微创经皮肾镜取石术与体外冲击波碎石治疗泌尿系结石的疗效比较

Comparison of Minimally Invasive Percutaneous Nephrolithotomy and Extracorporeal Shock Wave Lithotripsy in the Treatment of Urinary Calculi

目的探讨微创经皮肾镜取石术与体外冲击波碎石治疗泌尿系结石的疗效对比。方法选取2018年3月—2019年3月该院收治的86例泌尿系结石患者作为研究对象,根据治疗方法分为微创经皮肾镜治疗组(A组),共42例;和体外冲击波碎石治疗组(B组),共44例。对两组患者的术中出血量、手术时间、术后一次性结石清除率、治疗效果进行对比分析。结果A组的术中出血量和手术时间分别为(103.24±26.64)mL,(84.34±21.47)min;B组分别为0 mL,(31.87±21.64)min,B组的术中出血量和手术时间均明显少于A组,差异有统计学意义(t=25.714,11.283,P=0.000,0.000<0.05)。A组的一次性结石清除率和治疗效果总有效率分别为80.95%,92.86%;B组为56.82%,90.91%,两组治疗效果比较,差异无统计学意义(χ2=0.109,P=0.741>0.05),A组的一次性结石清除率要高于B组,差异有统计学意义(χ2=4.166,P=0.041<0.05)。结论体外冲击波碎石手术时间短,手术无出血,但其一次性碎石清除率较低,需进行多次碎石;微创经皮肾镜取石术结石清除率较高,手术时间及术中出血量较冲击波碎石多。

Objective To compare the efficacy of minimally invasive percutaneous nephrolithotomy and extracorporeal shock wave lithotripsy in the treatment of urinary calculi.Methods From March of 2018 to March 2019,86 patients with urinary stones from our hospital were selected as the subject of the study.According to the treatment method,there were 42 cases of minimally invasive percutaneous nephrolithotomy(group A),42 cases,and in-vitro shock wave lithotripsy(group B).The intraoperative blood loss,the time of operation,the one-time stone clearance after operation and the treatment effect were compared and analyzed.Results The intraoperative blood loss and operation time in group A were(103.24±26.64)mL,(84.34±21.47)min;in group B,it was 0 mL,(31.87±21.64)min.The amount of intraoperative blood loss and operation time in group B were significantly lower than those in group A,the difference was statistically significant(t=25.714,11.283,P=0.000,0.000<0.05).The clearance rate of disposable stones and the total effective rate of treatment in group A were 80.95%,92.86%in group B were 56.82%,90.91%.There was no significant difference between the two groups,the difference was statistically significant(χ2=0.109,P=0.741>0.05),and the clearance rate of disposable stones in group A was higher than that in group B,the difference was statistically significant(χ2=4.166,P=0.041<0.05).Conclusion Extracorporeal shock wave lithotripsy has a short operation time and no bleeding,but the clearance rate of one-off lithotripsy is low,so it is necessary to carry out multiple lithotripsy,and the stone clearance rate of minimally invasive percutaneous nephrolithotomy is higher than that of shock wave lithotripsy,and the operation time and intraoperative blood loss are more than those of shock wave lithotripsy.