负压组合式硬管镜联合输尿管软镜治疗无积水肾结石的可行性分析

Feasibility of Negative Pressure Combined Rigid Ureteroscopy Combined with Flexible Ureteroscopy in the Treatment of Un-hydronephrotic Renal Calculi

目的分析无积水肾结石患者接受负压组合式硬管镜(硕通镜)联合输尿管软镜治疗效果分析。方法选取2021年10月至2022年10月我院泌尿外科收治的无积水肾结石患者80例,根据随机数字表法分为观察组和对照组各40例。对照组接受经皮肾镜取石(PCNL)手术,观察组接受硕通镜联合输尿管软镜手术。对比观察两组围术期手术指标情况、术后感染情况以及结石清除率变化。结果观察组手术时间、术中出血量、住院时间、外周血红蛋白浓度下降值等围手术指标显著优于对照组,差异有统计学意义(P<0.05)。治疗后,两组患者CRP、PCT表达水平均低于手术前,且观察组低于对照组,差异有统计学意义(P<0.05)。术后1 d和术后1个月,观察组结石清除率显著高于对照组,差异有统计学意义(P<0.05)。结论对于小于3cm无积水肾结石疾病治疗,患者围手术时期治疗状况欠佳,且存在感染风险,影响结石清除效果,采取硕通镜联合输尿管镜治疗能够获得理想的手术治疗效果。

Objectives To analyze the therapeutic effect of negative pressure combined rigid ureteroscopy(Shuotong ureteroscopy)combined with flexible ureteroscopy in the treatment of renal calculi without hydronephrosis.Methods A total of 80 patients with un-hydronephrotic renal calculi admitted to the Urology Department of our hospital from October 2021 to October 2022 were selected and randomly divided into the observation group and the control group,with 40 patients in each group.The control group received percutaneous nephrolithotomy(PCNL),whereas the observation group received Shuotong ureteroscopy combined with flexible ureteroscopy.Perioperative indexes,postoperative infection and calculus clearance rate were compared between the two groups.Results Perioperative indexes such as operation time,intraoperative blood loss,hospital stay,and peripheral hemoglobin concentration decrease in the observation group were significantly better than those in the control group(P<0.05).The expression levels of CRP and PCT in the two groups were significantly lower after operation,and those in the observation group were significantly lower than those in the control group(P<0.05).The stone removal rate in the observation group was significantly higher than that in the control group on the first day and one month after operation(P<0.05).Conclusions For the treatment of renal calculi less than 3cm without hydronephrosis,the perioperative treatment condition of patients is not good,and there is a risk of infection,which impairs the effect of stone removal.The treatment of Shuotong ureteroscopy combined with ureteroscopy can achieve ideal surgical treatment effect.