微通道经皮肾镜取石术联合输尿管软镜钬激光碎石术对上尿路结石患者的影响

Effect of Microchannel Percutaneous Nephrolithotomy Combined with Ureteroscopic Holmium Laser Lithotripsy on Upper Urinary Tract Calculi

目的:探讨上尿路结石(UUTC)患者采用微通道经皮肾镜取石术(mPCNL)联合输尿管软镜钬激光碎石术(FURL)治疗的效果。方法:选取2020年3月—2022年12月浠水县人民医院收治的UUTC患者156例,采用随机数表法将其分为研究组(n=78)和对照组(n=78)。对照组给予FURL治疗,研究组给予mPCNL联合FURL治疗,比较两组一次性结石清除率、围手术期指标、疼痛程度、炎症指标、并发症发生率。结果:研究组一次性结石清除率为100%,高于对照组的93.59%,差异有统计学意义(P<0.05)。研究组手术时间长于对照组,住院时间短于对照组,术中出血量少于对照组,术后Hb下降值低于对照组,差异有统计学意义(P<0.05)。术后1 d,两组视觉模拟评分法(VAS)评分均较术前降低,且研究组低于对照组,差异有统计学意义(P<0.05)。术后1 d,两组C反应蛋白(CRP)、白细胞介素-6(IL-6)、降钙素原(PCT)水平均较术前降低,且研究组低于对照组,差异有统计学意义(P<0.05)。研究组并发症发生率为6.41%,低于对照组的21.79%,差异有统计学意义(P<0.05)。结论:给予UUTC患者mPCNL联合FURL治疗能够提高一次性结石清除率,改善围手术期指标,降低疼痛程度、炎症指标水平,降低并发症发生率。

Objective:To investigate the effect of microchannel percutaneous nephrolithotomy(mPCNL)combined with ureteroscopic holmium laser lithotripsy(FURL)in the treatment of upper urinary tract calculi(UUTC).Method:A total of 156 UUTC patients treated in Xishui County People's Hospital from March 2020 to December 2022 were selected,and they were divided into study group(n=78)and control group(n=78)by random number table method.The control group was given FURL treatment,and the study group was given mPCNL combined FURL treatment.The one-time stone clearance rate,perioperative indexes,pain degree,inflammatory indexes and complication rate were compared between the two groups.Result:The one-time stone clearance rate of the study group was 100%,higher than 93.59%of the control group,the difference was statistically significant(P<0.05).The operation time of the study group was longer than that of the control group,the hospitalization time was shorter than that of the control group,,the intraoperative blood loss was less than that of the control group,and the postoperative Hb decline value was lower than that of the control group,the differences were statistically significant(P<0.05).At 1 d after operation,visual analogue scale(VAS)scores of both groups were lower than those before operation,and the score of the study group was lower than that of the control group,the differences were statistically significant(P<0.05).At 1 d after operation,the levels of C-reactive protein(CRP),interleukin-6(IL-6)and procalcitonin(PCT)in both groups were lower than before operation,and the levels of the study group were lower than those of the control group,the differences were statistically significant(P<0.05).The complication rate in the study group was 6.41%,which was lower than 21.79%in the control group,the difference was statistically significant(P<0.05).Conclusion:In UUTC patients,mPCNL combined with FURL treatment can increase the one-time stone clearance rate,improve perioperative indexes,reduce the level of pain and inflammation indexes,and reduce the incidence of complications.