改良无管化经皮肾镜碎石取石术对肾输尿管上段结石患者围术期指标、术后疼痛和并发症的影响

The effect of modified tubeless percutaneous nephrolithotomy on perioperative indicators,postoperative pain and complications of patients with renal upper ureteral calculi

目的探讨改良无管化经皮肾镜碎石取石术对肾输尿管上段结石患者围术期指标、术后疼痛和并发症的影响。方法选取我院收治的70例肾输尿管上段结石患者,按照随机数字表法分为研究组(改良无管化经皮肾镜碎石取石术)与对照组(传统经皮肾镜碎石)各35例。比较两组结石清除率、术中情况(手术时间、术中出血量、输血率)、术后情况(漏尿时间、住院时间、医疗费用)、疼痛视觉模拟评分(VAS)、并发症发生情况。结果两组手术时间、术中出血量、输血率比较差异无统计学意义(P>0.05);研究组漏尿时间、住院时间、医疗费用低于对照组,术后轻度疼痛占比高于对照组,中重度疼痛占比低于对照组(P<0.05);两组发热、出血、感染等发生情况比较差异无统计学意义(P>0.05)。结论改良无管化经皮肾镜碎石取石术治疗肾输尿管上段结石疗效良好,能够促进患者术后恢复,减轻术后疼痛。

Objective To explore the effect of modified tubeless percutaneous nephrolithotomy on perioperative indicators,postoperative pain and complications in patients with renal upper ureteral calculi.Methods Clinical data of 70 patients with renal upper ureteral calculi admitted to our hospital were collected.The patients were divided into a study group and a control group by the random number table method,35 in each group.The observation group was treated with modified tubeless percutaneous nephrolithotomyand the control group was treated with traditional percutaneous nephrolithotomy.Stone clearance rate,intraoperative indexessuch as surgical time,intraoperative blood loss and blood transfusion rate,postoperative indexessuch as urine leakage time,hospital stay,and medical expense,pain level estimated by using Visual Analogue Scale(VAS)and occurrence of complications were compared between the two groups.Results There were no statistically significant differences in the surgical time,intraoperative blood loss and blood transfusion rate between the two groups(P>0.05).The urine leakage time,hospital stay and medical expense of the study group were significantly lower or shorter than those of the control group(P<0.05).The proportion of postoperative mild pain in the study group was significantly higher than that in the control group while the proportionin moderate and severe pain was significantly lower than that in the control group(P<0.05).There were no statistically significant differences in the occurrence of fever,bleeding and infection between the two groups(P>0.05).Conclusion The modified tubeless percutaneous nephrolithotomy has a good curative effect in the treatment of renal upper ureteral calculi.It can promote the postoperative recovery and relieve the postoperative pain.