逆行输尿管软镜联合可视穿刺经皮肾镜治疗复杂性肾结石的疗效分析  

Clinical effects on complex renal calculi with retrograde ureteroscopy combined with visual puncture and percutaneous nephroscope

作　　者：席勇[1] 吴云剑[1] 聂明[1] 尹勇[1] XI Yong;WU Yun-jian;NIE Ming;YIN Yong(Department of Urology,the First People s Hospital of Chengdu City,Chengdu 610000,China)

机构地区：[1]成都市第一人民医院泌尿外科,四川成都610000

出　　处：《东南大学学报（医学版）》2018年第2期263-267,共5页Journal of Southeast University(Medical Science Edition)

基　　金：四川省卫生和计划生育委员会科研课题(150026)

摘　　要：目的:探讨逆行输尿管软镜联合可视穿刺经皮肾镜治疗复杂性肾结石的临床疗效。方法:选择2015年4月至2016年4月我院收治的80例复杂性肾结石患者,按治疗方法不同分为实验组和对照组,实验组采用逆行输尿管软镜联合可视穿刺经皮肾镜治疗,对照组单纯接受可视穿刺经皮肾镜治疗,各40例。比较两组患者手术时间、手术出血量、手术前后血红蛋白及血肌酐水平、中性粒细胞明胶酶相关载脂蛋白(NGAL)及人肾损伤分子1(KIM-1)浓度,结石清除率及残留率,以及并发症情况。结果:两组患者手术时间、手术出血量差异无统计学意义(P>0.05)。两组患者治疗后血红蛋白浓度均有下降,对照组患者下降幅度大于实验组,差异有统计学意义(P<0.05)。两组患者治疗前后血肌酐浓度改变差异无统计学意义(P>0.05)。两组患者治疗后NGAL及KIM-1浓度均有升高,但实验组患者治疗后NGAL及KIM-1浓度升高幅度小于对照组,差异有统计学意义(P<0.05)。实验组结石清除率高于对照组,结石残留率低于对照组,并发症发生率低于对照组,差异均有统计学意义(均P<0.05)。结论:逆行输尿管软镜联合可视穿刺经皮肾镜治疗复杂性肾结石清除彻底,减少了肾脏损害及并发症发生率,有效性和安全性具有保障。Objective:To explore the clinical efficacy of retrograde ureteroscopy combined with visual puncture and percutaneous nephroscope in the treatment of complex renal calculi.Methods:80 cases of complicated renal calculi patients admitted in our hospital from April 2015 to April 2016 were divided into experimental group and control group according to different treatment methods.The experimental group was treated with retrograde ureteroscopy combined with visual puncture and percutaneous nephroscope.The control group received only visual puncture and percutaneous nephroscope.The operation time and blood loss amount,the changes of hemoglobin and serum creatinine levels,the changes of NGAL and KIM-1 levels,calculi clearance rate and residual rate,and complication were compared between the two groups.Results:There was no significant difference in operation time and blood loss amount between the two groups(P>0.05).The hemoglobin concentration of the two groups decreased after treatment,and the descending rate of the control group was higher than that of the experimental group,the difference was statistically significant(P<0.05).There was no significant difference in serum creatinine concentration between the two groups before and after treatment(P>0.05).The levels of NGAL and KIM-1 increased after treatment,but the ascending rate in the experimental group was less than that in the control group(P<0.05).Compared with the control group,the calculi clearance rate was higher and the residual rate was lower and the incidence of complications was lower in the experimental group,and the differences were statistically significant(P<0.05).Conclusion:Retrograde ureteroscopy combined with visual puncture and percutaneous nephroscope for the treatment of complex renal calculi can be completely cleared away,reduce the incidence of renal damage and complications,effectiveness and safety are guaranteed.

关 键 词：肾结石 经皮肾镜 输尿管软镜 临床疗效 

分 类 号：R692.4[医药卫生—泌尿科学]