膀胱软镜联合PCNL治疗肾结石患者的临床效果

Clinical effect of flexible cystoscope lithotripsy combined with PCNL in the treatment of patients with renal calculi

目的 探讨经皮肾镜（PCNL）联合膀胱软镜碎石取石术治疗肾结石的临床疗效及安全性.方法 选取本院既往治疗的80例肾结石患者作为观察组（采取PCNL＋联合膀胱软镜碎石取石术）,同期单独采用PCNL治疗的80例肾结石患者作为对照组,对比两组手术相关指标、并发症及实验室指标.结果 观察组和对照组的手术时间、术中出血量、术后留管时间、住院时间比较差异均无统计学意义（P＞0.05）;观察组患者的Ⅰ期结石清除率、术后1个月结石清除率均显著地高于对照组（P＜0.05）,观察组患者的二次手术率显著地高于对照组患者（P＜0.05）;术后24h观察组、对照组患者的血肌酐、TNF-α、NAG、β2-MG测定值较本组术前水平均显著的提高（P＜0.05）;术后1周观察组、对照组患者的血肌酐、TNF-α、NAG、β2-MG测定值均基本恢复至术前水平（P＞0.05）;观察组患者的手术并发症率6.25％ （5/80）与对照组的12.50％ （10/80）差异无统计学意义（P＞0.05）.结论 PCNL联合膀胱软镜碎石取石术治疗肾结石的手术效果优于单用PCNL,同时具有较好的安全性.

Objectives To investigate the clinical efficacy and safety of percutaneous renal mirror （PCNL） combined with flexible cystoscope lithotripsy in the treatment of renal calculi.Methods 80 patients with kidney stones in our hospital were selected as the observation group （PCNL combined with flexible cystoscope lithotripsy）,80 patients with kidney stones underwent PCNL alone at the same period as the control group.Two groups of surgery-related indicators,concurrent disease and laboratory parameters were compared.Results There were no statistically significant differences in operative time,blood loss,tube-retained time,hospitalization time between the two groups （P 〉 0.05）.Stone clearance rate at Ⅰ stage and after a month,reoperation rate in the observation group,were significantly higher than control group （P 〈0.05）.Measured values of serum creatinine,TNF-α,NAG,β2-MG 24h after operation in the two groups were significantly improved compared with preoperative levels （P 〈 0.05） and this measured values in the two groups 1 week after operation were restored to normal level （P〉 0.05）.The difference was not statistically significant in complication rate in the observation group and the control group （P 〉 0.05）.Conclusions PCNL combined with flexible cystoscope lithotripsy in the treatment of patients with kidney stones is better than alone PCNL,and it also has better security.