输尿管软镜碎石术和微创经皮肾取石术治疗肾盂肾盏结石的效果

Effect of Ureteral Flexible Lithotripsy and Minimally Invasive Percutaneous Nephrolithotomy for Pelvic Calyx Stones

目的 对比输尿管软镜碎石术与微创经皮肾取石术治疗肾盂肾盏结石的临床疗效。方法 简单随机选择2019年1—12月期间未宾市人民医院收治的100例肾盂肾盏结石患者为研究对象,参照计算机分组方式分为两组,每组50例。对照组治疗法为输尿管软镜碎石术,研究组治疗法为微创经皮肾取石术,对比两组治疗效果。结果 研究组手术时间(48.5±7.3)min、疼痛评分(2.8±0.4)分、住院时间(4.6±1.1)d均较对照组低,差异有统计学意义(t=22.310、15.006、9.603,P<0.05)。对照组术中出血量(12.5±2.9)mL与研究组(14.1±3.7)mL比较,差异无统计学意义(t=2.407,P>0.05)。研究组结石清除率为92.0%、输尿管穿孔率为4.0%、术后出血率为4.0%、发热率为2.0%与对照组比较,差异无统计学意义(χ^(2)=0.444、0.000、0.000、0.000,P>0.05)。研究组社会功能(81.8±6.9)分、情绪功能(81.6±6.6)分、角色功能(82.7±7.3)分、躯体功能(83.0±7.8)分均高于对照组,差异有统计学意义(t=6.989、10.162、9.793、7.512,P<0.05)。研究组术前Scr(73.5±5.8)μmol/L、BUN(5.1±0.7)mmol/L以及术后Scr(78.9±5.9)μmol/L、BUN(6.1±1.3)mmol/L与对照组比较,差异无统计学意义(t=0.177、1.240、0.261、1.725,P>0.05)。结论 输尿管软镜碎石术与微创经皮肾取石术治疗肾盂肾盏结石的效果均较为理想,各有优势与不足,在实际治疗时可根据患者实际情况选择最佳治疗方案。

Objective To compare the clinical efficacy of ureteral soft lithotripsy with minimally invasive percutaneous nephrolithotomy for the treatment of renal pelvic calyx stones.Methods A total of 100 patients with renal pelvis and calyces calculi admitted to Laibin People's Hospital from January to December 2019 were selected simply and randomly as research objects and divided into two groups with 50 cases in each group according to computer grouping method.The control group was treated with flexible ureteroscope lithotripsy,while the study group was treated with minimally invasive percutaneous nephrolithotomy.The therapeutic effect was compared between the two groups.Results Operation time(48.5±7.3)min,pain score(2.8±0.4)points and hospital stay(4.6±1.1)d in the study group were lower than those in the control group,and the difference was statistically significant(t=22.310,15.006,9.603,P<0.05).There was no statistically significant difference in intraoperative blood loss between the control group(12.5±2.9)mL and the study group(14.1±3.7)mL(t=2.407,P>0.05).Stone clearance rate was 92.0%,ureteral perforation rate was 4.0%,postoperative hemorrhage rate was 4.0%,heating at a rate was 2.0%in the study group compared with control group,and the difference was not statistically significant(χ^(2)=0.444,0.000,0.000,0.000,P>0.05).Social function(81.8±6.9)scores,emotional function(81.6±6.6)scores,role function(82.7±7.3)scores and physical function(83.0±7.8)scores in the study group were higher than those in the control group,and the difference was statistically significant(t=6.989,10.162,9.793,7.512,P<0.05).Preoperative Scr(73.5±5.8)μmol/L,BUN(5.1±0.7)mmol/L,postoperative Scr(78.9±5.9)μmol/L,BUN(6.1±1.3)mmol/L in the study group,compared with the control group,the difference was not statistically significant(t=0.177,1.240,0.261,1.725,P>0.05).Conclusion Both ureteroscopic lithotripsy and minimally invasive percutaneous nephrolithotomy have ideal effects in the treatment of renal pelvis calyces calculi,and each has its own advantages and disadvantages.In the actual treatment,the best treatment plan can be selected according to the actual situation of patients.