CAJ | 학술논문

目的：对比分析后腹腔镜肾囊肿去顶联合经皮肾穿刺碎石术与开放手术治疗肾囊肿合并肾或输尿管上段结石的效果，探讨后腹腔镜肾囊肿去顶联合经皮肾穿刺碎石术的安全性及有效性。方法：选取2010年1月至2013年12月80例来三家医院就诊的肾囊肿合并肾或输尿管上段结石患者作为研究对象，采用随机数表法随机分为观察组（40例，行后腹腔镜肾囊肿去顶联合经皮肾穿刺碎石术）和对照组（40例，行开放手术治疗）；统计并分析两组手术时间、手术出血量、术后胃肠功能恢复时间、术后下床活动时间、术后住院时间、术后疼痛视觉模拟评分法（ VAS ）评分、结石清除率、囊肿及结石复发率、并发症发生情况，对后腹腔镜肾囊肿去顶联合经皮肾穿刺碎石术的有效性和安全性作出评价。结果：观察组手术时间、手术出血量、术后胃肠功能恢复时间、术后下床活动时间、术后住院时间均明显低于对照组，差异均具有统计学意义（ P＜0．05）。观察组术后VAS评分明显低于对照组，差异具有统计学意义（ P＜0．05）；结石清除率明显高于对照组，差异具有统计学意义（ P＜0．05）；观察组术后3个月囊肿复发率、结石复发率均低于对照组，但差异不具有统计学意义（ P＞0．05）。观察组感染发生率明显低于对照组，差异具有统计学意义（P ＜0．05）；观察组其余各项并发症发生率均低于对照组，但差异不具有统计学意义（ P＞0．05）。结论：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具有手术出血少、创伤小、术后疼痛轻、结石清除率高和囊肿及结石复发率低等优点，值得临床推广借鉴。
목적：대비분석후복강경신낭종거정연합경피신천자쇄석술여개방수술치료신낭종합병신혹수뇨관상단결석적효과，탐토후복강경신낭종거정연합경피신천자쇄석술적안전성급유효성。방법：선취2010년1월지2013년12월80례래삼가의원취진적신낭종합병신혹수뇨관상단결석환자작위연구대상，채용수궤수표법수궤분위관찰조（40례，행후복강경신낭종거정연합경피신천자쇄석술）화대조조（40례，행개방수술치료）；통계병분석량조수술시간、수술출혈량、술후위장공능회복시간、술후하상활동시간、술후주원시간、술후동통시각모의평분법（ VAS ）평분、결석청제솔、낭종급결석복발솔、병발증발생정황，대후복강경신낭종거정연합경피신천자쇄석술적유효성화안전성작출평개。결과：관찰조수술시간、수술출혈량、술후위장공능회복시간、술후하상활동시간、술후주원시간균명현저우대조조，차이균구유통계학의의（ P＜0．05）。관찰조술후VAS평분명현저우대조조，차이구유통계학의의（ P＜0．05）；결석청제솔명현고우대조조，차이구유통계학의의（ P＜0．05）；관찰조술후3개월낭종복발솔、결석복발솔균저우대조조，단차이불구유통계학의의（ P＞0．05）。관찰조감염발생솔명현저우대조조，차이구유통계학의의（P ＜0．05）；관찰조기여각항병발증발생솔균저우대조조，단차이불구유통계학의의（ P＞0．05）。결론：강경신낭종거정연합경피신천자쇄석술치료신낭종합병신혹수뇨관상단결석구유수술출혈소、창상소、술후동통경、결석청제솔고화낭종급결석복발솔저등우점，치득림상추엄차감。
Objective: To compare and analyse the clinical efficacy of retroperitoneal laparoscopic renal cyst unroofing combined with minimally invasive percutaneous nephrolithotomy with open surgery in the treatment of renal cyst combined with renal or upper ureteral calculi , to discuss the safety and efficacy of retroperitoneal laparoscopic renal cyst unroofing combined with minimally invasive percutaneous nephrolithotomy .Method:From January 2010 to December 2013, selected 80 cases of re-nal cyst combined with renal or upper ureteral calculi treated in our hospital as study objects .They were randomly divided into observation group and control group by random number table method .The observation group received retroperitoneal laparoscop-ic renal cyst unroofing combined with minimally invasive percutaneous nephrolithotomy treatment , the control group received open surgery treatment .Compared and analysed the efficacy difference between the two groups in operation time , intraoperative blood soss, postoperative gastrointestinal function recovery time , postoperative ambulation time , postoperative hospital stay , postoperative pain visual analog scale( VAS) score, stone clearance rate , cysts and stone recurrence rate and the occurrence of complications .Evaluated the safety and efficacy of retroperitoneal laparoscopic renal cyst unroofing combined with minimally in -vasive percutaneous nephrolithotomy .Result:The observation group were significantly lower than the control group in operative time, blood loss, postoperative recovery of gastrointestinal function , postoperative ambulation time , postoperative hospital stay , the differences were statistically significant (P <0.05).The observation group was significantly lower than the control group in postoperative VAS score , the difference was statistically significant ( P <0.05); the observation group was significantly higher than the control group in stone clearance rate , the difference was statistically significant ( P <0.05);The observation group was lower than the control group in cyst recurrence rate , stone recurrence rate 3 months after the operation , but the difference were not statistically significant ( P>0.05) .The observation group was significantly lower than the control group in the incidence of infection rate, the difference was statistically significant (P <0.05);the observation group were lower than the control group in other complication rates, but the differences were not statistically significant (P>0.05).Conclusion:Retroperitoneal laparo-scopic renal cyst unroofing combined with minimally invasive percutaneous nephrolithotomy has the advantage of less blood loss , smaller surgical trauma , less postoperative pain , stone clearance rate and low recurrence rate of renal cysts and stones , etc.in the treatment of renal cysts and renal or upper ureteral calculi , It's worthy of clinical reference .