微通道经皮肾镜联合输尿管软镜钬激光碎石术与双通道经皮肾镜取石术在复杂肾结石患者中的应用效果

Effectiveness of Microchannel Percutaneous Nephrolithotomy Combined with Ureteral Flexible Scope Holmium Laser Lithotripsy and Dual-channel Percutaneous Nephrolithotomy in Patients with Complex Renal Stones

目的:探讨微通道经皮肾镜联合输尿管软镜钬激光碎石术与双通道经皮肾镜取石术在复杂肾结石患者中的应用效果。方法:选取2019年6月—2023年6月西安唐城医院收治的复杂肾结石患者60例作为研究对象,随机分为对照组和研究组,各30例。对照组行双通道经皮肾镜取石术治疗,研究组行微通道经皮肾镜联合输尿管软镜钬激光碎石术治疗。比较两组应用效果。结果:研究组手术时间、首次下床时间及住院时间短于对照组,术中出血量少于对照组,差异有统计学意义(P<0.001);研究组结石一次性清除率及术后1个月清除率均高于对照组,差异有统计学意义(P<0.05);术后1 d,两组C反应蛋白、白细胞介素-6、肿瘤坏死因子-α、白细胞计数、尿肾损伤分子-1、尿素氮及血肌酐水平均高于术前,差异有统计学意义(P<0.05)。结论:在复杂肾结石治疗中应用微通道经皮肾镜联合输尿管软镜钬激光碎石术可有效提高结石清除率,且不会增加炎性刺激及对肾功能的损伤。

Objective:To investigate the application effect of microchannel percutaneous nephrolithotomy combined with ureteral flexible scope holmium laser lithotripsy versus dual-channel percutaneous nephrolithotomy lithotripsy in patients with complex renal stones.Methods:Sixty patients with complex renal stones admitted to Xi'an Tangcheng Hospital from June 2019 to June 2023 were selected as the study subjects and randomly divided into the control group and the study group,each with thirty cases.The control group was treated with double-channel percutaneous nephrolithotomy,and the study group was treated with microchannel percutaneous nephrolithotomy combined with ureteral flexible scope holmium laser lithotripsy.The application effects of the two groups were compared.Results:The operation time,first time out of bed and hospitalization time of the study group were shorter than that of the control group,and intraoperative bleeding was less than that of the control group,with statistically significant differences(P<0.001);the one-time stone removal rate and 1-month postoperative removal rate of the study group were higher than that of the control group,with statistically significant differences(P<0.05);at 1 d postoperatively,the levels of C-reactive protein,interleukin-6,tumor necrosis factor-α,leukocyte count,urinary kidney injury molecule-1,urea nitrogen and blood creatinine were higher than those of preoperative period in both groups,and the difference was statistically significant(P<0.05).Conclusion:The application of microchannel percutaneous nephrolithotomy combined with ureteral flexible scope holmium laser lithotripsy in the treatment of complex renal stones can effectively improve the stone removal rate without increasing inflammatory irritation and damage to renal function.