局麻经皮肾镜下碎石取石术在基层医院上尿路结石患者中的应用

Application of local anesthesia percutaneous nephroscope lithoipsy in patients with upper urinary tract calculi in grass-roots hospitals

目的探讨局麻经皮肾镜下碎石取石术(PCNL)在基层医院上尿路结石患者中的应用。方法选取2018年5月~2020年3月我院收治的60例上尿路结石患者作为研究对象,按照随机数字表法分组方法分为对照组(30例)与研究组(30例)。对照组采用腰-硬联合麻醉下行PCNL治疗,研究组采用局麻下行PCNL治疗。比较两组患者的手术指标、肾功能指标以及疼痛分级。结果研究组患者的手术时间、肾造瘘管留置时间、住院时间短于对照组,结石清除率高于对照组,差异均有统计学意义(P<0.05)。术前,两组患者的血尿素氮(BUN)、肌酐(Cr)水平比较,差异无统计学意义(P>0.05);术后,研究组患者的BUN、Cr水平均低于对照组,差异有统计学意义(P<0.05)。两组患者的疼痛程度比较,差异无统计学意义(P>0.05)。结论在基层医院开展局麻PCNL治疗上尿路结石患者,能缩短患者的手术时间和住院时间,提高结石清除率,进而改善患者的肾功能,具有较高的可行性,值得在基层医院推广应用。

Objective To explore the application of local anesthesia percutaneous nephroscope lithoipsy(PCNL)in patients with upper urinary tract calculi in grass-roots hospitals.Methods A total of 60 patients with upper urinary tract calculi admitted to our hospital from May 2018 to March 2020 were selected as the research objects.They were divided into control group(30 cases)and study group(30 cases)according to the random grouping method.The control group was treated with PCNL under combined spinal and epidural anesthesia,and the study group was treated with PCNL under local anesthesia.The surgical index,renal function index and pain grade of the two groups of patients were compared.Results The operation time,indwelling time and hospitalization time of the patients in the study group were shorter than those of the control group,and the stone clearance rate was higher than that of the control group,the differences were statistically significant(P<0.05).Before surgery,there were no significant differences in blood urea nitrogen(BUN)and creatinine(Cr)between the two groups(P>0.05).After surgery,BUN and Cr levels were lower than those in the control group,and the differences were statistically significant(P<0.05).There was no statistically significant difference in the degree of pain between the two groups(P>0.05).Conclusion Carrying out local anesthesia PCNL in grass-roots hospitals to treat patients with upper urinary tract calculi can shorten the operation time and hospitalization time of patients,improve the stone clearance rate,and thus improve the renal function of patients.It is worthy of popularization and application in grass-roots hospitals.