可视化穿刺系统应用于经皮肾镜碎石取石术治疗2 cm以上肾结石患者的治疗效果

Therapeutic effect of applying the visual puncture system in percutaneous nephrolithotomy for patients with renal calculi above 2 cm

目的探究可视化穿刺系统应用于经皮肾镜碎石取石术治疗≥2 cm肾结石的治疗效果。方法选取本院2020年6月~2021年9月行经皮肾镜碎石取石术(percutaneous nephrolithotomy,PCNL)治疗的巨大肾结石(直径≥2 cm)患者46例,根据入院时间分为观察组(n=23)和对照组(n=23)两组,观察组选用F4,8穿刺针,在可视光导纤维引导下建立经皮肾盂通道至目标肾盏,扩张通道后使用气压弹道碎石后冲出;对照组采用传统引导方式穿刺后扩张,使用气压弹道碎石后冲出结石。记录两组患者的手术Ⅰ期清石率,术后是否出现并发症,手术时间,术后住院时间和术中出血量。结果观察组患者平均住院时间(10.30±2.82)d小于对照组(10.78±2.47)d(P>0.05)。术中出血量(61.7±22.28)mL小于对照组(117.35±18.98)mL(P<0.01)。手术时间(69.70±15.52)min小于对照组(83.87±13.17)min(P<0.01)。手术并发症发生率(4.35%)小于对照组(8.70%),手术Ⅰ期清石率(95.65%)高于对照组(82.61%)。结论应用可视化穿刺系统的经皮肾镜碎石取石术治疗2 cm以上的肾结石具有较好的治疗效果。

Objective To investigate the therapeutic effect of applying the visual puncture system in percutaneous nephrolithotomy for patients with renal calculi≥2 cm.Methods Forty-six patients with renal calculi≥2 cm treated by percutaneous nephrolithotomy(PCNL)from June 2020 to September 2021 were selected and divided into observation group(n=23)and control group(n=23)according by admisson time.In the observation group,a percutaneous renal pelvis channel to the target renal calyces was established using F4,8 puncture needles under the guidance of visible optical waveguides.After the channel was dilated,the calculi were rushed out after pneumatic ballistic lithotripsy.The control group was dilated after puncture with traditional guidance,the calculi were rushed out after pneumatic ballistic lithotripsy.The obvervational index included the immediate stone-free rate,the postoperative complications,time of operation,hospital stays after operation and amount of bleeding during operation.Results In the observation group,average hospital stay(10.30±2.82)d was shorter than that in the control group(10.78±2.470)d(P>0.05).Intraoperative bleeding(61.7±22.28)mL was less than that in the control group(117.35±18.98)mL(P<0.01).Surgical duration(69.70±15.52)min was shorter than that in the control group(83.87±13.17)min(P<0.01).The incidence of surgical complications(4.35%)was lower than that in the control group(8.70%),and immediate stone-free rate(95.65%)was higher than that in the control group(82.61%).Conclusion Percutaneous nephrolithotomy with visual puncture system has a better therapeutic effect on patients with renal calculi≥2 cm.