复杂肾结石患者行经皮肾碎石取石术治疗的效果观察

Effect of Percutaneous Nephrolithotomy in Patients with Complicated Renal Calculi

目的:分析经皮肾碎石取石术和开放性手术治疗复杂性肾结石的临床效果。方法:选取本院2016年2月-2017年8月收治的复杂肾结石患者80例作为研究对象,按照随机数字表法将其分为试验组和对照组,各40例。对照组行开放性手术取石治疗,试验组行经皮肾镜取石术治疗,比较两组手术用时、术中出血量、术后应用止痛药、发热和结石清除有效情况,以及下床活动和住院时间。结果:试验组手术用时为(61.2±25.7)min、术中出血量为(210.1±24.0)mL均明显少于对照组的(85.0±27.3)min及(414.0±37.0)mL,差异均有统计学意义(P<0.05)。试验组术后应用止痛药、发热情况均明显低于对照组,结石清除有效情况明显高于对照组,差异均有统计学意义(P<0.05)。试验组下床活动时间为(34.2±16.2)h、住院时间(5.0±1.3)d,对照组下床活动时间为(45.7±22.5)h、住院时间(6.5±2.3)d,试验组下床活动及住院时间均明显短于对照组,差异均有统计学意义(t=2.623 3、3.590 8,P=0.010 5、0.000 6)。结论:通过经皮肾镜碎石术的治疗方法,能够有效缩短复杂性肾结石患者的住院时间,明显减少术中出血量,临床推广价值存在。

ObjectiveTo analyze the clinical effects of percutaneous nephrolithotomy and open surgery in the treatment of complicated renal calculi.Method：A total of 80 patients with complicated renal calculi admitted in our hospital from February 2016 to August 2017 were selected as the study objects.According to the random number table method,they were divided into experimental group and control group,40 cases in each group.The control group was treated with open surgery,the experimental group was treated by percutaneous nephrolithotomy.The surgical time,intraoperative blood volume and postoperative analgesics,fever and stone clearance efficacy and getting out of bed and hospitalization time between the two groups were compared.Result：The surgical time and intraoperative blood volume in the experimental group were （61.2±25.7） min and （210.1±24.0） mL respectively were significantly shorter than （85.0±27.3） min and （414.0±37.0） mL in the control group,the differences were statistically significant （P〈0.05）. The application of postoperative analgesics and fever in the experimental group were significantly lower than those in the control group,the effective rate of stone clearance was significantly higher than that in the control group,the differences were statistically significant （P〈0.05）.The getting out of bed and hospitalization time in the experimental group were （34.2±16.2） h and （5.0±1.3） d respectively,the control group were （45.7±22.5） h and （6.5±2.3） d respectively,the getting out of bed and hospitalization time in the experimental group were significantly shorter than those in the control group,the differences were statistically significant （t=2.623 3,3.590 8,P=0.010 5,0.000 6）.Conclusion：The treatment of percutaneous nephrolithotomy can effectively shorten the hospitalization time of patients with complicated renal calculi,significantly reduce intraoperative bleeding volume and the clinical value of promotion exists.