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目的:比较不同成分上尿路结石行经皮肾镜取石术的疗效和安全性。方法:回顾性分析2009年4月～2010年11月完成的190例经皮肾镜取石术患者的临床资料:按照术后结石成分分析结果分为草酸盐结石、尿酸盐结石及磷酸盐结石三组,比较三组结石负荷、手术时间、清石率、手术前后血红蛋白(Hb)水平变化及发热等指标的差异。结果:三组结石体积分别为草酸盐组(10.07±25.60)cm3,尿酸盐组(10.91±11.38)cm3,磷酸盐组(19.19±56.16)cm3,差异无统计学意义(P=0.584)。手术时间分别为草酸盐组(76.2±38.9)min,尿酸盐组(90.4±46.8)min,磷酸盐组(76.6±37.0)min,差异无统计学意义(P=0.155)。清石率分别为草酸盐组75.0%,尿酸盐组68.3%,磷酸盐组63.3%,差异无统计学意义(P=0.316)。术后发热病例数分别为草酸盐组30例,尿酸盐组15例,磷酸盐组17例,差异无统计学意义(P=0.740)。手术前后Hb降低值分别为草酸盐组(12.6±11.1)g/L,尿酸盐组(12.2±11.2)g/L,磷酸盐组(10.2±12.1)g/L,差异无统计学意义(P=0.469)。草酸盐组4例输血,尿酸盐组1例输血,磷酸盐组5例输血。结论:草酸盐结石、尿酸盐结石及磷酸盐结石行经皮肾镜取石术的手术疗效相似,并发症发生率也相似。
Objective: To compare the efficacy and safety of percutaneous nephrolithotomy on different components of urinary calculi. Methods: The clinical data of 190 patients who underwent percutaneous nephrolithotomy were retrospectively analyzed from April 2009 to November 2010: According to the results of postoperative calculi analysis, they were divided into oxalate stones, urate stones and phosphate The three groups of stones were compared. The load of stone, the operation time, the rate of clear stone, the change of hemoglobin (Hb) before and after operation and the fever were compared. Results: The volumes of stones in the three groups were no significant difference (P = 0.584), oxalate group (10.07 ± 25.60) cm3, urate group (10.91 ± 11.38) cm3 and phosphate group (19.19 ± 56.16) . The operation time was 76.2 ± 38.9 min in oxalate group, 90.4 ± 46.8 min in urate group and 76.6 ± 37.0 min in phosphate group, respectively. There was no significant difference between the two groups (P = 0.155). The rates of clear stone were 75.0% for oxalate group, 68.3% for urate group and 63.3% for phosphate group, respectively, with no significant difference (P = 0.316). There were 30 cases of oxalate group, 15 cases of urate group and 17 cases of phosphate group. The difference was not statistically significant (P = 0.740). Hb decreased before and after surgery were oxalate group (12.6 ± 11.1) g / L, urate group (12.2 ± 11.2) g / L, phosphate group (10.2 ± 12.1) g / L, the difference was not statistically significant (P = 0.469). In the oxalate group, 4 transfusions, 1 transfusion in the urate group, and 5 transfusions in the phosphate group. Conclusion: The oxalic acid stones, uric acid stones and phosphate stones are similar in the operation of percutaneous nephrolithotomy, and the complication rates are also similar.