经皮肾穿刺造瘘联合输尿管镜碎石术治疗梗阻性肾积脓的临床效果

Clinical effect of percutaneous nephrolithotomy combined with ureteroscopic lithotripsy for obstructive renal empyema

目的探讨经皮肾穿刺造瘘(PCN)联合输尿管镜碎石术(URL)治疗梗阻性肾积脓的临床效果。方法选取2017年1月~2018年7月我院收治的98例梗阻性肾积脓患者作为研究对象,按照随机抽签方法分为两组,每组各49例。对照组给予经尿道输尿管置管引流术治疗,观察组给予PCN联合URL治疗,对两组总有效率、手术时间、术中出血量、住院时间及住院费用及并发症发生率(感染、发热、出血)进行比较。结果观察组治疗总有效率高于对照组,差异有统计学意义(P<0.05)。两组手术时间、术中出血量比较,差异无统计学意义(P>0.05);观察组住院时间短于对照组,住院费用低于对照组,差异有统计学意义(P<0.05);观察组并发症总发生率低于对照组,差异有统计学意义(P<0.05)。结论PCN联合URL治疗梗阻性肾积脓有较高的临床价值,可在促进患者康复的同时减少并发症的发生,值得临床推广应用。

Objective To investigate the clinical effect of percutaneous nephrolithotomy(PCN)combined with ureteroscopic lithotripsy(URL)in the treatment of obstructive renal empyema.Methods Ninety-eight patients with obstructive renal empyema admitted to our hospital from January 2017 to July 2018 were enrolled in the study.They were divided into two groups according to the random sampling method,49 cases in each group.The control group was treated with transurethral ureteral drainage.The observation group was treated with PCN combined with URL.The total effective rate,operation time,intraoperative blood loss,hospitalization time,hospitalization cost and complication rate(infection,fever,bleeding)between two groups were compared.Results The total effective rate of the observation group was higher than that of the control group,and the difference was statistically significant(P<0.05).There was no significant difference in the operation time and intraoperative blood loss between the two groups(P>0.05).The hospitalization time of the observation group was shorter than that of the control group,and the hospitalization cost was lower than that of the control group,the differences were statistically significant(P<0.05).The total incidence of complications in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion PCN combined with URL has a high clinical value in the treatment of obstructive renal empyema.It can promote the recovery of patients and reduce complications,which is worthy of application and promotion.