经皮肾镜联合输尿管软镜治疗对复杂性肾结石BMG、BUA的影响及临床疗效分析

Effect of percutaneous nephroscopy combined with flexible ureteroscope on BMG and BUA of complex renal calculi and its clinical efficacy

目的分析经皮肾镜联合输尿管软镜治疗复杂性肾结石BMG、BUA的影响及临床疗效分析。方法回顾性选取2015年1月至2017年10月在本院收治的复杂性肾结石患者120例,根据手术方法分为对照组和观察组,各60例。对照组患者采用微创经皮肾镜碎石取石术治疗,观察组患者采用微创经皮肾镜联合输尿管软镜碎石取石术治疗,分析两组患者治疗后的临床疗效。结果观察组患者手术时间、排气时间、住院时间短于对照组,术中出血量少于对照组(P<0.05)。观察组患者结石清除率为90%(54/60),对照组为75%(45/60),观察组患者结石清除率高于对照组(P<0.05)。术前,两组患者肾功能指标、hs-CRP、AngⅠ、AngⅡ水平比较无统计学差异(P>0.05)。治疗后,观察组患者BMG、BUA、NGAL、Cys-C、hs-CRP、AngⅠ、AngⅡ水平均低于对照组(P<0.05)。观察组患者并发症率为8.33%(5/60),对照组为21.67%(13/60),观察组患者并发症率低于对照组(P<0.05)。结论经皮肾镜联合输尿管软镜治疗复杂性肾结石可减少术中出血量,缩短住院时间,减轻机体应激反应,对患者肾功能影响较小,且安全性高。

Objective To analyze the clinical effect and safety of percutaneous nephroscopy combined with soft ureteroscopy in the treatment of complicated renal calculi. Methods From January 2015 to October 2017, 120 cases of complicated renal calculi in our hospital were retrospectively selected. The patients in the control group were treated with minimally invasive percutaneous nephrolithotripsy and the patients in the observation group were treated with minimally invasive percutaneous nephrolithotomy combined with ureteral soft lithotripsy. The clinical effect of two groups was analyzed after treatment. Results Operation time, exhaust time, hospitalization time of the observation group were shorter than the control group, intraoperative bleeding was less than the control group (P<0.05). The stone clearance rate of the observation group was 90%, the control group was 75%, the stone clearance rate was higher than the control group (P<0.05). Before the operation, renal function index. Hs-CRP, Ang I of two group were no significant differences between the levels of Ang II (P>0.05). After the treatment, BMG, BUA, NGAL, Cys-C, hs-CRP, Ang I and Ang II levels of the observation group were lower than the control group (P<0.05), and the incidence of complications in the observation group was 8.33%, the control group was 21.67%, and the rate of complications in the observation group was lower than that of the control group (P<0.05). Conclusions Percutaneous nephrolithotomy combined with flexible ureteroscopy for the treatment of complex renal calculi can reduce blood loss, shorten hospitalization time, relieve stress reaction, and has little effect on renal function and safety.