CAJ | 학술논문

目的：研究单通道微创经皮肾镜取石术（MPCNL）微创治疗复杂性肾结石的临床疗效及其对患者性功能的影响。方法：选取我院2012年1月至2014年2月接受治疗的116例复杂性肾结石患者，以抽签随机分组方法分为观察组与对照组，每组各58例，观察组予以 MPCNL 治疗，对照组为开放性手术治疗，随访6个月，对比并观察两组治疗效果及治疗后对患者性功能的影响。结果：治疗结果显示：（1）观察组在手术时间（58．59±31．79）min、手术出血量（201．66±22．54）mL、住院时间（5．12±1．29）d、并发症出现率（11．00％）方面均低于对照组手术时间（101．32±27．46）min、手术出血量（408．54±35．16）mL、住院时间（8．49±2．34）d、并发症出现率（21．00％），差异有统计学意义（P ＜0．05）；（2）两组结石清除率分别为93．10％、91．38％，观察组略高但与对照组差异无统计学意义（P ＞0．05）；（3）治疗随访6个月后，观察组患者的勃起功能、患者及其配偶的性生活满意度及性功能质量评分与对照组相比，差异均具有统计学意义（P ＜0．05），但两组性欲对比无差异（P ＞0．05）。结论：在复杂性肾结石的治疗中采用 MPCNL 可缩短手术时间和住院时间，抑制术中出血以及术后并发症，具有较高的临床推广价值。
목적：연구단통도미창경피신경취석술（MPCNL）미창치료복잡성신결석적림상료효급기대환자성공능적영향。방법：선취아원2012년1월지2014년2월접수치료적116례복잡성신결석환자，이추첨수궤분조방법분위관찰조여대조조，매조각58례，관찰조여이 MPCNL 치료，대조조위개방성수술치료，수방6개월，대비병관찰량조치료효과급치료후대환자성공능적영향。결과：치료결과현시：（1）관찰조재수술시간（58．59±31．79）min、수술출혈량（201．66±22．54）mL、주원시간（5．12±1．29）d、병발증출현솔（11．00％）방면균저우대조조수술시간（101．32±27．46）min、수술출혈량（408．54±35．16）mL、주원시간（8．49±2．34）d、병발증출현솔（21．00％），차이유통계학의의（P ＜0．05）；（2）량조결석청제솔분별위93．10％、91．38％，관찰조략고단여대조조차이무통계학의의（P ＞0．05）；（3）치료수방6개월후，관찰조환자적발기공능、환자급기배우적성생활만의도급성공능질량평분여대조조상비，차이균구유통계학의의（P ＜0．05），단량조성욕대비무차이（P ＞0．05）。결론：재복잡성신결석적치료중채용 MPCNL 가축단수술시간화주원시간，억제술중출혈이급술후병발증，구유교고적림상추엄개치。
Objectives:To study the clinical effect of single channel minimally invasive percutaneous neph-rolithotomy in minimally invasive treatment of complicated renal calculi and its effect on sexual function of patients. Methods:1 1 6 complex renal calculi patients in our hospital from January 201 2 to February 201 4 were selected and randomly divided into observation group and control group,46 cases in each group.The observation group received MPCNL treatment and the control group received open operation treatment,with 6 months of follow -up.The influ-ence and therapeutic effect of the two groups before and after the treatment were observed.Results:The results showed that (1 )in the observation group,operation time was (58.59 ±31 .79)min,amount of bleeding was (201 .66 ±22.54)ml,the time of hospitalization was (5.1 2 ±1 .29)d,the incidence of complications was (1 1 %),which were lower than these of the control group,operation time of (1 01 .32 ±27.46)min,operation hemorrhage of (408.54 ±35.1 6)ml,hospitalization time of (8.49 ±2.34)d,the incidence of complications of (21 %).The difference was statistically significant (P <0.05);(2)in the two groups,the stone clearance rate were 93.10% and 91 .38% respectively,without significant difference (P >0.05);(3)after 6 months’treatment, the differences in the erectile function,sexual satisfaction and sexual function and quality of patients and their spouses score between the two groups were statistically significant (P <0.05),but not difference in the aspect of sexuality, (P >0.05).Conclusion:MPCNL in the treatment of complicated renal calculi can shorten the operation time and discharge time,decrease intraoperative bleeding and postoperative complications,which has higher clinical value.