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目的:比较超声引导下经皮肾镜应用双频双导管碎石术与单导管超声碎石系统治疗肾结石的优缺点。方法:2008年1月～2012年7月收治138例肾结石患者,对其中63例患者采用双频双导管碎石系统(Cyber-wand)治疗(观察组),对75例患者采用瑞士EMS公司的单导管超声碎石系统治疗(对照组),比较两组的碎石时间、手术时间、结石取净率、平均住院日以及术中出血量等指标。结果:138例患者均获得手术成功,观察组63例患者60例单侧取石,3例双侧取石(均先行单侧取石,术后1个月行另一侧取石),一共66侧取石,平均碎石时间(32.1±15.4)min;对照组73例单侧取石,2例双侧取石,共77侧取石,平均碎石时间(44.7±21.2)min,观察组平均碎石时间明显短于对照组,差异有统计学意义(P<0.05);观察组平均手术时间(68.7±32.8)min短于对照组(77.8±43.5)min(P<0.05);结石取净率95.45%(63/66)明显高于对照组84.42%(65/77)(P<0.05)。两组的术中平均出血量、平均住院日差异无统计学意义(P>0.05)。结论:经皮肾镜应用双频双导管碎石系统治疗肾结石碎石效率高、手术时间短、结石取净率高且并发症较少,值得临床推广。
OBJECTIVE: To compare the advantages and disadvantages of ultrasound-guided percutaneous nephrolithotomy with dual-frequency dual-catheter lithotripsy and single-catheter ultrasonic lithotripsy in the treatment of kidney stones. METHODS: One hundred and thirty-eight patients with nephrolithiasis were enrolled from January 2008 to July 2012. Sixty-three of these patients were treated with the dual-frequency dual-conduit lithotripsy (observation group). 75 patients were treated with Swiss EMS (Control group). The gravel time, operation time, stone removal rate, average length of stay and intraoperative blood loss were compared between the two groups. Results: All the 138 patients were successful in operation. Sixty-three patients in the observation group received unilateral lithotripsy and bilateral biopsy in three patients (both unilateral stone removal and stone removal on the other one month after operation) The average gravel time was 32.1 ± 15.4 min. In the control group, 73 patients were unilateral and 2 patients were scored on both sides with a total of 77 sides. The average gravel time was 44.7 ± 21.2 min. The average gravel time in the observation group was significantly shorter than (68.7 ± 32.8) min in observation group was shorter than that in control group (77.8 ± 43.5) min (P <0.05); The recovery rate of stone was 95.45% (63 / 66) was significantly higher than the control group 84.42% (65/77) (P <0.05). There was no significant difference in average intraoperative blood loss and average length of stay between the two groups (P> 0.05). Conclusion: Percutaneous nephrolithotomy using double-frequency dual-catheter lithotripsy is an effective method for the treatment of renal stone lithotripsy. It has the advantages of high efficiency, short operative time, high rate of stone removal and few complications, which is worthy of clinical promotion.