肾盂成型并肾折叠固定治疗巨大肾积水的临床疗效评价

Evaluation on Clinical Curative Effect of Pyeloplasty and Kidney Fold Fixation in Treatment of Giant Hydronephrosis

目的探讨肾盂成型并肾折叠固定治疗巨大肾积水的临床疗效评价。方法方便选取2012年4月—2016年4月在该院泌尿外科治疗的50例巨大肾积水患者随机分为两组,对照组采用开放性肾盂成型并肾折叠固定术,观察组采用腹腔镜肾盂成型并肾折叠固定术,比较两组患者的各项手术指标、手术效果、并发症发生情况。结果观察组术中出血量(80.3±19.5)m L、术后止痛药物使用时间(36.3±8.2)h、住院时间(8.1±1.3)d、恢复正常工作时间(15.2±3.4)d均较对照组明显降低,差异有统计学意义(P<0.05);术后随访1年,两组肾积水均明显明显减少,肾功能有所恢复,但手术效果差异无统计学意义(P>0.05);观察组并发症发生率4.00%明显低于对照组,差异有统计学意义(P<0.05)。结论腹腔镜肾盂成型并肾折叠固定治疗巨大肾积水效果更佳,能够有效保留患肾的形态和功能,更有利于患者术后的恢复,具有积极的临床意义。

Objective To study the evaluation of clinical curative effect of pyeloplasty and kidney fold fixation in treatment of giant hydronephrosis. Methods 50 cases of patients with giant hydronephrosis treatd in our hospital from Apirl 2012 to April 2016 were convenient selectd and randomly divided into two groups, the control group were treated with open pyeloplasty and kidney fold fixation, while the observatin group adopted the laparoscopic pyeloplasty and kidney fold fixation,and vairous operatin indexes, opeation effect and occurrence of complications were compared between the two groups. Results The intraoperative bleeding amount, use time of postoperative analgesic drugs, legnth of stay, reovery time in the observation group obviusly decreased comapred with those in the control group, which were respectively(80.3±19.5)m L,(36.3±8.2)h,(8.1±1.3)d,(15.2±3.4)d, and the differnece was statistically signficant(P<0.05), the uronephrosis obviously decreased in the two groups after 1-year follow-up, and the renal function was recovered, but the difference in the oeprative effect was statstically signficant,(P>0.05), and the incidence rate of complications was obviously lower than that in the control gropu,which was 4.00% in the observation group and the difference was statistically signfiicant(P<0.05). Conclusion The effect of laparoscopic pyeloplasty and kidney fold fixation in treatment of giant hydronephrosis is better, which can effectively reserve the renal morphology and function, and it is more conduive to the recovery of patients after operation and it is of positive significance.