经皮肾镜应用第四代EMS超声联合气压弹道碎石清石系统治疗肾结石210例疗效观察

Clinical observation on application of the fourth generation EMS ultrasonic combined pneumatic ballistic lithotripsy clearing stone system based on percutaneous nephroscope to treat 210 cases of kidney stones

目的:探究经皮肾镜下应用第四代EMS超声联合气压弹道碎石清石系统治疗肾结石患者的效果。方法:从2012年10月~2014年8月收治的肾结石患者中选取420例行经皮肾镜手术,均分为观察组和对照组。对照组采用传统的微创经皮肾镜穿刺气压弹道取石术治疗,观察组给以经皮肾镜应用第四代EMS超声联合气压弹道碎石清石系统治疗。比较术后两组患者的生存质量(生活满意度、健康指数、情感得分、一般感情指数)以及不良反应(严重术后出血、局部组织损伤、肾功能损伤),并评价疗效。结果:观察组Ⅰ期结石清除率为94.29%(198/210),对照组为84.76%(178/210),差异有统计学意义(t=10.15,P<0.05);术后两组患者生活满意度、健康指数、情感得分、一般感情指数比较差异有统计学意义(P<0.05),观察组与对照组术后分别与术前比较亦差异有统计学意义(P<0.05);观察组术后局部组织损伤发生率为1.90%(4/210),对照组为6.67%(14/210),差异有统计学意义(x^2=5.80,P<0.05),严重术后出血、肾功能损伤两组比较差异无统计学意义(P>0.05)。结论:经皮肾镜应用第四代EMS超声联合气压弹道碎石清石系统治疗肾结石患者临床疗效显著,安全性高,术后不良反应发生率低,适合在临床上推广。

Objective:To explore the clinical curative effect of the fourth generation of EMS ultrasonic combined pneumatic ballistic lithotripsy clearing stone system based on percutaneous nephroscope to treat kidney stones.Methods:From Oct.2012 to Aug.2014,420 eases of renal calculi were selected,subjected to percutaneous nephrolithotomy and equally divided into two groups:observation group and control group.The control group was given traditional minimally invasive percutaneous nephrolithotomy with air pressure ballistic lithotomy,and the observation group was treated with the fourth generation of EMS ultrasonic combined pneumatic ballistic lithotripsy clearing stone system.The postoperative quality of life,adverse reactions and the curative effect were compared between two groups.Results;Stone clearance rate in the observation group at stage I was 94.29%(198/210),and that in the control group was 84.76%(178/210)(t = 10.15,P<0.05).There were significant difference in life satisfaction,healthy index,emotional score,the sentiment index between two groups after operation(P<0.05).There was significant difference in both two groups before and after operation(P<0.05).The incidence of postoperative local tissue injury in the observation group was 1.90%(4/210) and 6.67%(14/210) in the control group(x^2 = 5.80,P<5.80).There was no statistically significant difference(P>0.05) in postoperative bleeding and renal damage between the two groups.Conclusions:The fourth generation of EMS ultrasonic combined pneumatic ballistic lithotripsy clearing stone system based on percutaneous nephroscope is effective and safe in the treatment of renal stones,the incidence of postoperative adverse reaction was low,and it is worth popularizing in clinic.