无管化经皮肾镜碎石术治疗单纯性肾结石及输尿管上段结石的效果

Effect of tubeless percutaneous nephrolithotomy on simple renal calculi and upper ureteral calculi

目的探讨无管化经皮肾镜碎石术(tPCNL)治疗单纯性肾结石及输尿管上段结石的效果方法。方法选取2014年8月~2018年11月我院收治的200例泌尿结石患者作为研究对象,按照随机数字表法将其分为对照组与观察组,每组各100例。对照组采取常规经皮肾镜取石术(PCNL),观察组则采取tPCNL。比较两组患者的手术时间、住院时间、术后排尿功能恢复时间、一次性碎石成功率、结石清除率及术后并发症总发生率。结果两组患者的手术时间、一次性碎石成功率及结石清除率比较,差异无统计学意义(P>0.05);观察组患者的住院时间、术后排尿功能恢复时间均短于对照组,差异有统计学意义(P<0.05);观察组患者的术后并发症总发生率(4.0%)低于对照组(17.0%),差异有统计学意义(P<0.05)。结论单纯性肾结石及输尿管上段结石患者的治疗过程中,采取tPCNL能够缩短患者的住院和术后排尿功能恢复时间,降低术后并发症的发生风险,促进病情恢复,但在结石清除率上与传统经皮肾镜相当,值得临床借鉴实施。

Objective To explore the effect and method of tubeless percutaneous nephrolithotomy (tPCNL) in the treatment of simple renal calculi and upper ureteral calculi. Methods A total of 200 patients with urinary calculi admitted to our hospital from August 2014 to November 2018 were selected as the research objects. According to the random number table method, they were divided into control group and observation group, with 100 cases in each group. The control group was treated with routine percutaneous nephrolithotomy (PCNL), while the observation group was treated with tPCNL. The operation time, hospitalization time, recovery time of urinary function after operation, success rate of one-time lithotripsy, stone clearance rate and total incidence of complications were compared between the two groups. Results There were no significant differences in operation time, success rate of disposable lithotripsy and stone clearance rate between the two groups (P>0.05). The hospital stay and recovery time of urinary function in the observation group were shorter than those in the control group, and the differences were significant (P<0.05). The total incidence of postoperative complications in the observation group (4.0%) was lower than that in the control group (17.0%), and the difference was statistically significant (P<0.05). Conclusion During the treatment of patients with simple renal calculi and upper ureteral calculi, tPCNL can shorten the hospitalization and postoperative recovery time of urination function, reduce the risk of postoperative complications, and promote the recovery of the disease. However, the stone clearance rate is equivalent to that of traditional percutaneous nephrolithotomy, which is worthy of clinical reference and implementation.