微通道经皮肾镜碎石术治疗上路尿结石患者碎石效果研究

Study on the Effect of Microchannel Percutaneous Nephrolithotomy in the Treatment of Patients with Upper Urinary Calculi

目的 研究微通道经皮肾镜碎石术对上路尿结石患者碎石效果及并发症的影响。方法 选取2018年12月-2021年6月在我院诊治的42例上路尿结石患者为研究对象,采用随机数字表法分为对照组和观察组,各21例。对照组采用标准通道经皮肾镜碎石术治疗,观察组采用微通道经皮肾镜碎石术治疗,比较两组手术指标、结石清除率、结石清理时间、术后疼痛度及并发症发生率。结果 观察组术中出血量、住院时间均小于对照组,手术时间、结石直径均长于对照组(P<0.05);观察组结石清除率为95.24%,高于对照组的80.95%(P<0.05);观察组结石清理时间长于对照组(P<0.05);观察组0级、Ⅰ级疼痛发生率高于对照组,Ⅱ级、Ⅲ级疼痛发生率低于对照组(P<0.05);观察组并发症发生率为4.76%,低于对照组的19.05%(P<0.05)。结论 微通道经皮肾镜碎石术对上路尿结石患者碎石效果确切,可提高结石清除率,减轻术后疼痛度,降低并发症发生率,是一种安全性高的治疗方法,但其手术和结石清理时间较长,临床应合理选择手术方案。

Objective To study the effect of microchannel percutaneous nephrolithotomy on lithotripsy and complications in patients with upper urinary calculi.Methods A total of 42 patients with upper urinary calculi diagnosed and treated in our hospital from December 2018 to June 2021 were selected as the research objects. They were divided into control group and observation group by random number table method, with 21 cases in each group. The control group was treated with standard channel percutaneous nephrolithotomy, and the observation group was treated with microchannel percutaneous nephrolithotomy. The surgical indexes, stone clearance rate, stone clearance time, postoperative pain and complication rate were compared between the two groups.Results The intraoperative blood loss and hospitalization time of the observation group were less than those of the control group, and the operation time and stone diameter were longer than those of the control group( P<0.05). The stone clearance rate of the observation group was 95.24%, which was higher than 80.95% of the control group(P<0.05). The stone clearance time in the observation group was longer than that in the control group(P<0.05). The incidence of grade 0 and grade Ⅰ pain in the observation group was higher than that in the control group, and the incidence of grade Ⅱ and grade Ⅲ pain was lower than that in the control group(P <0.05). The incidence of complications in the observation group was 4.76%, which was lower than 19.05% in the control group(P<0.05).Conclusion Microchannel percutaneous nephrolithotomy is effective in the treatment of patients with upper urinary calculi, which can improve the stone clearance rate, reduce postoperative pain, reduce the incidence of complications, and is a safe treatment method. However, the operation and stone clearance time is long, and the clinical operation scheme should be reasonably selected.