16F微通道经皮肾镜联合1470nm激光治疗肾盂旁囊肿的疗效观察

Therapeutic effect of 16 F microchannel percutaneous nephroscopy combined with 1470 nm laser in the treatment of parapelvic cysts

目的探讨16 F微通道经皮肾镜联合1470 nm半导体激光治疗肾盂旁囊肿的临床疗效。方法回顾性选取广东医科大学附属阳江医院2016年1月至2018年12月收治的49例肾盂旁囊肿患者为研究对象。按照治疗方式不同将所有患者分为两组,其中观察组24例进行16 F微通道经皮肾镜联合1470 nm半导体激光治疗,对照组25例进行腹腔镜肾盂旁囊肿去顶减压术。观察比较两组患者手术时间、术中出血量、术后卧床时间、住院时间治疗前后视觉模拟评分(VAS)及复查情况。结果观察组患者手术时间(33±5)min、术中出血量(18±4)ml、术后卧床时间(16±3)h及住院时间(4.1±0.8)d均明显少于对照组(54±10)min、(49±12)ml、(29±6)h、(5.7±1.2)d,二者比较差异均有统计学意义(P<0.05)。治疗后,观察组VAS评分(3.82±1.03)分明显低于对照组(5.53±1.24)分,二者差异有统计学意义(P<0.05)。两组患者治疗后进行复查,症状缓解率(91.67%vs 76.00%),并发症发生率(4.17%vs 8.00%)及复发率(0.00%vs 4.00%)差异均无统计学意义(P>0.05)。结论16 F微通道经皮肾镜联合1470 nm半导体激光治疗肾盂旁囊肿临床疗效显著,可缩短手术时间,降低出血量,降低患者术后疼痛程度,促进康复,值得临床推广应用。

Objective To investigate the clinical efficacy of 16 F microchannel percutaneous nephroscopy combined with 1470 nm semiconductor laser in the treatment of parapelvic cysts.Methods Forty-nine cases of parapelvic cysts admitted to our hospital from January 2016 to December 2018 were retrospectively selected as the study subjects.All patients were divided into two groups according to different treatment methods.24 patients in the observation group were treated with 16 F microchannel percutaneous nephroscopy combined with 1470 nm semiconductor laser,and 25 patients in the control group were treated with laparoscopic decompression of parapelvic cyst.The operation time,intraoperative blood loss,postoperative outpatient activity time,hospitalization time were compared between the two groups.The visual analogue scale(VAS)scores before and after treatment were compared between the two groups.Results The operation time(33±5)min,intraoperative blood loss(18±4)ml,postoperative outpatient activity time(16±3)h,and hospitalization time(4.1±0.8)d in the observation group,were significantly less than those of the control group[(54±10)min,(49±12)ml,(29±6)h,(5.7±1.2)d](P<0.05).After treatment,the VAS score(3.82±1.03)in the observation group was significantly lower than that in the control group(5.53±1.24),and the difference was statistically significant(P<0.05).The two groups of patients were reviewed after treatment.There was no difference in symptom relief rate(91.67%vs 76.00%),complication rate(4.17%vs 8.00%)and recurrence rate(0.00%vs 4.00%).The differences were was not statistically significant(P>0.05).Conclusion 16 F Micro-channel percutaneous nephrolithotomy combined with 1470 nm semiconductor laser in the treatment of para-negative cysts has a significant clinical effect,which can shorten the operation time,reduce the amount of bleeding,improve the pain of patients and promote rehabilitation,which is worthy of clinical application.