输尿管软镜与微通道经皮肾镜碎石术治疗肾结石对并发症发生率的改善评价

Evaluation of the Improvement of Complication Rate by Flexible Ureteroscope and Microchannel Percutaneous Nephrolithotomy in the Treatment of Renal Calculi

目的系统分析输尿管软镜与微通道经皮肾镜碎石术治疗肾结石对并发症发生率的改善效果。方法选取2018年3月—2021年3月该院治疗的106例肾结石患者作为研究目标,随机分为对照组(n=53)、研究组(n=53)。研究组以输尿管软镜碎石术治疗,对照组以微通道经皮肾镜碎石术治疗,比较两组患者的改善效果、并发症发生率、结石清除率、肾功能指标、手术时间、术中出血量以及术后住院时间。结果治疗前,研究组肾功能指标与对照组对比,差异无统计学意义(P>0.05);治疗后,研究组肾功能指标与对照组对比,差异有统计学意义(P<0.05)。治疗后,对照组Cr(55.86±8.44)μmol/L、BUN(6.37±1.13)mmol/L、NGAL(5.59±1.58)μg/L高于研究组,差异有统计学意义(t=2.080、3.448、4.137,P<0.05)。研究组总有效率(98.11%)、结石清除率(100.00%)均高于对照组(83.02%、75.47%),差异有统计学意义(χ^(2)=7.067、14.817,P<0.05)。研究组并发症发生率(3.77%)低于对照组(18.87%),差异有统计学意义(χ^(2)=6.014,P<0.05)。研究组手术时间(56.77±4.52)min、术中出血量(6.20±1.42)mL、术后住院时间(4.11±1.32)d均优于对照组的(61.22±5.60)min、(26.62±6.54)mL、(7.52±2.11)d,差异有统计学意义(t=4.501、22.213、9.974,P<0.05)。结论以输尿管软镜碎石术治疗肾结石患者可明显提升患者的临床效果与结石清除率,减少并发症,改善肾功能指标,缩短手术时间以及术后住院时间,减少术中出血量,值得临床研究与推广。

Objective To systematically analyze the effect of flexible ureteroscopy and microchannel percutaneous nephrolithotomy on the incidence of complications in the treatment of renal calculi.Methods 106 patients with renal calculi treated in the hospital from March 2018 to March 2021 were selected,and they were randomly divided into the control group(n=53)and the study group(n=53).The study group was treated with flexible ureteroscopic lithotripsy,and the control group was treated with microchannel percutaneous nephrolithotomy.The improvement effect,complication rate,stone clearance rate,renal function index,operation time,intraoperative blood loss and postoperative hospital stay were compared in the two groups.Results Before treatment,there was no statistically significant difference in renal function indexes between the study group and the control group(P>0.05);after treatment,the renal function indexes were compared between the study group and the control group,and the difference was statistically significant(P<0.05).After treatment,Cr(55.86±8.44)μmol/L,BUN(6.37±1.13)mmol/L,and NGAL(5.59±1.58) μg/L in the study group were higher than those in the control group, and the differences were statistically significant (t=2.080, 3.448 , 4.137, P<0.05). The total effective rate (98.11%) and stone clearance rate (100.00%) of the study group were higher than those of the control group (83.02%, 75.47%), and the difference was statistically significant (χ^(2)=7.067, 14.817, P<0.05). The incidence of complications in the study group (3.77%) was lower than that in the control group (18.87%), and the difference was statistically significant (χ^(2)=6.014, P<0.05). The operation time of the study group (56.77±4.52) min, intraoperative blood loss (6.20±1.42) mL, and postoperative hospital stay (4.11±1.32) d were all better than those of the control group (61.22±5.60) min, (26.62±6.54) mL, (7.52±2.11) d, the difference was statistically significant (t=4.501, 22.213, 9.974, P<0.05). Conclusion Flexible ureteroscopic lithotripsy in the treatment of patients with renal calculi can significantly improve the clinical effect and stone clearance rate, reduce complications and improve renal function indicators. It is worthy of clinical research and promotion to shorten the operation time and postoperative hospital stay, and reduce the amount of intraoperative blood loss.