分期输尿管软镜钬激光碎石术与微通道经皮肾镜碎石术治疗2~4cm肾结石的随机对照分析

Experience of randomized controlled value of staged flexible ureteroscope holmium laser lithotripsy and microchannel percutaneous nephrolithotomy in the treatment of 2-4cm kidney stones

目的探讨分期输尿管软镜钬激光碎石术与微通道经皮肾镜碎石术治疗2~4cm肾结石的随机对照价值。方法选择2015年1月~2018年6月我院收治的2~4cm肾结石患者68例为对象,应用随机数字表法进行分组,划分为对照组(34例)与研究组(34例)。对照组实施微通道经皮肾镜碎石术,研究组实施分期输尿管软镜钬激光碎石术,比较分析两组的临床疗效。结果研究组患者的临床治疗总有效率为97.06%,明显高于对照组患者(82.35%),差异有统计学意义(P<0.05);研究组患者治疗后的总体健康评分为(74.65±12.30)分,生理功能评分为(72.90±13.70)分,生理职能评分为(65.65±10.35)分,躯体疼痛评分为(72.80±11.50)分,活力评分为(80.65±14.60)分,社会功能评分为(81.85±14.80)分,情感职能评分为(90.25±12.80)分,精神健康评分为(77.65±13.80)分,明显高于对照组患者[(62.60±10.05)分、(66.70±10.50)分、(58.40±8.70)分、(66.95±10.50)分、(71.80±12.40)分、(74.70±12.50)分、(77.65±13.50)分、(66.35±12.50)分],差异有统计学意义(P<0.05);研究组患者的并发症发生率为2.94%,明显低于对照组患者(20.59%),差异有统计学意义(P<0.05)。结论分期输尿管软镜钬激光碎石术治疗2~4cm肾结石的临床治疗总有效率高于微通道经皮肾镜碎石术,且治疗后生活质量明显改善,且并发症发生率低,有重要作用价值。

Objective To investigate the randomized controlled value of staged flexible ureteroscope holmium laser lithotripsy and microchannel percutaneous nephrolithotomy in the treatment of 2-4cm kidney stones.Methods 68 patients with 2-4cm kidney stones who were treated in our hospital from January 2015 to June 2018 were selected as subjects of this study.The patients were divided into control group(34 cases)and study group(34 cases)according to the random number table method.The control group underwent microchannel percutaneous nephrolithotomy,and the study group underwent staged flexible ureteroscope holmium laser lithotripsy.The clinical efficacy of the two groups was compared and analyzed.Results The total effective rate of clinical treatment in the study group was 97.06%,which was significantly higher than that in the control group(82.35%),and the difference was statistically significant(P<0.05).The overall health score of patients in the study group after treatment was(74.65±12.30)points,the physiological function score was(72.90±13.70)points,the physiological role score was(65.65±10.35)points,the somatic pain score was(72.80±11.50)points,the vitality score was(80.65±14.60)points,the social function score was(81.85±14.80)points,the emotional function score was(90.25±12.80)points,and the mental health score was(77.65±13.80)points,which were significantly higher than those of patients in the control group[(62.60±10.05)points,(66.70±10.50)points,(58.40±8.70)points,(66.95±10.50)points,(71.80±12.40)points,(74.70±12.50)points,(77.65±13.50)points and(66.35±12.50)points],and the differences were statistically significant(P<0.05).The incidence of complications in the study group was 2.94%,which was significantly lower than that in the control group(20.59%),and the difference was statistically significant(P<0.05).Conclusion The total effective rate of staged flexible ureteroscope holmium laser lithotripsy for 2-4cm kidney stones is higher than that of microchannel percutaneous nephrolithotomy.The quality of life is significantly improved after treatment,and the incidence of complications is low,which has important function value.