探讨微创经皮肾镜取石术治疗上尿路结石合并感染患者的临床疗效

The clinical efficacy of minimally invasive percutaneous nephrolithotomy in the treatment of upper urinary tract calculi complicated with infection

目的探讨微创经皮肾镜取石术治疗上尿路结石合并感染患者的临床疗效。方法选取2019年11月至2021年10月赤壁市蒲纺医院收治的118例上尿路结石合并感染患者作为研究对象,按照随机数字表法分为对照组与观察组,每组59例。对照组行传统输尿管切开取石术,观察组行微创经皮肾镜取石术,比较两组临床疗效、手术相关指标、疼痛程度、术后并发症发生率、血清炎症应激指标。结果观察组治疗总有效率为94.92%,高于对照组的83.05%,差异有统计学意义(P<0.05);观察组手术时间、住院时间均短于对照组,术中出血量少于对照组,差异有统计学意义(P<0.05);术后1、3、7 d,观察组视觉模拟评分法(VAS)评分均低于对照组,差异有统计学意义(P<0.05);观察组术后并发症发生率低于对照组,差异有统计学意义(P<0.05);术后3 d,两组白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)、内皮素(ET-1)、C反应蛋白(CRP)、WBC水平均高于治疗前,但观察组低于对照组,差异有统计学意义(P<0.05)。结论微创经皮肾镜取石术治疗上尿路结石合并感染效果显著,可减小患者损伤,减轻疼痛感,降低并发症发生率,且对炎症应激指标水平影响较小,值得临床推广应用。

Objective To investigate the clinical efficacy of minimally invasive percutaneous nephrolithotomy in the treatment of upper urinary tract calculi complicated with infection.Methods A total of 118 patients with upper urinary tract calculi complicated with infection admitted to Pufang Hospital of Chibi City from November 2019 to October 2021 were selected as the research subjects,they were divided into the control group and the observation group according to the random number table method,with 59 cases in each group.The control group underwent traditional ureterolithotomy,and the observation group underwent minimally invasive percutaneous nephrolithotomy.The clinical efficacy,surgery-related indicators,pain degree,postoperative complication rate,and serum inflammatory stress indicators were compared between the two groups.Results The total effective rate of treatment in the observation group was 94.92%,which was higher than 83.05%in the control group,and the difference was statistically significant(P<0.05).The operation time and hospitalization time in the observation group were shorter than those in the control group,and the intraoperative blood loss was less than that in the control group,the differences were statistically significant(P<0.05).On the 1,3 and 7 d after operation,the visual analogue scale(VAS)scores in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).The incidence of postoperative complications in the observation group was lower than that in the control group,the difference was statistically significant(P<0.05).3 d after operation,the levels of interleukin-6(IL-6),interleukin-8(IL-8),tumor necrosis factor-α(TNF-α),endothelin-1(ET-1),C-reactive protein(CRP)and WBC of the two groups were higher than those before treatment,but the observation group was lower than the control group,the differences were statistically significant(P<0.05).Conclusion Minimally invasive percutaneous nephrolithotomy is effective in the treatment of upper urinary tract calculi with infection,it can reduce the damage of patients,relieve pain,reduce the incidence of complications,and has little effect on the level of inflammatory stress index,which is worthy of clinical promotion and application.