经皮肾镜下气压弹道碎石联合超声碎石术处理复杂性肾结石的效果观察

Observation of the effect of pneumatic lithotripsy under percutaneous nephrolithotomy combined with ultrasound lithotripsy in the treatment of complex renal calculi

目的探讨复杂性肾结石应用超声碎石术、经皮肾镜下气压弹道碎石(PCNL)联合治疗方案的疗效。方法本文收集2014年7月~2016年2月于我院实施治疗的复杂性肾结石患者106例作对比研究,以随机红蓝签抽签的方式分为两组,各53例,其中对照组应用开放手术治疗,观察组应用PCNL联合超声碎石术治疗,对比分析两组研究结果。结果观察组术中出血量、手术时间、住院天数均低于对照组(P<0.01),观察组住院费用高于对照组(P<0.01);治疗前,两组Scr指标水平比较,差异无统计学意义(P>0.05),观察组治疗1周、3个月Scr指标水平均低于对照组(P<0.01),两组治疗6个月Scr指标水平比较,差异无统计学意义(P>0.05);观察组总并发症发生率为9.43%,显著低于对照组的30.19%(P<0.01);观察组结石清除率为92.45%,明显高于对照组的83.02%(P<0.05)。结论临床上针对复杂性肾结石处理应用PCNL联合超声碎石术治疗方案,可取得较为理想的治疗效果,提升结石排除率,临床推广价值较高。

Objective To investigate the therapeutic effect of combined therapy of ultrasound lithotripsy and pneumatic lithotripsy under percutaneous nephrolithotomy（PCNL） for complex renal calculi.Methods A total of 106 patients with complex renal calculi who were given the treatment in our hospital from July 2014 to February 2016 were collected and enrolled in this comparative study.They were evenly divided into two groups according to the random blue and red lottery draw,53 cases in each group.The control group was treated with open surgery,and the observation group was treated with PCNL combined with ultrasonic lithotripsy.The study results were compared and analyzed between the two groups.Results The blood loss during operation,operation time and length of hospital stay in the observation group were lower than those in the control group（P〈0.01）.The hospitalization cost in the observation group was higher than that in the control group（P〈0.01）;before treatment,there was no significant difference in Scr level between the two groups（P〈0.05）.The level of Scr in the observation group was lower than that in the control group at 1 week and 3 months（P〈0.01）.There was no significant difference in Scr level between the two groups at 6 months（P〉0.05）;the total complication rate of observation group was 9.43%,which was significantly lower than that of 30.19% in the control group（P〈0.05）;the stone clearance rate of observation group was 92.45%,which was significantly higher than that of 83.02% in the control group（P〈0.01）.Conclusion Combined therapy of PCNL and ultrasound lithotripsy in the treatment of complex renal calculi in clinical situation can achieve ideal therapeutic effect and increase the clearance rate of stones.The value of clinical promotion and application is high.