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目的:比较B超与X线定位微创经皮肾取石术治疗上尿路结石的临床疗效。方法:选取2010年3月到2012年9月我院收治的上尿路结石患者190例,按照随机数字表法将患者分为研究组和对照组,每组95例;对照组给予X线定位微创经皮肾取石术,研究组给予B超定位微创经皮肾取石术治疗,两组再分为肥胖组和正常体型组;比较各组结石清除率、手术时间、术中出血量、住院时间、并发症发生率及穿刺定位时间。结果:研究组一期结石清除率高于对照组,两组比较差异具有统计学意义(X2=10.751,P=0.024);研究组手术时间、术中出血量、住院时间均显著优于对照组,两组比较差异具有统计学意义(t=9.214,9.013,10.012,P=0.012,0.015,0.009);两组均无严重并发症发生,并发症发生率比较无统计学意义(X2=3.120,P=0.120),研究组中肥胖组定位时间明显长于正常体型组,差异有统计学意义(t=22.939,P=0.003),也长于对照组的肥胖组,差异有统计学意义(t=10.979,P=0.009)。结论:B超定位微创经皮肾取石术治疗上尿路结石具有较好的效果,结石的清除率高,对患者危害小,有利于患者康复。对于肥胖患者,B超定位相对于X线定位无优势。
OBJECTIVE: To compare the clinical efficacy of minimally invasive percutaneous nephrolithotomy using B-ultrasound and X-ray in the treatment of upper urinary tract calculi. Methods: From March 2010 to September 2012, 190 patients with upper urinary tract stones admitted to our hospital were divided into study group and control group according to random number table method, with 95 cases in each group. The control group was given X-ray positioning Minimally invasive percutaneous nephrolithotomy, the study group given minimally invasive percutaneous nephrolithotomy B treatment, the two groups were divided into obesity group and normal body type; stone clearance rate, operative time, intraoperative blood loss, Length of stay, complication rate and puncture location time. Results: The stone clearance rate in the study group was higher than that in the control group (X2 = 10.751, P = 0.024). The operation time, intraoperative blood loss and hospital stay in the study group were significantly better than those in the control group (T = 9.214,9.013,10.012, P = 0.012,0.015,0.009). No serious complication occurred in both groups, and the complication rate was not statistically significant (X2 = 3.120, (T = 22.939, P = 0.003), which was also longer than that of the control group (P = 0.120). The difference was statistically significant (t = 10.979 , P = 0.009). Conclusion: B-positioning minimally invasive percutaneous nephrolithotomy for the treatment of upper urinary tract stones has a good effect, high rate of stone removal, less harmful to patients, is conducive to patient rehabilitation. For obese patients, B-ultrasound has no advantage over X-ray.