两种碎石取石术治疗输尿管结石的疗效及对机体创伤程度的影响

The effect of two kinds of lithotripsy on ureteral calculi and its influence on the degree of trauma

目的探讨微通道经皮肾镜碎石取石(minimally percutaneous nephrolithotomy,MPCNL)术与经尿道输尿管镜碎石取石(ureteroscopic lithotomy,URL)术对输尿管上段结石治疗效果、机体创伤程度的影响差异。方法入选对象为2020年1月-2022年12月潜江市人民医院收治的60例输尿管上段结石患者,随机分为研究组与对照组,每组各30例。对照组应用URL术,研究组应用MPCNL术。比较两组的碎石总有效率、创伤因子水平、手术相关指标、术后并发症发生率。结果研究组的碎石总有效率(96.67%)高于对照组(80.00%),结石清除率(96.67%)高于对照组(80.00%)(P<0.05)。研究组术后的ESR水平高于对照组(P<0.05);研究组术后的sVCAM-1水平低于对照组(P<0.05)。研究组的手术时间长于对照组(P<0.05);研究组的术中出血量多于对照组(P<0.05);研究组的住院天数短于对照组(P<0.05)。研究组术后并发症发生率低于对照组(P<0.05)。结论MPCNL术较URL术治疗输尿管结石具有更高效的碎石成功率和结石清除率,安全有效。

Objective To investigate the difference in the effect of microchannel percutaneous nephrolithotomy(MPCNL)and transureteroscopic lithotomy(URL)on the curative effect and the degree of trauma in patients with ureteral calculi.Methods The selected subjects were 60 patients with ureteral calculi admitted to the hospital from January 2020 to December 2022,who were randomly divided into the study group and the control group,30 cases in each.The control group applied URL technique,and the study group applied MPCNL technique.The effective rate of lithotripsy,trauma factor levels,surgery-related fingers,and postoperative complication rates were compared between the two groups.Results The lithotripsy efficiency rate(96.67%)was higher in the study group than in the control group(80.00%),and the stone removal rate(96.67%)was higher than in the control group(80.00%)(P<0.05).The postoperative ESR level in the study group was higher than that in the control group(P<0.05);the postoperative sVCAM-1 level in the study group was lower than that in the control group(P<0.05).The operative time in the study group was longer than that in the control group(P<0.05);intraoperative bleeding in the study group was more than that in the control group(P<0.05);and the number of hospital days in the study group was shorter than that in the control group(P<O.05).The incidence of postoperative complications in the study group was lower than that in the control group(P<0.05).Conclusion MPCNL has higher lithotripsy success rate and stone clearance rate than URL in the treatment of ureteral calculi,is safe and effective,and has less impact on body trauma.