微创经皮肾镜碎石术联合输尿管软镜碎石术治疗孤立肾结石的临床研究

Clinical study of minimally invasive percutaneous nephrolithotomy combined with ureteral soft lithotripsy in the treatment of isolated kidney stones

目的探讨微创经皮肾镜碎石术联合输尿管软镜碎石术治疗孤立肾结石的临床效果,并进行比对。方法选取孤立肾结石患者96例,根据两组患者治疗方法的不同分为两组,每组48例,对照组患者予以微创经皮肾镜碎石术治疗,观察组行输尿管软镜碎石术进行治疗,观察两组患者手术指标、治疗效果及治疗后肾功能。结果观察组观察组患者手(104.59±18.61)min术时间显著长于对照组(72.46±16.67)min,但术中出血量(104.59±18.61)ml、术后肠道功能恢复时间(24.21±14.69)d、住院时间(10.04±1.43)d均显著少于对照组(122.31±16.39)ml、(33.46±11.38)d、(12.98±1.32)d,差异有统计学意义(P<0.05);观察组患者一期清石率及术后出血率显著低于对照组,但术后感染率显示低于对照组(P<0.05),术后复发率比较差异无统计学意义;治疗后对照组患者Scr显著高于观察组(P<0.05);治疗后NGAL与观察组比较差异无统计学意义。结论微创经皮肾镜碎石术联合输尿管软镜碎石术治疗孤立肾结石效果良好,微创经皮肾镜碎石的手术时间短和清石率较高,输尿管软镜碎石的术中出血少、复发率小,为保证手术的效果应根据患者实际情况而对手术治疗方案进行合理选取。

Objective To explore the clinical effect of minimally invasive percutaneous nephrolithotomy combined with ureteral soft lithotripsy for the treatment of isolated kidney stones and to compare.Methods96patients with isolated renal calculi admitted in our hospital were divided into two groups according to the different treatment methods.The patients in the control group were treated with minimally invasive Percutaneous nephrolithotomy was performed.The observation group was treated with ureteroscopic soft lithotripsy.The surgical indexes,the therapeutic effect and the renal function after treatment were observed.Results The observation group of patients in the observation group hand(104.59±18.61)min operation time was significantly longer than that of the control group(72.46±16.67)min,but the amount of intraoperative bleeding(104.59±18.61)ml,postoperative intestinal function recovery time(24.21±14.69)d,hospitalization time(10.04±1.43)were significantly lower than control group(122.31±16.39)ml,(33.46±11.38)d,(12.98±1.32)d,the difference by t test(P<0.05);observe the stone clearance rate and postoperative bleeding after a period group was significantly lower than the control group,but the postoperative infection rate showed lower than that of the control group(P<0.05),the recurrence rate was significantly difference;the control group after treatment in patients with Scr was significantly higher than the observation group(P<0.05);and the difference of NGAL after treatment in observation group was not significant.Conclusion Minimally invasive percutaneous nephrolithotomy combined ureteroscope lithotripsy for the treatment of solitary kidney calculi with good effect,minimally invasive percutaneous nephrolithotomy operation time short and high stone clearance rate,flexible ureteroscopy of less bleeding,lower recurrence rate,to ensure the effect of the surgery should be based on the actual situation of patients for surgical treatment make a reasonable selection.