对比微创经皮肾镜和大通道经皮肾镜在肾结石中的清除效果及不良反应分析

Efficacy and Side Effects of Minimally Invasive Percutaneous Nephroscopy and Large Channel Percutaneous Nephroscopy in the Removal of Kidney Stones

目的研讨微创经皮肾镜和大通道经皮肾镜在肾结石中的清除效果及不良反应。方法选取2019年10月—2022年12月婺源县人民医院收治的80例肾结石患者为研究对象,依据随机数表法分为对照组和观察组,各40例。对照组行大通道经皮肾镜取石术(percutaneous nephrolithotomy,PCNL)治疗,观察组行微创PCNL手术治疗,比较两组手术基本指标、一期结石清除率、机体炎性反应以及并发症发生率。结果观察组术中出血量、下床活动及住院时间少于对照组,一期结石清除率高于对照组,差异有统计学意义(P<0.05)。术后,观察组C反应蛋白与降钙素原水平低于对照组,差异有统计学意义(P<0.05)。观察组并发症发生率(5.00%)低于对照组(20.00%),差异有统计学意义(χ^(2)=4.114,P=0.042)。结论微创PCNL手术用于肾结石的治疗能够减少术中出血,提高一期结石清除率,减轻机体炎性反应,减少不良反应发生,促进患者术后恢复,优于大通道PCNL。

Objective To study the efficacy and side effects of minimally invasive percutaneous nephroscopy and large channel percutaneous nephroscopy in the removal of kidney stones.Methods A total of 80 patients diagnosed with kidney stones in Wuyuan County People's Hospital from October 2019 to December 2022 were selected.According to the random number table method,they were divided into control group and observation group,with 40 cases in each group.The control group received large channel percutaneous nephrolithotomy(PCNL)treatment,and the observation group received minimally invasive PCNL surgery.The basic indexes,primary stone clearance,inflammatory response and incidence of complications were compared between the two groups.Results In addition to the operation time,the intraoperative blood loss,getting out of bed activity and hospitalization time in the observation group were less than those in the control group,and the first-stage stone clearance rate was higher than that in the control group,the differences were statistically significant(P<0.05).After operation,the levels of C-reactive protein and procalcitonin in the observation group were lower than those in the control group,the differences were statistically significant(P<0.05).The proportion of postoperative complications in the observation group(5.00%)was lower than that in the control group(20.00%),the difference was statistically significant(χ^(2)=4.114,P=0.042).Conclusion Minimally invasive PCNL surgery for the treatment of kidney stones can reduce intraoperative bleeding,increase the first-stage stone clearance rate,reduce the inflammatory response of the body,reduce the occurrence of adverse reactions,and promote postoperative recovery of patients,which is superior to large channel PCNL.