复杂性肾结石患者采用B超引导下侧卧位MPCNL治疗的效果及肾功能、神经体液因子、性功能的评估

Curative Effect,Renal Function,Neurohumoral Factors and Sexual Function of Patients with Complicated Renal Calculi Treated with B-ultrasound Guided MPCNL in a Lateral Decubitus Position

目的评估复杂性肾结石患者采用B超引导下侧卧位单通道微创经皮肾镜取石术(MPCNL)治疗的效果及肾功能、神经体液因子、性功能。方法回顾性选取2015年1月-2017年10月我院收治的复杂性肾结石患者160例,根据治疗方法不同分为对照组和观察组,各80例。对照组采用开放性手术治疗,观察组患者采用B超引导下侧卧位MPCNL治疗,分析两组患者的疗效,并对两组患者手术前后肾功能、神经体液因子、性功能进行比较。结果观察组患者手术时间、排气时间、住院时间短于对照组,术中出血量少于对照组(P<0.05)。两组患者结石清除率比较无统计学差异(P>0.05)。观察组患者术后血尿、感染、发热发生率均低于对照组,但尿瘘发生率与对照组比较无统计学差异(P>0.05)。术后,观察组患者的Cys C、Urea、Cr水平明显低于对照组(P<0.05);观察组患者hs-CRP、PCT、AngⅡ水平低于对照组(P<0.05);观察组患者性生活满意度及性功能质量评分均高于对照组(P<0.05),但两组性欲对比无统计学差异(P>0.05)。结论 B超引导下侧卧位MPCNL治疗复杂性肾结石手术时间短,出血量少,安全性高,对肾脏功能损伤小,且有助于提高性功能。

Objective To evaluate the curative effect, renal function, neurohumoral factors and sexual function of patients with complicated renal calculi treated with B-ultrasound guided MPCNL in a lateral decubitus position. Methods A total of 160 cases of complicated renal calculi treatedin our hospital between January 2015 and October 2017 were selected and divided into the control group and the observation group according to treatment methods, with 80 cases in each group. The control group was treated with open surgery, while the observation group was treated with B-ultrasound guided MPCNLin a lateral decubitus posi-tion. The curative effects of the two groups were analyzed, and the renal function, neurohumoral factors and sexual function were compared between the two groups before and after operation. Results The duration of surgery, anal exhaust time and hospital stay in the observation group were shorter than those in the control group, and the intraoperative blood loss was less in the observation group than in the control group （P〈0. 05）. There was no significant difference in stone clearance rate between the two groups （P〉0. 05）. The incidence of postoperative hematuria, infections and fever in the observation group was lower than that in the control group, but there was no significant difference in the incidence of urinary fistula between the two groups （P〉0. 05）. After treatment, the levels of CysC, Urea and Cr in the observation group were significantly lower than those in the control group （P〈0. 05）. The levels of hs-CRP, PCT and Ang II in the observation group were lower than those of the control group （P〈0. 05）. The sexual life satisfaction and sexual function scores in the observation group were higher than those in the control group （P〈0. 05）, but there was no significant difference in sexual desire between the two groups （P〉0. 05）. Conclusion B-ul-trasound guided lateral recumbent MPCNL involves a short duration of surgry, less bleeding, good safety and less stress in the body. This approach does little damage to kidney function and helps to improve sexual function.