经皮肾镜碎石取石术与开放手术治疗肾结石的临床效果与安全性比较

Comparison of clinical effects and safety between percutaneous nephrolithotomy and open surgery in the treatment of renal calculi

目的对比经皮肾镜碎石取石术(PCNL)与开放手术治疗肾结石的临床效果及安全性。方法择取2019年6月至2020年12月于我院住院治疗的30例肾结石患者作为研究对象,按照随机数字表法将其分为对照组和观察组,每组15例。对照组实施开放手术,观察组实施PCNL。比较两组的手术相关指标、术后结石完全清除情况、肾功能指标[血尿素氮(BUN)、血肌酐(SCr)、血尿酸(BUA)、血清β_(2)微球蛋白(β_(2)-MG)]水平、术后并发症发生情况、生活质量评分。结果观察组的手术持续时间、首次下床活动时间、肾造瘘置管时间、住院时间均短于对照组,术中出血量小于对照组,差异具有统计学意义(P<0.05)。两组的术后结石完全清除率比较,差异无统计学意义(P>0.05)。术后次日,两组的BUN、SCr、BUA、β_(2)-MG水平均高于术前,但观察组均低于对照组,差异具有统计学意义(P<0.05)。观察组的术后并发症总发生率低于对照组,差异具有统计学意义(P<0.05)。观察组的躯体功能、心理功能、社会功能、物质功能评分均高于对照组,差异具有统计学意义(P<0.05)。结论PCNL与开放手术治疗肾结石相比较而言,两者手术效果相似,但PCNL在术中的损伤、术后肾功能的恢复及术后并发症等方面具有明显的优势,有利于术后生活质量的提高。

Objective To compare the clinical effects and safety of percutaneous nephrolithotomy(PCNL)and open surgery in the treatment of renal calculi.Methods Thirty patients with renal calculi who were hospitalized in our hospital from June 2019 to December 2020 were selected as the research objects,and the patients were divided into control group and observation group according to the random number table method,with 15 cases in each group.The control group underwent open surgery,and the observation group underwent PCNL.The operation related indexes,complete removal of stones after operation,renal function indexes[blood urea nitrogen(BUN),serum creatinine(SCr),blood uric acid(BUA),serumβ_(2)-microglobulin(β_(2)-MG)]levels,postoperative complications and quality of life scores were compared between the two groups.Results The operation duration,first ambulation time,renal fistula catheterization time and hospitalization time in the observation group were shorter than those in the control group,and the intraoperative blood loss was less than that in the control group,the differences were statistically significant(P<0.05).There was no significant difference in the complete stone clearance rate between the two groups(P>0.05).The next day after operation,the levels of BUN,SCr,BUA andβ_(2)-MG in the two groups were higher than those before operation,but those in the observation group were lower than the control group,the differences were statistically significant(P<0.05).The total incidence of postoperative complications in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).The physical function,psychological function,social function,material function scores in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).Conclusion Compared with open surgery for renal calculi,PCNL has similar surgical effects,but PCNL has obvious advantages in intraoperative injury,postoperative renal function recovery and postoperative complications,which is conducive to the improvement of postoperative quality of life.