经皮肾镜取石术治疗肾结石的临床有效性及出血因素探究

Clinical Efficacy and Hemorrhagic Factors of Percutaneous Nephrolithotomy in the Treatment of Kidney

目的探讨经皮肾镜取石术治疗肾结石患者的临床有效性及出血因素。方法方便选择该院于2010年10月—2017年6月期间接收的肾结石患者80例作为研究对象,按照术后有无严重出血进行分组,随机选择术后无严重出血患者40例为对照组,术后严重出血患者40例为观察组,共80例,对两组患者的手术时间、结石大小、一次取石成功率、多次穿刺通道率、合并高血压、合并糖尿病、肾功能不全、泌尿系统感染等分布情况进行分析。结果对照组完全取净率为97.50%,观察组完全取净率为95.00%,比较差异无统计学意义(P>0.05)。观察组手术时间为(125.71±15.42)min,对照组手术时间为(112.43±16.72)min(P<0.05);观察组结石大小为(3.75±1.43)cm,对照组结石大小为(2.06±1.12)cm(P<0.05);观察组合并糖尿病占比22.5%,泌尿系统感染占比45.0%,一次取石成功占比60.0%,多次穿刺通道占比25.0%,肾积水占比55.0%与对照组5.0%,20.0%,90.0%,7.5%,27.5%差异有统计学意义(P<0.05)。结论对肾结石患者采用经皮肾镜取石术治疗疗效显著,其中大体积结石、合并糖尿病、肾积水等为导致术后严重出血的危险因素,应加强预防。

Objective This paper tries to investigate the clinical efficacy and factors of bleeding after percutaneous nephrolithotomy in treatment of renal calculi.Methods 80 patients with renal calculi in this hospital from October 2010 to June 2017 were convenient received as the research objects,40 cases of the postoperative without serious bleeding were randomly divided into the control group,40 patients with severe postoperative bleeding were randomly selected as the observation group,the operation time,stone size,success rate of stone removal,multiple puncture channel rate,hypertension,diabetes mellitus,renal dysfunction,urinary tract infection were analyzed.Results In the control group,the clearance rate was 97.50%,the observation group of 95.00%,there was no significant difference（P〉0.05）,the operation time of the observation group was（125.71±15.42）min,the control group was（112.43 ±16.72）min（P〈 0.05）; the stone size in the observation group was（3.75±1.43）cm,the control group of（2.06±1.12）cm（P〈0.05）; the combined with diabetes accounted for 22.5% in the observation group,45.0% of urinary tract infection,successful lithotomy accounted for 60.0%,multiple puncture channels accounted for 25.0%,55.0% of hydronephrosis and those in the control group were 5.0%,20.0%,90.0%,7.5%,27.5%,with significant difference（P 〈0.05）.Conclusion The percutaneous nephrolithotomy in treatment of renal calculi has remarkable effect,and the massive stones,diabetes and hydronephrosis are the risk factors for causing severe postoperative hemorrhage,so the prevention should be strengthened.