肾感染患者输尿管下段结石碎石术的临床疗效研究

Clinical efficacy ofStudy on efficacy of renal fistula combined with ureteroscopic lithotripsy for ureteral calculi in patients with renal infections

目的观察肾感染患者输尿管下段结石碎石术的临床疗效,目的为输尿管下段结石的治疗提供参考。方法将2013年4月-2015年6月320例来医院就诊的输尿管下段结石患者随机分为两组,对照组和观察组各160例,对照组采用微通道经皮肾镜碎石术,观察组则采用肾造瘘结合经尿道输尿管镜下碎石术;比较两组间一期手术成功率及结石清除率、手术时间比较组间差异。结果观察组泌尿系统感染率及术后感染总发生率分别为3.75%和10.63%,显著低于对照组的13.75%和21.88%;观察组一期手术成功率为99.38%,显著高于对照组88.13%;观察组术后1周、1月、3月结石清除率分别为76.25%、88.13%和98.75%,均显著高于同期对照组65.63%、76.63%和82.50%,组间差异有统计学意义(P<0.05)。结论肾造瘘结合经尿道输尿管镜下碎石治疗并发肾感染的输尿管下段结石具有手术成功率高、结石清除率高、创伤小、术后恢复快的优点。

OBJECTIVE To observe the clinical efficacy of ureteroscopic lithotripsy for ureteral calculi in patients with renal infections so as to provide guidance for treatment of lower ureteral calculi.METHODS A total of 320 patients with lower ureteral calculi who were treated in the hospital from Apr 2013 to Jun 2015 were enrolled in the study and randomly divided into the observation group and the control group,with 160 cases in each group.The control group was treated with micro channel percutaneous renal lithotripsy,while the observation group was treated with renal fistula combined with ureteroscopic lithotripsy.The success rate of one stage operation,calculi clearance rate,operation duration,length of hospital stay,and hospitalization expenses were observed and compared between the two groups.RESULTS The incidence of urinary system infections of the observation group was3.75%,significantly lower than 13.75% of the control group;the total incidence of postoperative infections of the observation group was 10.63%,significantly lower than 21.88% of the control group.The success rate of one stage operation of the observation group was 99.38%,significantly higher than 88.13% of the control group.The calculi clearance rates of the observation group were respectively 76.25%,88.13%,and 98.75%after the surgery for 1week,1 month,and 3 months,significantly higher than 65.63%,76.63%,and 82.50% of the control group（P〈0.05）.CONCLUSIONThe renal fistula combined with ureteroscopic lithotripsy has such advantages as the high success rate of operation,high clearance rate of calculi,little trauma,and rapid postoperative recovery in the treatment of the lower ureteral calculi patients complicated with renal infections.