微创经皮肾镜碎石术联合输尿管软镜治疗嵌顿性输尿管上段结石的疗效分析

Analysis on the Curative Effect of Minimally Invasive Percutaneous Nephrolithotripsy Combined with Flexible Ureteroscope in the Treatment of Impacted Upper Ureteral Calculi

目的探讨微创经皮肾镜碎石术联合输尿管软镜治疗嵌顿性输尿管上段结石的应用价值。方法选取我院2015年8月至2016年3月收治的嵌顿性输尿管上段结石患者73例,随机分为观察组(35例)和对照组(38例)。观察组行微创经皮肾镜碎石术联合输尿管软镜,对照组单纯行微创经皮肾镜碎石术治疗。观察比较两组患者的结石清除率、肾功能指标以及手术时间。结果术后1周,观察组的结石清除率为91.43%,显著高于对照组的65.79%(P<0.05);术后4周,观察组的结石清除率为97.14%,显著高于对照组的76.32%(P<0.05)。观察组的手术时间明显长于对照组(P<0.05)。手术前后两组患者的肾功能指标比较差异均无统计学意义(P>0.05)。结论微创经皮肾镜碎石术联合输尿管软镜治疗嵌顿性输尿管上段结石,虽然手术时间较长,但结石清除率高,疗效确切,且能最大程度地保护患者的肾功能,值得推广。

Objective To explore the application value of minimally invasive percutaneous nephrolithotripsy combined with flexible ureteroscope in the treatment of impacted upper ureteral calculi. Methods 73 cases of patients with impacted upper ureteral calculi admitted to our hospital fi＇om August 2015 to March 2016 were selected and randomly divided into observation group （35 cases） and control group （38 cases）. The observation group received minimally invasive percutaneous nephrolithotripsy combined with flexible ureteroscope, while the control group only received minimally invasive percutaneous nephrolithotripsy. The stone clearance rate, indicators of renal function and operation time of patients were observed and compared between the two groups. Results One week after operation, the stone clearance rate of the observation group was 91.43%, significantly higher than 65.79% of the control group （P〈0.05）. 4 weeks after operation, the stone clearance rate of the observation group was 97.14%, significantly higher than 76.32% of the control group （P 〈0.05）. The operation time of the observation group was significantly longer than that of the control group （P〈0.05）. No statistical difference was found in the indicators of renal function before and after operation between the two groups （P〉0.05）. Conclusions Minimally invasive percutaneous nephrolithotripsy combined with flexible ureteroscope in the treatment of impacted upper ureteral calculi has higher stone clearance rate and exact clinical effect despite its longer operation time, which can maximumly protect patients＇ renal function, and is worthy of promotion.