复杂性肾结石患者应用超声引导微创经皮肾镜加输尿管软镜治疗的效果观察

Effect observation of ultrasound-guided minimally invasive percutaneous nephrolithotomy combined with flexible ureteroscope in the treatment of complex renal calculi

目的研究超声引导微创经皮肾镜联合输尿管软镜治疗复杂性肾结石的临床效果。方法80例复杂性肾结石患者,根据治疗方法不同分为对照组与研究组,每组40例。对照组采用超声引导微创经皮肾镜治疗,研究组在对照组基础上联合输尿管软镜治疗。比较两组患者术中出血量、手术时间、住院时间、结石清除情况、术后并发症发生情况及治疗前后肾功能指标。结果研究组手术时间(70.6±6.8)min、住院时间(6.1±1.1)d短于对照组的(90.5±8.4)min、(8.7±1.5)d,术中出血量(75.8±12.6)ml少于对照组的(110.2±15.3)ml,差异具有统计学意义(P<0.05)。治疗后,两组患者肌酐与尿激酶水平均较本组治疗前升高,但研究组肌酐水平低于对照组,尿激酶水平高于对照组,差异具有统计学意义(P<0.05)。研究组患者结石清除率95.0%(38/40)高于对照组的77.5%(31/40),差异具有统计学意义(P<0.05)。研究组患者术后并发症发生率7.5%(3/40)低于对照组的27.5%(11/40),差异具有统计学意义(P<0.05)。结论超声引导微创经皮肾镜联合输尿管软镜治疗复杂性肾结石,临床效果显著,一次性结石清除率高,手术创伤小,对患者肾功能的影响较低,患者术后并发症发生率低,安全性高,值得临床广泛推广应用。

Objective To study the clinical effect of ultrasound-guided minimally invasive percutaneous nephrolithotomy combined with flexible ureteroscope in the treatment of complex renal calculi.Methods A total of 80 patients with complex renal calculi were divided into control group and research group according to different treatment methods,with 40 cases in each group.The control group was treated with ultrasound-guided minimally invasive percutaneous nephrolithotomy,and the research group was treated with flexible ureteroscope on the basis of the control group.The intraoperative blood loss,operation time,hospitalization time,stone clearance,postoperative complications and renal function indexes before and after treatment were compared between the two groups.Results The operation time(70.6±6.8)min and hospitalization time(6.1±1.1)d in the research group were shorter than(90.5±8.4)min and(8.7±1.5)d in the control group,and the intraoperative blood loss(75.8±12.6)ml was less than(110.2±15.3)ml in the control group.All the differences were statistically significant(P<0.05).After treatment,the levels of creatinine and urokinase in the two groups were higher than those before treatment in this group,but the level of creatinine in the research group was lower than that in the control group,and the level of urokinase was higher than that in the control group.All the differences were statistically significant(P<0.05).The stone clearance rate 95.0%(38/40)in the research group was higher than 77.5%(31/40)in the control group,and the difference was statistically significant(P<0.05).The postoperative complication rate 7.5%(3/40)in the research group was lower than 27.5%(11/40)in the control group,and the difference was statistically significant(P<0.05).Conclusion Ultrasound guided-minimally invasive percutaneous nephrolithotomy combined with flexible ureteroscope has significant clinical effect in the treatment of complex renal calculi,with high one-time stone clearance rate,small surgical trauma,low impact on renal function,low postoperative complication rate and high safety,which is worthy of wide clinical promotion and application.