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Objective: To investigate the clinic therapeutic effects of Percutaneous Nephrolithotomy in the treatment of complex renal nephrolithiasis,comparing with open surgery.Methods:Clinical application of percutaneous nephrolithotomy in 47cases and open surgery in 30 cases were analyzed retrospectively at our hospital from 2003 to 2008.The mean operation time ,cost and hospital stay,the stone clearance rate ,post and intra operation complications,and renal function progress at discharge home and follow up were compared.All complications were described.The dates were performed by statistical analysis.Results:The stone cleanrance rate at discharge in PCNL group is 78.72%(37/47), and 87.50%(35/40)at follow up. But the stone cleanrance rate of 56.67%(17/30), 68.00%(17/25)at discharge and follow up in open operation group respectively. (p=0.039<0.05,at discharge home between two groupes, and at follow up p=0.056>0.05).The intraoperational complications in 5 cases among PCNL group take 10.63%,and 13 cases in open operation take 43.33%. The postoperative complications in 10 cases (21.27%),and12 cases (40.00%)respectively(the intraoperative p=0.006<0.05,the post operative p=0.013<0.05). The intraoperative average blood losses are 98.910ml,and 172.670ml in open operation group. (u=4.246 p=0.000<0.05).The mean operation time are 1.960+0.470 hours for PCNL and 2.080+0.250 hours for open operation,respectively(t=0.309>0.05).The mean hospitalization are 20+3.7 days for PCNL,and 26.57+4.8days for open operation.The mean serum creatinine76+18.084umol/l(44.790-132.860)versus 125.310+33.278 umol/l(280.230-87.120)between PCNL group and open operation 3 months later at follow up, (u=4.288 p=0.000<0.05). Then 82.087+12.045 umol/l (112.37-61.077)for PCNL versus 99.828+18.258 umol/l (67.34-138.78)for open operation,(u=6.617 p=0.000<0.05)6 months later at follow up.Conclusions: PCNL is a valuable treatment option for complex renal calculi for its safety,effective and less damage,but its cost is higher than open surgery.So it is adapt to spread in excellent and good condition hospital.
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