经皮肾镜取石术与输尿管软镜碎石术治疗直径≤2 cm肾结石的效果

Effect of Percutaneous Nephrolithotomy and Flexible Ureteroscope Lithotripsy in the Treatment of Kidney Stones with the Diameter of≤2 cm

目的:探讨经皮肾镜取石术与输尿管软镜碎石术治疗直径≤2 cm肾结石的效果。方法:选取2018年1月—2022年2月盱眙县人民医院收治的62例直径≤2 cm肾结石患者。根据抽签法将其分为对照组与观察组,各31例。对照组给予经皮肾镜取石术,观察组给予输尿管软镜碎石术。比较两组术后1周、1个月的结石清除率,围手术期指标,术前、术后2 d肾功能及应激指标、炎症因子及并发症。结果:术后1周、1个月,两组结石清除率比较,差异无统计学意义(P>0.05)。观察组手术时间长于对照组,术中出血量、住院费用均少于对照组,住院时间短于对照组,差异有统计学意义(P<0.05)。术后2 d,两组血肌酐(Scr)、血尿素氮(BUN)、肾上腺素(AD)、去甲肾上腺素(NE)、皮质醇(Cor)、C反应蛋白(CRP)、白细胞介素-6(IL-6)、白细胞介素-10(IL-10)、降钙素原(PCT)、白细胞计数(WBC)水平均升高,观察组Scr、BUN、AD、NE、Cor、CRP、IL-6、IL-10、PCT、WBC水平均低于对照组,差异有统计学意义(P<0.05)。观察组并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论:相较于经皮肾镜取石术,输尿管软镜碎石术能改善肾功能,减轻炎症反应及应激反应,且术后并发症少。

Objective:To explore the effect of percutaneous nephrolithotomy and flexible ureteroscope lithotripsy in the treatment of kidney stones with the diameter of≤2 cm.Method:A total of 62 patients with kidney stones with a diameter of≤2 cm admitted to Xuyi County People's Hospital from January 2018 to February 2022 were selected.They were divided into control group and observation group according to the lottery method,with 31 cases in each group.The control group was given percutaneous nephrolithotomy,and the observation group was given flexible ureteroscope lithotripsy.The stone clearance rate 1 week and 1 month after surgery,perioperative indexes,renal function and stress indexes,inflammatory factors before and 2 d after surgery and complications were compared between the two groups.Result:At 1 week and 1 month after surgery,there was no significant difference in stone clearance rate between the two groups(P>0.05).The surgical time of the observation group was longer than that of the control group,the intraoperative blood loss volume and hospitalization cost were less than those of the control group,and the hospitalization time was shorter than that of the control group,the differences were statistically significant(P<0.05).At 2 d after surgery,serum creatinine(Scr),blood urea nitrogen(BUN),adrenaline(AD),norepinephrine(NE),cortisol(Cor),C-reactive protein(CRP),interleukin-6(IL-6),interleukin-10(IL-10),procalcitonin(PCT)and white blood cell count(WBC)levels were all increased in both groups,the levels of Scr,BUN,AD,NE,Cor,CRP,IL-6,IL-10,PCT and WBC in observation group were lower than those in control group,and the differences were statistically significant(P<0.05).The incidence of complications in the observation group was lower than that in the control group,the difference was statistically significant(P<0.05).Conclusion:Compared to percutaneous nephrolithotomy,flexible ureteroscope lithotripsy can improve renal function,reduce inflammatory and stress reactions,and have fewer postoperative complications.