微创经皮肾镜取石术治疗上尿路结石合并感染的临床研究

Clinical effect of minimally invasive percutaneous nephrolithotomy lithotomy on treatment of upper urinary tract stones complicated with infections

目的探讨二期微创经皮肾镜取石术治疗上尿路结石并感染的临床效果,以期提高临床治疗水平。方法选取2010年2月-2013年2月85例上尿路结石并感染患者为研究对象,予以一期经皮肾穿刺造瘘,二期行经皮肾镜取石术,观察治疗后的情况;采用SPSS13.0软件进行统计分析,计量资料采用t检验,计数资料采用χ2检验。结果 85例患者中经皮肾镜取石术98次,通道以单通道为主,占67.06%,一期清除率78.82%,结石总清除率为96.47%,平均手术时间(108.53±12.53)min,平均住院天数(14.66±7.83)d;并发症以发热、肾通道疼痛为主,发生率分别为18.82%和10.59%,其他并发症的发生率均较低;而治疗后可明显改善肾功能和降低白细胞水平(P<0.05),对肝功能和血脂水平等则无明显影响性。结论二期微创经皮肾镜取石术治疗上尿路结石并感染临床效果满意,并发症发生率低。

OBJECTIVE To explore the clinical effect of stageⅡ minimally invasive percutaneous nephrolithotomy on treatment of upper urinary tract calculi complicated with infections so as to improve the clinical treatment. METHODS Totally 85cases of upper urinary tract calculi complicated with infections,who were treated in the hospital from Feb 2010 to Feb 2013,were enrolled in the study,then the subjects received the stageⅠ percutaneous nephrostomy and stageⅡ percutaneous nephrolithotomy lithotomy,the therapeutic effect was observed,the statistical analysis was performed with the use of SPSS13.0software,the t-test was conducted for the analysis of measurement data,and the chi-square test was carried out for the analysis of count data.RESULTS Totally 85patients have underwent the percutaneous nephrolithotomy lithotomy for 98times,with the single channel dominant（67.06%）;the clearance rate of the stageⅠ was 78.82%,the total clearance rate of stones was 96.47%;the average operation duration was（108.53±12.53）min;the average hospitalization duration was（14.66±7.83）d; the fever and pain of kidney channel were the major complications,the incidence rates were 18.82% and 10.59%, respectively;the incidence rates of other complications were relatively low.The renal function has been significantly improved through the treatment,and the level of while blood cells was markedly reduced（P0.05）,the stage Ⅱ percutaneous nephrolithotomy lithotomy had significant effect on the liver function or the lipid level. CONCLUSIONThe stageⅡ minimally invasive percutaneous nephrolithotomy lithotomy can achieve satisfactory clinical effect on the treatment of upper urinary tract calculi complicated with infections,and the incidence of the complications is low.