微创经皮肾镜取石术治疗输尿管上段结石合并肾积脓

Minimally Invasive Percutaneous Nephrolithotomy in Treatment of Upper Ureteral Calculi Combined with Pyonephrosis

目的分析微创经皮肾镜取石术在治疗输尿管上段结石合并肾积脓中的临床疗效。方法选取2015年6月-2016年8月我院采用经皮肾镜取石术治疗的输尿管上段结石合并肾积脓患者41例作为研究对象,将所有患者随机分为两组,A组20例,B组21例。A组采用经皮肾镜取石术,B组先行肾造瘘术,后行取石术,对比两组治疗情况及并发症发生率。结果 A组手术时间、住院时间及住院费用均低于B组,差异有统计学意义（P〈0.05）,两组术中出血量、取石成功率及并发症发生率比较,差异无统计学意义（P〉0.05）。结论微创经皮肾镜取石术治疗输尿管上段结石合并肾积脓临床效果显著,安全可靠,可有效可减少住院时间及住院费用,术后需严密观察,加强抗感染治疗。

Objective To analyze the clinical efficacy of minimally invasive percutaneous nephrolithotomy（PCNL） in treatment of upper ureteral calculi combined with pyonephrosis. Methods 41 patients with upper ureteral calculi combined with pyonephrosis treated with PCNL in our hospital from June 2015 to August 2016 were randomly divided into A group（n=20） and B group（n=21）.A group took PCNL,B group firstly took nephrostomy and then took nephrolithotomy.The treatment conditions and the incidence of complications of two groups were compared. Results The surgery time,hospital stays and hospitalization expense of A group were lower than those of B group（P〈0.05）,and there was no statistical difference in the intraoperatve bleeding volume,success rate of stone removal and incidence of complications between the two groups（P〉0.05）. Conclusion Minimally invasive PCNL for treating upper ureteral calculi combined with pyonephrosis has significant clinical effects,which is safe,reliable and can effectively reduce hospital stays and expense.After surgery,patients should be carefully observed and strengthened anti-infection treatment.