经自然腔道的输尿管硬镜联合软镜治疗2cm以上肾结石的疗效、疼痛程度及血红蛋白分析

Efficacy,Pain Degree and Hemoglobin Analysis of Rigid Ureteroscopy Combined with Flexible Ureteroscopy through Natural Cavity in the Treatment of Kidney Stones Larger than 2cm

目的:对2cm以上肾结石患者接受微创经皮肾镜碎石术、经自然腔道的输尿管硬镜联合软镜术治疗1个月后的临床病情控制优良率、疼痛程度及血红蛋白进行研究。方法:参与本次研究的2cm以上肾结石患者72例,时间为2019年8月-2020年8月,采用信封法分组,分为手术1组和手术2组各36例。手术1组采用微创经皮肾镜碎石术,手术2组采用经自然腔道的输尿管硬镜联合软镜术。对比两组术后血红蛋白下降值、平均住院时间、治疗前与治疗1个月后简式麦吉尔疼痛问卷SF-MPQ(short-form McGill pain questionnaire)评分、临床病情控制优良率。结果:手术2组平均住院时间短于手术1组(P<0.05);手术2组术后血红蛋白下降值低于手术1组(P<0.05);治疗1个月后,手术2组SF-MPQ量表评分明显低于手术1组(P<0.05),手术2组临床病情控制优良率相比手术1组更高(P<0.05)。结论:2cm以上肾结石患者接受经自然腔道的输尿管硬镜联合软镜术治疗的临床病情控制优良率更高,疼痛程度及血红蛋白水平下降值更低。

Objective:To investigate the excellent and good rate of clinical disease control,pain degree and hemoglobin in patients with renal calculi larger than 2 cm after 1 month of treatment with minimally invasive percutaneous nephrolithotripsy and rigid ureteroscopy combined with flexible ureteroscopy through natural cavity.Methods:A total of 72 patients with kidney stones larger than 2 cm treated in a hospital from August 2019 to August 2020 were enrolled in this study.They were divided into surgery group 1 and surgery group 2 by envelope method.36 cases in operation group 1 was treated with minimally invasive percutaneous nephrolithotripsy,and 36 cases in operation group 2 was treated with rigid ureteroscopy combined with flexible ureteroscopy through natural cavity.The decreased value of postoperative hemoglobin,average length of hospital stay,SF-MPQ(short-form McGill Pain Questionnaire) score before treatment and 1 month after treatment,and the excellent and good rate of clinical condition control were investigated.Results:The average hospitalization time of operation group 2 was shorter than that of operation group 1(P<0.05).The decrease of postoperative hemoglobin in operation group 2 was lower than that in operation group 1(P<0.05).After 1 month of treatment,the score of SF-MPQ in the operation group 2 was significantly lower than that in the operation group 1(P<0.05),and the rate of good clinical disease control was higher than that in the operation group 1(P<0.05).Conclusion:Patients with renal calculi larger than 2 cm who received rigid ureteroscopy combined with flexible ureteroscopy through natural cavity have higher rate of good clinical condition control,lower pain degree and lower hemoglobin level.