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后腹腔镜肾囊肿去顶联合经皮肾穿刺碎石术治疗肾囊肿合并肾或输尿管上段结石的临床疗效观察(1)
http://www.100md.com 2015年5月15日 《中国现代医生》 2015年第14期
     [摘要] 目的 探讨肾囊肿合并肾或输尿管上段结石患者运用后腹腔镜肾囊肿去顶联合经皮肾穿刺碎石术治疗的临床效果。 方法 选择2012年9月~2014年9月间我院诊治的50例肾囊肿合并肾或输尿管上段结石的患者,将其均分为两组,对照组25例患者实施开放性手术治疗,观察组25例患者运用后腹腔镜肾囊肿去顶联合经皮肾穿刺碎石术治疗,比较两组患者的术中出血量、手术时间、术后胃肠功能恢复时间、术后住院时间、术后下床活动时间、结石清除率、结石及囊肿复发率、并发症发生率、术后疼痛视觉模拟评分(VAS)等。 结果 观察组患者的术中出血量、手术时间、术后胃肠功能恢复时间、术后住院时间、术后下床活动时间、术后疼痛视觉模拟评分(VAS)均明显低于对照组(P<0.05);观察组患者的结石清除率明显高于对照组(P<0.05);3个月后复查,观察组患者结石复发率及囊肿复发率低于对照组,但差异无统计学意义(P>0.05)。观察组患者感染发生率低于对照组(P<0.05)。结论 肾囊肿合并肾或输尿管上段结石患者运用后腹腔镜肾囊肿去顶联合经皮肾穿刺碎石术治疗具有创伤小、手术出血量少、术后疼痛轻、囊肿及结石的清除率高、复发率低等多个优点,值得在临床上推广使用。
, 百拇医药
    [关键词] 后腹腔镜;肾囊肿;经皮肾穿刺碎石术;肾或输尿管上段结石

    [中图分类号] R699 [文献标识码] B [文章编号] 1673-9701(2015)14-0037-04

    [Abstract] Objective To study the clinical effects of retroperitoneal laparoscopy renal cyst unroofing combined with percutaneous nephrolithotomy for patients with renal cyst complicated with upper renal or ureteral calculi. Methods 50 patients with renal cyst complicated with upper renal or ureteral calculi who were diagnosed and treated in our hospital from September 2012 to September 2014 were selected. They were equally assigned to two groups. 25 patients in the control group were given the treatment of open surgery, and 25 patients in the observation group were given the treatment of retroperitoneal laparoscopy renal cyst unroofing combined with percutaneous nephrolithotomy. Amount of bleeding during the surgery, surgery time, postoperative recovery time of gastrointestinal functions, postoperative hospitalization time, postoperative exercise time, calculi clearance rate, relapse rate of calculi or cyst, incidence rate of complications, VAS and other indices between the two groups were compared. Results Amount of bleeding during surgery, surgery time, postoperative recovery time of gastrointestinal functions, postoperative hospitalization time, postoperative exercise time and VAS in the observation group were all significantly lower than those in the control group, (P<0.05); calculi clearance rate in the observation group was significantly higher than that in the control group (P<0.05); selected patients were re-examined after three months, and calculi relapse rate and cyst relapse rate in the observation group were both lower than those in the control group, but the differences were not statistically significant (P>0.05). Incidence rate of infections in the observation group was lower than that in the control group (P<0.05). Conclusion Retroperitoneal laparoscopy renal cyst unroofing combined with percutaneous nephrolithotomy for patients with renal cyst complicated with upper renal or ureteral calculi has various advantages of less trauma, less amount of bleeding during surgery, less pain after surgery, higher clearance rate of cyst and calculi and lower relapse rate, which is worthy of clinical promotion and application., 百拇医药(张晓 谢波 莫启旺)
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