微通道经皮肾镜Cyberwand超声碎石术治疗复杂性肾结石的疗效

Efficacy of microchannel percutaneous nephrolithotripsy with cyberwand ultrasound in complex renal calculi

目的探讨微通道经皮肾镜Cyberwand超声碎石术对复杂性肾结石的疗效。方法回顾性分析河北医科大学第一医院2019年2月至10月收治的83例采用经皮肾镜Cyberwand超声碎石术治疗的复杂性肾结石患者的资料,依据手术方式分组,其中有43例实施标准通道手术(标准组),余40例实施微通道手术(微通道组)。结果微通道组手术时间为(135.89±21.30)min,长于标准组的(105.78±20.05)min,差异有统计学意义(P<0.05);2组术中出血量和1期结石清除率比较差异均无统计学意义(P>0.05);2组术后3 d、术后1周血肌酐(Scr)、血尿素氮(BUN)水平均低于术前,且2组术后1周Scr、BUN水平均低于术后3 d(P<0.05),而2组Scr、BUN水平比较差异均无统计学意义(P>0.05);微通道组并发症发生率为2.50%,低于标准组的13.95%(P<0.05)。结论微通道和标准通道经皮肾镜Cyberwand超声碎石术治疗复杂性肾结石效果相当,且均可显著减轻结石对肾功能的损害,虽然前者可导致手术时间延长,但可减少术后并发症。

Objective To explore the efficacy of microchannel percutaneous nephrolithotripsy with cyberwand ultrasound in the treatment of complex renal calculi.Methods The clinical data of 83 cases of complex renal calculi treated with percutaneous nephrolithotripsy with cyberwand ultrasound in our hospital during Feb.2019 and Oct.2019 were retrospectively analyzed.According to the operation methods,the patients were divided into standard channel operation group(group A,n=43)and microchannel operation group(group B,n=40).Results The operation time of group B was(135.89±21.30)min,which was longer than that of group A[(105.78±20.05)min,P<0.05].There were no significant differences between the two groups in the amount of intraoperative bleeding and stone-clearance rate in the first stage(P>0.05).The serum levels of serum creatinine(Scr)and blood urea nitrogen(BUN)in both groups 3 days and 1 week after operation were lower than those be fore operation[group A:(120.89±19.78)μmol/L,(90.15±12.46)μmol/L vs.(175.85±22.47)μmol/L,(7.07±2.05)mmol/L,(5.04±1.08)mmol/L vs.(11.43±2.56)mmol/L;group B:(122.58±21.67)μmol/L,(89.53±15.82)μmol/L vs.(173.69±23.75)μmol/L,(7.63±1.89)mmol/L,(4.63±1.12)mmol/L vs.(10.09±2.63)mmol/L](P<0.05),and these indexes 1 week after operation were lower than those 3 days after operation(P<0.05).There were no significant differences in serum Scr and BUN levels between the two groups(P>0.05).The incidence of complications in group B was 2.50%,which was lower than that in group A(13.95%,P<0.05).Conclusion Compared with standard channel percutaneous nephrolithotripsy,microchannel percutaneous nephrolithotripsy with cyberwand ultrasound has the same efficacy in the treatment of complex renal calculi,and can significantly reduce the damage of calculi to renal function.Although the microchannel approach needs longer operation time,it can reduce postoperative complications.