中国现代医生
中國現代醫生
중국현대의생
CHINA MODERN DOCTOR
2015年
14期
37-40
,共4页
后腹腔镜%肾囊肿%经皮肾穿刺碎石术%肾或输尿管上段结石
後腹腔鏡%腎囊腫%經皮腎穿刺碎石術%腎或輸尿管上段結石
후복강경%신낭종%경피신천자쇄석술%신혹수뇨관상단결석
Retroperitoneal laparoscopy%Renal cyst%Percutaneous nephrolithotomy%Upper renal or ureteral calculi
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。
目的：探討腎囊腫閤併腎或輸尿管上段結石患者運用後腹腔鏡腎囊腫去頂聯閤經皮腎穿刺碎石術治療的臨床效果。方法選擇2012年9月~2014年9月間我院診治的50例腎囊腫閤併腎或輸尿管上段結石的患者，將其均分為兩組，對照組25例患者實施開放性手術治療，觀察組25例患者運用後腹腔鏡腎囊腫去頂聯閤經皮腎穿刺碎石術治療，比較兩組患者的術中齣血量、手術時間、術後胃腸功能恢複時間、術後住院時間、術後下床活動時間、結石清除率、結石及囊腫複髮率、併髮癥髮生率、術後疼痛視覺模擬評分（VAS）等。結果觀察組患者的術中齣血量、手術時間、術後胃腸功能恢複時間、術後住院時間、術後下床活動時間、術後疼痛視覺模擬評分（VAS）均明顯低于對照組（P<0.05）；觀察組患者的結石清除率明顯高于對照組（P<0.05）；3箇月後複查，觀察組患者結石複髮率及囊腫複髮率低于對照組，但差異無統計學意義（P>0.05）。觀察組患者感染髮生率低于對照組（P<0.05）。結論腎囊腫閤併腎或輸尿管上段結石患者運用後腹腔鏡腎囊腫去頂聯閤經皮腎穿刺碎石術治療具有創傷小、手術齣血量少、術後疼痛輕、囊腫及結石的清除率高、複髮率低等多箇優點，值得在臨床上推廣使用。
목적：탐토신낭종합병신혹수뇨관상단결석환자운용후복강경신낭종거정연합경피신천자쇄석술치료적림상효과。방법선택2012년9월~2014년9월간아원진치적50례신낭종합병신혹수뇨관상단결석적환자，장기균분위량조，대조조25례환자실시개방성수술치료，관찰조25례환자운용후복강경신낭종거정연합경피신천자쇄석술치료，비교량조환자적술중출혈량、수술시간、술후위장공능회복시간、술후주원시간、술후하상활동시간、결석청제솔、결석급낭종복발솔、병발증발생솔、술후동통시각모의평분（VAS）등。결과관찰조환자적술중출혈량、수술시간、술후위장공능회복시간、술후주원시간、술후하상활동시간、술후동통시각모의평분（VAS）균명현저우대조조（P<0.05）；관찰조환자적결석청제솔명현고우대조조（P<0.05）；3개월후복사，관찰조환자결석복발솔급낭종복발솔저우대조조，단차이무통계학의의（P>0.05）。관찰조환자감염발생솔저우대조조（P<0.05）。결론신낭종합병신혹수뇨관상단결석환자운용후복강경신낭종거정연합경피신천자쇄석술치료구유창상소、수술출혈량소、술후동통경、낭종급결석적청제솔고、복발솔저등다개우점，치득재림상상추엄사용。
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 treat-ment 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 hospi-talization 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, post-operative 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.
