超微经皮肾镜和输尿管软镜治疗肾结石的对比

To Compare the Infection Control and Curative Effect of Ultramicro-percutaneous Nephroscopy and Flexible Ureteroscope in the Treatment of Renal Calculi

目的对比超微经皮肾镜与输尿管软镜在治疗肾结石中的感染控制及临床疗效。方法选入2017年6月-2018年9月医院收治的100例肾结石患者,所有患者依照随机将分组原则,利用随机数字法分组,经皮肾镜组50例利用超微经皮肾镜碎石术(UPCNL)治疗,尿管软镜组50例则利用输尿管软镜碎石术(URSL)治疗,对照两组患者手术时间、术中失血量、住院时间、治疗效果、感染情况、血红蛋白、血肌酐。结果本次观察中应用超微经皮肾镜碎石术治疗的经皮肾镜组患者手术时间、住院时间均短于应用输尿管软镜碎石术治疗的尿管软镜组(P <0.05),经皮肾镜组术中失血量及感染发生率更低(P <0.05),在治疗后两组血肌酐、血红蛋白水平对照中均为经皮肾镜组更高(P <0.05),治疗有效率对照中经皮肾镜组显著高于输尿管软镜组(P <0.05)。结论肾结石患者的治疗中采用超微经皮肾镜效果较输尿管软镜更佳,可表现为治疗有效率更高,感染发生率更低,住院时间、手术时间更短,术中失血量更少,术后血红蛋白、血肌酐水平更高,可优先考虑。

Objective To compare the infection control and clinical efficacy of ultramicro-percutaneous nephroscopy and flexible ureteroscope in the treatment of renal calculi.Methods 100 patients with renal calculi admitted to our hospital from June 2017 to September 2018 were selected.All patients were randomly divided into two groups according to the principle of random number.50 patients in the percutaneous nephroscopy group were treated by ultramicro percutaneous nephrolithotomy(UPCNL),and 50 patients in the flexible ureteroscopy group were treated by flexible ureteroscope lithotripsy(URSL).The operation time,intraoperative blood loss,hospitalization time,treatment effect,infection,hemoglobin and serum creatinine were observed.Results The operation time and hospitalization time of the patients in the percutaneous nephrolithotomy group were shorter than those in the flexible ureteroscope group(P<0.05).The blood loss and infection rate were lower in the 02 percutaneous nephrolithotomy group(P<0.05).After treatment,the serum creatinine and infection rate were lower in the two groups.The level of hemoglobin in the control group was higher than that in the percutaneous nephroscopy group(P<0.05),and the treatment efficiency in the percutaneous nephroscopy group was significantly higher than that in the flexible ureteroscope group(P<0.05).Conclusion Ultra-micro percutaneous nephroscopy is more effective than flexible ureteroscope in the treatment of renal calculi,which can be manifested as higher treatment efficiency,lower incidence of infection,shorter hospital stay,shorter operation time,less intraoperative blood loss and higher levels of hemoglobin and creatinine after operation.