CAJ | 학술논문

目的：总结微创经皮肾镜取石术与标准通道经皮肾镜取石术经验和手术技巧以及适应证。方法回顾性分析本人于2007年1月至2013年12月采用B超引导下微创经皮肾镜取石术与标准通道经皮肾镜取石术治疗3324例肾、输尿管结石患者的临床资料，分析其疗效及并发症进而总结两种手术的优缺点及适应证。结果3324例患者完成手术，其中1723例行微通道经皮肾镜手术，1601例行标准通道经皮肾镜术。2组术后结石清除率分别为95．4％、99．5％；手术时间分别为（67±31．4）分钟、（45．1±22．4）分钟；术中出血量分别为（101±25．6）ml、（159±34．2）ml；术后并发症发生率分别为12．2％，23．6％。结论微通道经皮肾镜取石术与标准通道经皮肾镜取石术都是安全微创的手术方式。微通道经皮肾镜取石术并发症及出血风险较低，但是取石效率低于标准通道经皮肾镜取石术，要根据具体病人合理选择两种术式。
목적：총결미창경피신경취석술여표준통도경피신경취석술경험화수술기교이급괄응증。방법회고성분석본인우2007년1월지2013년12월채용B초인도하미창경피신경취석술여표준통도경피신경취석술치료3324례신、수뇨관결석환자적림상자료，분석기료효급병발증진이총결량충수술적우결점급괄응증。결과3324례환자완성수술，기중1723례행미통도경피신경수술，1601례행표준통도경피신경술。2조술후결석청제솔분별위95．4％、99．5％；수술시간분별위（67±31．4）분종、（45．1±22．4）분종；술중출혈량분별위（101±25．6）ml、（159±34．2）ml；술후병발증발생솔분별위12．2％，23．6％。결론미통도경피신경취석술여표준통도경피신경취석술도시안전미창적수술방식。미통도경피신경취석술병발증급출혈풍험교저，단시취석효솔저우표준통도경피신경취석술，요근거구체병인합리선택량충술식。
Objective To summarize experience of mini-percutaneous nephrolithotomy and standard percu-taneous nephrolithotomy(PCNL)in the treatment of upper urinary calculi and improve curative level and opera-tion skills and prevention of complications. Methods We retrospectively analyzed the data of 3324 patients trea-ted for upper urinary calculi between 2007 . 01 and 2013 . 12 ,in which 1723 patients underwent mini-percuta-neous nephrolithotomy (MPCNL),while 1601 patients were performed by standard-percutaneous nephrolithoto-my. The success rate of stone fragmentation ,the mean operating time and cadaverine quantity of bleeding of pa-tients undergoing mini-percutaneous nephrolithotomy and percutaneous nephrolithotomy were recorded . Results The stone -free rate of MPCNL group and PCNL group w as 95. 4%、99. 5%,respectively. The operation time was 67 ± 31. 4min、45. 1 ± 22. 4min,respectively. The cadaverine quantity of bleeding was 101 ± 25. 6 ml、159 ± 34. 2ml,respectively. The mean hospital stay was 9. 7 ± 1. 4 day、9. 3 ± 2. 3 day and 7. 5~1. 7 day. respectively. The rate of complications was 12. 2% and 23. 6%,respectively. Conclusions Both mini-percutaneous nephro-lithotomy and standard percutaneous nephrolithotomy are safe in the treatment of Upper Urinary Calculi. MPC-NL,which was characterized by its safety,much more minimal in vasiveness but the low clearance rate of ureter-al calculi could be the best choice for the treatmen t of upper urinary calculi <2cm.