COMPARISON OF TREATMENT OF RENAL CALCULI BY OPEN SURGERY, PERCUTANEOUS NEPHROLITHOTOMY, AND EXTRACORPOREAL SHOCKWAVE LITHOTRIPSY
COMPARISON OF TREATMENT OF RENAL CALCULI BY OPEN SURGERY, PERCUTANEOUS NEPHROLITHOTOMY, AND EXTRACORPOREAL SHOCKWAVE LITHOTRIPSY
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DOI：
10.1136/bmj.292.6524.879
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发表时间：
1986-03-29
影响因子：
105.7
通讯作者：
WICKHAM, JEA
中科院分区：
文献类型：
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作者：
CHARIG, CR;WEBB, DR;WICKHAM, JEA
本研究旨在比较不同的治疗肾结石的方法，以确定哪种方法最具成本效益和成功。1052例肾结石患者中，开放手术350例，经皮肾镜取石术350例，体外冲击波碎石术（ESWL）328例，经皮肾镜取石术联合ESWL 24例。如果三个月后结石被消除或减少到小于2 mm，则治疗被定义为成功。273例（78%）患者在开放手术后获得成功，289例（83%）患者在经皮肾镜取石术后获得成功，301例（92%）患者在ESWL后获得成功，15例（62%）患者在经皮肾镜取石术和ESWL后获得成功。相对于NHS，开放手术的总费用估计为3500英镑，经皮肾镜取石术为1861英镑，ESWL为1789英镑，ESWL和肾镜取石术均为3210英镑。体外冲击波碎石术不会造成失血，发病率低，是使患者恢复正常生活的最便宜和最快的方法。
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 .pnd.3500 for open surgery, .pnd.1861 for percutaneous nephrolithotomy, .pnd.1789 for ESWL, and .pnd.3210 for both ESWL and nephrolithotomy. ESWL caused no blood loss and litle morbidity and is the cheapest and quickest way of returning patients to normal life.