单通道微创经皮肾镜取石术联合逆行输尿管软镜治疗复杂性肾结石的疗效观察

Effect of single-channel minimally invasive percutaneous nephrolithotomy plus retrograde intrarenal surgery on complex renal calculi

目的研究单通道微创经皮肾镜取石术联合逆行输尿管软镜治疗复杂性肾结石的疗效观察。方法选择2017年1月—2020年1月收治的56例复杂性肾结石患者,按随机数字表法分为对照组和研究组,每组各28例。对照组实施多通道微创经皮肾镜取石术治疗,研究组实施单通道微创经皮肾镜取石术联合逆行输尿管软镜治疗,观察两组患者手术相关情况、疼痛舒适评分、排尿情况、生存质量、术后并发症。结果两组手术时间无差异,两组术前前列腺症状评分(IPSS)、最大尿流率(Q_(max))无差异,手术前两组患者生存质量无差异,P>0.05,研究组手术其他情况均优于对照组,研究组术后5 h、48 h疼痛评分低于对照组,舒适度评分高于对照组,术后3个月研究组IPSS评分低于对照组,Q_(max)高于对照组,出院时研究组生存质量高于对照组,研究组术后并发症总发生率10.71%低于对照组28.57%,差异有统计学意义,P<0.05。结论对于复杂性肾结石采取单通道微创经皮肾镜取石术联合逆行输尿管软镜,可获得较为理想的效果,住院明显缩短,并提升患者生存质量,术后疼痛较小,术后并发症概率较低,安全型较高,舒适度较为良好,值得应用。

Objective To explore the effect of single-channel minimally invasive percutaneous nephrolithotomy plus retrograde intrarenal surgery on complex renal calculi.Methods A total of 56 complex renal calculi patients treated from January 2017 to January 2020 were selected and randomly divided into a control group and an observation group,with 28 cases in each group.The control group received multi-channel minimally invasive percutaneous nephrolithotomy;the research group received single-channel minimally invasive percutaneous nephrolithotomy and retrograde intrarenal surgery.Operation conditions,pain and comfort scores,micturition conditions,life quality,and postoperative complications of the two groups were observed.Results There were no significant differences in operation time,preoperative International Prostate Symptom Score(IPSS),maximum flow rate(Qmax),and life quality between the two groups(P>0.05).After surgery,the operation conditions in the research group were better than those in the control group;after 5 h and 48 h of surgery,the pain scores of the research group were lower than those of the control group,and the comfort scores were higher;after 3 months of surgery,the IPSS and Qmax of the research group were better than those of the control group;the life quality score at discharge of the research group was higher than that of the control group;the postoperative complication rate in the research group(10.71%)was lower than that in the control group(28.57%)(P<0.05).Conclusion The single-channel minimally invasive percutaneous nephrolithotomy combined with retrograde intrarenal surgery can shorten hospital stays,reduce postoperative pain and postoperative complication rate,and improve life quality,treatment safety,and comfort degree.