开放手术、经皮肾镜取石术和体外冲击波碎石术治疗肾结石的比较。
Comparison of treatment of renal calculi by open surgery, percutaneous nephrolithotomy, and extracorporeal shockwave lithotripsy.
作者信息
Charig C R, Webb D R, Payne S R, Wickham J E
出版信息
Br Med J (Clin Res Ed). 1986 Mar 29;292(6524):879-82. doi: 10.1136/bmj.292.6524.879.
This study was designed to compare different methods of treating renal calculi in order to establish which was the most cost effective and successful. Of 1052 patients with renal calculi, 350 underwent open surgery, 350 percutaneous nephrolithotomy, 328 extracorporeal shockwave lithotripsy (ESWL), and 24 both percutaneous nephrolithotomy and ESWL. Treatment was defined as successful if stones were eliminated or reduced to less than 2 mm after three months. Success was achieved in 273 (78%) patients after open surgery, 289 (83%) after percutaneous nephrolithotomy, 301 (92%) after ESWL, and 15 (62%) after percutaneous nephrolithotomy and ESWL. Comparative total costs to the NHS were estimated as 3500 pounds for open surgery, 1861 pounds for percutaneous nephrolithotomy, 1789 pounds for ESWL, and 3210 pounds for both ESWL and nephrolithotomy. ESWL caused no blood loss and little morbidity and is the cheapest and quickest way of returning patients to normal life.
本研究旨在比较治疗肾结石的不同方法，以确定哪种方法最具成本效益且最为成功。在1052例肾结石患者中，350例行开放手术，350例行经皮肾镜取石术，328例行体外冲击波碎石术（ESWL），24例同时行经皮肾镜取石术和ESWL。若三个月后结石被清除或缩小至小于2毫米，则治疗定义为成功。开放手术后273例（78%）患者取得成功，经皮肾镜取石术后289例（83%）成功，ESWL后301例（92%）成功，经皮肾镜取石术和ESWL联合治疗后15例（62%）成功。据估计，国民保健制度（NHS）的比较总成本为：开放手术3500英镑，经皮肾镜取石术1861英镑，ESWL 1789英镑，ESWL和肾镜取石术联合治疗3210英镑。ESWL不引起失血且发病率低，是让患者恢复正常生活最便宜、最快的方法。
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