超微经皮肾镜治疗直径<3 cm肾结石的安全性及有效性

Safety and efficacy of super-mini percutaneous nephrolithotomy for the diagnosis of kidney stones<3 cm in diameter

目的探究超微经皮肾镜治疗直径<3 cm肾结石的安全性及有效性。方法选取2016年7月至2018年8月于本院治疗的80例直径<3 cm的肾结石患者为研究对象,依据随机数字表法分成对照组、研究组,每组各40例。对照组行输尿管软镜碎石术(FURL),研究组行超微经皮肾镜碎石术(SMP)。比较两组手术指标、住院时间、血红蛋白、血肌酐、并发症及各阶段结石清除率。结果研究组平均手术时间、住院时间、术中出血量、治疗费用均明显短于对照组(P<0.05);研究组术后血红蛋白明显高于对照组(P<0.05);血肌酐、血尿素氮组间比较,差异无统计学意义(P>0.05);研究组术后第7天、第60天结石清除率明显高于对照组(P<0.05);对照组发热、肾绞痛发生率高于研究组(P<0.05)。结论SMP与FURL治疗直径<3 cm肾结石对患者肾功能无明显影响,而SMP术后各阶段结石清除率更高,发热、肾绞痛发生率较低,疗效突出。

Objective To explore the safety and efficacy of super-mini percutaneous nephrolithotomy(SMP)for the treatment of kidney stones<3 cm in diameter.Methods Eighty patients with diameter<3 cm kidney stones treated in our hospital from July 2016 to August 2018 were enrolled in the study.They were divided into the control group and the study group according to the random number table,40 cases with each group.The control group underwent flexible ureteroscopic lithotripsy(FURL),and the study group underwent ultramicroscopic percutaneous nephrolithotomy.The surgical indexes,hospitalization time,hemoglobin,serum creatinine,complications and stone cleaning rate at each stage were compared between the two groups.Results The average operation time,hospital stay,intraoperative blood loss,and treatment cost were significantly shorter in the study group than the control group(P<0.05).The blood urea nitrogen hemoglobin in the study group was significantly higher than the control group(P<0.05),and there was no significant difference between the serum creatinine and blood urea nitrogen groups(P>0.05).The removal rate of stones on the 7th,60th day after operation was significantly higher in the study group than the control group(P<0.05).The incidence of fever and renal colic in the control group was higher than the study group.Conclusions The results showed that ultramicroscopic percutaneous nephrolithotomy and ureteroscopic lithotripsy for the treatment of renal function with diameter<3 cm had no significant effect on the renal function of patients,and the removal of stones at various stages after ultrastructural percutaneous nephrolithotomy.The rate is higher,the incidence of fever and renal colic is lower,and the curative effect is outstanding.