微创单通道经皮肾镜钬激光碎石与体外冲击波碎石术治疗肾结石的临床疗效及安全性研究

Clinical Efficacy and Safety of Minimally Invasive Single-Channel Percutaneous Nephroscopic Holmium Laser Lithotripsy and Extracorporeal Shock Wave Lithotripsy in the Treatment of Renal Calculi

目的 研究微创单通道经皮肾镜钬激光碎石(PCNL)与体外冲击波碎石术(ESWL)治疗肾结石的临床疗效及安全性。方法 选择2020年3月至2022年2月于本院治疗的138例肾结石患者,按随机数字表法将其分为两组,各69例。对照组采用ESWL治疗,观察组采用微创单通道PCNL治疗。比较两组患者手术时间、肾功能指标、结石清除率及并发症发生情况。结果 观察组手术时间为(56.55±12.48)min,短于对照组的(64.19±15.23)min,术后观察组胱抑素-C(Cys-C)水平为(2.78±1.03)ng/L、肌酐(Scr)水平为(93.82±22.91)μmol/L及尿素氮(BUN)水平为(7.19±1.28)mmol/L,均低于对照组的(3.29±1.12)ng/L、(104.64±24.10)μmol/L、(8.02±1.41)mmol/L,观察组结石清除率98.55%高于对照组82.61%,并发症总发生率2.90%低于对照组11.59%,差异有统计学意义(P<0.05)。结论 肾结石患者采用微创单通道PCNL治疗结石清除率高且并发症少,可缩短手术时间,减轻对患者肾功能的损伤,临床应用安全性高。

Objective To study the clinical efficacy and safety of minimally invasive single-channel percutaneous nephroscopic holmium laser lithotripsy(PCNL) and extracorporeal shock wave lithotripsy(ESWL) in the treatment of renal calculi.Methods A total of 138 patients with renal calculi who were treated in our hospital from March 2020 to February 2022 were selected and divided into two groups according to the random number table method, with 69 cases in each group.The control group was treated with ESWL, and the observation group was treated with minimally invasive single-channel PCNL. The operation time, renal function index, stone clearance rate and complications were compared between the two groups.Results The operation time of the observation group was(56.55±12.48)min, which was shorter than that of the control group(64.19±15.23)min.The postoperative cystatin-C(Cys-C)level of the observation group was(2.78±1.03)ng/L, The level of creatinine(Scr) was(93.82±22.91)μmol/L and the level of blood urea nitrogen(BUN) was(7.19±1.28)mmol/L,which were lower than those of the control group(3.29±1.12)ng/L,(104.64±24.10)μmol/L,(8.02±1.41)mmol/L, the stone clearance rate in the observation group 98.55% was higher than that in the control group 82.61%, and the total incidence of complications 2.90% was lower than that in the control group 11.59%. The difference was statistically significant(P<0.05).Conclusion Minimally invasive single-channel PCNL for renal calculi patients has a low stone clearance rate and fewer complications, which can shorten the operation time and reduce the damage to the renal function of the patients. The clinical application is safe.