经皮肾镜联合输尿管软镜碎石取石术对复杂性肾结石患者结石残留率、术后恢复和生活质量的影响

Effect of percutaneous nephrolithotomy combined with flexible ureteroscopic lithotripsy on residual stone rate,postoperative recovery and quality of life in patients with complex renal calculi

目的:探讨经皮肾镜联合输尿管软镜碎石取石术对复杂性肾结石患者结石残留率、术后恢复和生活质量的影响。方法:选取106例复杂性肾结石患者,依据手术方式的不同,分为对照组(可视化经皮肾镜碎石术)51例和研究组(可视化经皮肾镜联合输尿管软镜碎石取石术)55例。比较两组手术时间、术中出血量、术后住院天数、术后下床时间、术后结石残留率、术后并发症发生率和手术前后生活质量评分等情况。结果:与对照组比较,研究组术中出血量明显减少,手术时间、术后住院天数、术后下床时间均明显缩短(P<0.01)。相比对照组研究组术后结石残留率显著下降(P<0.05)。相比术前,两组患者术后心理状态、物质生活、躯体功能评分均显著提高,且研究组术后生活质量评分较对照组明显提高(P<0.05)。与对照组比较,研究组术后并发症总发生率显著下降(P<0.05)。结论:可视化经皮肾镜联合输尿管软镜碎石取石术可有效降低复杂性肾结石患者术后结石残留率,减少手术时间和住院天数,促进患者术后康复,同时可有效提高术后生活质量,降低术后并发症发生率,具有较高的安全性。

Objective:To analyze the influence of percutaneous nephrolithotomy combined with flexible ureteroscopic lithotripsy on residual stone rate,postoperative recovery and quality of life in patients with complex renal calculi.Methods:106 patients with complex renal calculi were divided into control group(percutaneous nephrolithotomy,51 cases)and study group(flexible ureteroscopic lithotripsy,55 cases)according to different operation methods.The operation time,intraoperative bleeding volume,postoperative hospitalization days,postoperative time of getting out of bed,postoperative residual stone rate,incidence rate of postoperative complications,preoperative and postoperative quality of life scores were compared between the two groups.Results:Compared with the control group,the amount of intraoperative bleeding in the study group was significantly reduced,and the operation time,postoperative hospitalization days and postoperative time of getting out of bed were significantly shortened(all P<0.01).Compared with the control group,the residual stone rate in the study group was decreased significantly(P<0.05).Compared with pre-operation,the scores of psychological state,material life and physical function in the two groups were significantly improved,and the scores of quality of life in the study group were significantly higher than those in the control group(P<0.05).Compared with the control group,the total incidence of postoperative complications in the study group was decreased significantly(P<0.05).Conclusion:Percutaneous nephrolithotomy combined with flexible ureteroscopic lithotripsy can effectively reduce the residual rate of calculi in patients with complex renal calculi,shorten the operation time and hospitalization days,promote the postoperative rehabilitation of patients.Meanwhile,it can effectively improve the quality of postoperative life,reduce the incidence of postoperative complications,has high safety.