不同腔镜碎石术治疗肾下盏结石的疗效及安全性比较

Clinical effects and safety comparison of different kinds of minimally invasive endoscopic scheme in the treatment of patients with renal calculi in infra pole

目的探讨输尿管软镜碎石术和经皮超微肾镜碎石术治疗肾下盏结石疗效及安全性差异,为手术方案选择积累更多循证医学证据。方法选取本院2016年1月至2018年8月收治肾下盏结石患者136例,以随机抽签法分为对照组(68例)和观察组(68例),分别采用输尿管软镜碎石术和经皮超微肾镜碎石术治疗;比较两组术后3 d和28 d结石清除率、手术用时、术后疼痛评分、术后舒适度评分、术后住院时间、术后实验室指标水平及术后并发症发生率。结果观察组术后3 d和28 d结石清除率均显著高于对照组(P<0.05);观察组手术用时显著少于对照组(P<0.05);两组术后疼痛评分、舒适度评分及Hb下降值比较差异无统计学意义(P>0.05);观察组术后住院时间显著多于对照组(P<0.05);观察组术后WBC计数、PCT及hs-CRP水平显著低于对照组(P<0.05);同时两组术后发热和血尿发生率比较差异均无统计学意义(P>0.05)。结论经皮超微肾镜碎石术治疗肾下盏结石较输尿管软镜碎石术在提高结石清除效果和缩短手术用时方面具有优势,且可能降低术后继发炎症反应水平;而输尿管软镜碎石术应用则有助于加快术后康复进程。

Objective To investigate the clinical effects and safety differences of FURS and SMP in the treatment of patients with renal in infra pole.Methods From January 2016 to August 2018,136 patients with renal calculi in infra pole were chosen in the period in our hospital and randomly divided into both groups including control group(68 case)with FURS operation and observation group(68 case)with SMP operation,and the operation time,postoperative pain score,postoperative comfort score,postoperative hospitalization time,post-operative laboratory index level and postoperative complication incidence of both groups were compared.Results The stone clearance rate in 1 d and 28 d after operation of observation group were significantly higher than control group(P<0.05).The operation time of observation group were significantly shorter than control group(P<0.05).There was no significant difference in the Hb decline value after operation,postoperative pain score and postoperative comfort score between 2 groups(P<0.05).The postoperative hospitalization time of observation group were significantly longer than control group(P<0.05).The levels of WBC count,PCT and hs-CRP after operation of observation group were significantly less than control group(P<0.05).There was no significant difference in the postoperative complication incidence between 2 groups(P<0.05).Conclusions SMP in the treatment of patients with renal in infra pole can efficiently removal the renal stones,shorten the operation time and be helpful to reduce the body's inflammatory response and FURS application possess the advantages including accelerate recovery process.