的肾结石[2]。本研究旨在比较分析经皮肾镜取石术与传统开放性手术治疗肾结石的疗效，现报道如下。

1 资料与方法

1.1 一般资料

将2014年12月～2016年12月我院收治的60例肾结石患者作为研究对象，排除肾肿瘤及合并肾结核、肾积脓者。……