微创经皮肾镜取石术治疗肾结石的应用效果观察及评定

Application efficacy observation and evaluation of minimally invasive percutaneous nephrolithotomy in the treatment of renal calculi

目的探讨微创经皮肾镜取石术治疗肾结石的应用效果。方法 90例肾结石患者,据术式不同分为对照组和观察组,每组45例。对照组开展传统通道手术治疗,观察组行微创经皮肾镜取石术治疗。比较两组肾结石手术干预效果;出血总量、术后发热时间、使用抗生素时间和出院时间;手术前后肾功能相关指标。结果观察组患者的总有效率100.00%显著高于对照组的77.78%,差异具有统计学意义(χ2=11.25, P<0.05)。手术前两组患者的血肌酐(Scr)、尿素氮(BUN)水平比较差异无统计学意义(P>0.05);手术后观察组患者的Scr、BUN水平均低于对照组,差异具有统计学意义(P<0.05)。观察组出血总量少于对照组,术后发热时间、使用抗生素时间和出院时间均短于对照组,差异具有统计学意义(P<0.05)。结论肾结石患者行微创经皮肾镜取石术疗效肯定,对肾功能有改善作用,且可减少并发症和出血,减少抗生素使用,缩短住院时间。

Objective To investigate the application effect of minimally invasive percutaneous nephrolithotomy in the treatment of renal calculi. Methods A total of 90 patients with renal calculi were divided into control group and observation group according to different operative methods, 45 cases in each group. The control group was treated by traditional channel surgery, the observation group underwent minimally invasive percutaneous nephrolithotomy. The renal calculi effect of surgical intervention, total amount of bleeding, postoperative fever time, antibiotic use time and discharge time, renal function related indicators before and after surgery were compared between the two groups. Results The total effective rate of the observation group was 100.00%, which was significantly higher than 77.78% of the control group, the difference was statistically significant（χ^2=11.25, P〈0.05）. There were no significant differences in the levels of serum creatinine concentration（Scr） and blood urine nitrogen（BUN） between the two groups before surgery（P〈0.05）. The levels of Scr and BUN in the observation group were significantly lower than those in the control group, the differences were statistically signficant（P〈0.05）. The total amount of bleeding in the observation group was significantly less than that in the control group, postoperative fever time, antibiotic use time and discharge time of the observation group were significantly shorter than those of the control group, the differences were statistically significant（P〈0.05）. Conclusion Minimally invasive percutaneous nephrolithotomy for renal calculi patients has definite curative effect, can improve renal function, reduce complications and bleeding, reduce the use of antibiotics, shorten the length of stay.