对比经尿道输尿管软镜碎石术与经皮肾镜碎石术在肾结石患者中的应用效果

Comparing on Effect of Flexible Ureteral Lithotripsy and Percutaneous Nephrolithotripsy in Patients with Kidney Stones

目的将经尿道输尿管软镜碎石术与经皮肾镜碎石术治疗肾结石的疗效进行对照分析。方法选取2018年1月—2021年12月南京中医药大学附属徐州市中医院泌尿外科收治的200例肾结石患者,按照随机数表法分为观察组(n=150)与对照组(n=50),观察组接受输尿管软镜碎石术治疗,对照组接受经皮肾镜碎石术治疗,比较两组一次碎石成功率、总结石清除率、手术时间、术中出血量、碎石时间、住院时间,以及术前、术后的Scr、BUN、CRP、WBC指标以及并发症发生率。结果观察组一次碎石成功率为88.00%,高于对照组的66.00%,差异有统计学意义(P<0.05);两组的总结石清除率比较,差异有统计学意义(P<0.05);观察组的手术时间、碎石时间、住院时间均短于对照组,术中失血量少于对照组,差异有统计学意义(P<0.05);术前,两组Scr、BUN指标对比,差异无统计学意义(P>0.05),术后,观察组Scr、BUN均低于对照组,差异有统计学意义(P<0.05);术前,两组CRP、WBC指标比较,差异无统计学意义(P>0.05),术后,观察组CRP、WBC均低于对照组,差异有统计学意义(P<0.05);观察组并发症发生率为0.67%,低于对照组的10.00%,差异有统计学意义(χ^(2)=8.247,P<0.05)。结论经尿道输尿管软镜碎石术治疗肾结石的效果更好,在治疗疾病,解除痛苦,改善患者肾功能的同时,能够大大减少手术并发症的发生,保证治疗的安全,促进患者尽早康复,适合临床普及应用。

Objective To compare the efficacy of transurethral flexible ureterolithotripsy and percutaneous nephrolithotripsy in the treatment of kidney stones.Methods From January 2018 to December 2021,200 patients with renal calculi admitted to urology department of Xuzhou Hospital of Traditional Chinese Medicine affiliated to Nanjing University of Traditional Chinese Medicine were selected and randomly divided into the observation group(n=150)and the control group(n=50).The observation group received ureteroscopic lithotripsy,and the control group received percutaneous nephrolithotripsy.The success rate of primary lithotripsy,summarized stone removal rate,operation time,intraoperative bleeding,lithotripsy time,and hospital stay,and the preoperative and postoperative Scr,BUN,CRP,WBC indicators and complication rate of the two groups were compared.Results The success rate of primary lithotripsy in the observation group was 88.00%higher than that 66.00%in the control group,the difference was statistically significant(P<0.05).There was statistically significant difference in the total stone clearance rate between the two groups(P<0.05);the operation time,lithotripsy time and hospitalization time of the observation group were shorter than those of the control group,and the intraoperative blood loss was less than that of the control group,the difference was statistically significant(P<0.05);before operation,there was no statistically significant difference in the indexes of Scr and BUN between the two groups(P>0.05).After operation,the Scr and BUN in the observation group were lower than those in the control group,and the difference was statistically significant(P<0.05);before operation,there was no statistically significant difference in CRP and WBC between the two groups(P>0.05).After operation,CRP and WBC in the observation group were lower than those in the control group,the difference was statistically significant(P<0.05);the incidence of complications in the observation group was 0.67%lower than 10.00%in the control group,the difference was statistically significant(χ^(2)=8.247,P<0.05).Conclusion Transurethral soft ureteroscope lithotripsy is better in the treatment of renal calculi.It can treat the disease,relieve the pain and improve the kidney function.It can greatly reduce the occurrence of surgical complications,ensure the safety of treatment,promote the early recovery of patients,suitable for clinical application.