可视化穿刺在无积水肾结石经皮肾镜取石术中的应用效果分析

Analysis of the Application Effect of Visual Puncture in Percutaneous Nephrolithotomy for Renal Calculi without Hydronephrosis

目的:探讨可视化穿刺在无积水肾结石经皮肾镜取石术中的应用效果.方法:选取2018年1月-2019年9月本院收治的94例无积水肾结石患者为研究对象,按照治疗方法将其分为对照组44例和观察组50例.对照组采用经皮肾镜取石术治疗,观察组采用可视化穿刺经皮肾镜取石术治疗.比较两组的围术期相关指标、血红蛋白及血白细胞计数、并发症发生情况和术后1个月的清石率.结果:观察组手术时间、住院时间均短于对照组,术中出血量少于对照组,输血率、术后疼痛评分、术后镇痛药使用率均低于对照组,碎石成功率高于对照组,差异均有统计学意义(P<0.05).术后,两组血红蛋白均下降,血白细胞计数均升高,观察组血红蛋白高于对照组,血白细胞计数低于对照组,差异均有统计学意义(P<0.05).观察组患者的并发症发生率为4.00%,显著低于对照组的18.18%,差异有统计学意义(P<0.05).观察组患者术后1个月的清石率为94.00%,高于对照组的79.55%,差异有统计学意义(P<0.05).结论:在无积水肾结石患者经皮肾镜取石术中采用可视化穿刺术安全有效,有助于提高结石清除率,降低输血率和并发症发生率.

Objective:To explore the application effect of visual puncture in percutaneous nephrolithotomy for renal calculi without hydronephrosis.Method:A total of 94 patients of renal calculi without hydronephrosis admitted to our hospital from January 2018 to September 2019 were selected as study subjects.They were divided into control group 44 cases and observation group 50 cases according to the treatment method.The control group was treated with percutaneous nephrolithotomy,the observation group was treated with visual puncture percutaneous nephrolithotomy.Perioperative indexes,hemoglobin and white blood cell count,complications,and stone clearing rate 1 month after operation were compared between the two groups.Result:The operative time and hospital stay of the observation group were shorter than those of the control group,the intraoperative blood loss was less than that of the control group,the blood transfusion rate,postoperative pain score and postoperative analgesic use rate were all lower than those of the control group,the success rate of lithotripsy was higher than that of the control group,with statistically significant differences(P<0.05).After surgery,the hemoglobin in both groups were decreased,the white blood cell count were increased,the hemoglobin in the observation group was higher than that in the control group,the white blood cell count was lower than that in the control group,with statistically significant differences(P<0.05).The complication rate in the observation group was 4.00%,significantly lower than 18.18%in the control group,with a statistically significant difference(P<0.05).The clear stone rate in the observation group was 94.00%one month after operation,higher than 79.55%in the control group,with statistically significant difference(P<0.05).Conclusion:Visual puncture is safe and effective in the percutaneous nephrolithotomy for patients of renal calculi without hydronephrosis,which is helpful to improve the stone clearance rate,reduce the blood transfusion rate and the incidence of complications.