基于超声引导下超微经皮肾镜碎石术在肾盂结石治疗中的临床效果分析  

Analysis on the clinical effect of ultrasound-guided smPCNL in the treatment of pyelolithiasis

作　　者：赵磊[1] 黄亮 陈旭东[1] 李颖[1] 张洑源 ZHAO Lei;HUANG Liang;CHEN Xu-dong(The Second Department of Urinary Surgery,Dandong Central Hospital,Dandong 118000,China;不详)

机构地区：[1]丹东市中心医院泌尿外二科,辽宁丹东118000 [2]解放军联勤保障部队第967医院泌尿外科,辽宁大连116000

出　　处：《中国医学装备》2021年第2期51-54,共4页China Medical Equipment

摘　　要：目的:探讨超声引导下超微经皮肾镜碎石术(smPCNL)在肾盂结石治疗中的临床应用价值。方法:选取120例肾盂结石患者,采用随机数表法将其分为对照组和观察组,每组60例。对照组采用经输尿管镜取石术(FURS)治疗,观察组采用smPCNL治疗,比较两组患者术前、术中及术后的临床指标。结果:两组患者肾结石单发比例、结石形状、感染和肾积水比例差异不显著,无统计学意义(x^(2)=0.159,x^(2)=0.310,x^(2)=0.34,x^(2)=0.288;P>0.05),且结石大小组间比较差异亦无统计学意义(t=0.273,P>0.05);观察组手术时间为(61.25±24.70)min,对照组为(78.49±27.05)min,组间比较差异有统计学意义(t=2.102,P<0.05);观察组结石清除率为93.33%,对照组为78.33%,观察组优于对照组,组间比较差异有统计学意义(x^(2)=5.551,P<0.05);观察组术后住院时间和自主活动时间为(3.74±1.31)d和(1.13±0.15)d,对照组为(5.29±1.86)d和(1.47±0.26)d,组间比较差异有统计学意义(t=2.929,t=2.674;P<0.05);观察组并发症患者占比为13.33%,对照组为21.67%,观察组优于对照组,组间比较差异有统计学意义(x^(2)=4.183;P<0.05)。结论:超声引导下smPCNL可有效提高手术质量,降低手术风险,提升手术效果,在肾盂结石手术治疗方面具有较高的临床应用价值。Objective:To discuss the clinical application value of ultrasound-guided super-mini percutaneous nephrolithotripsy(smPCNL)in the treatment of pyelolithiasis.Methods:A total of 120 patients with pyelolithiasis admitted to the hospital were selected and were divided into the control group and the observation group by using random number table,with 60 cases in each group.The control group underwent flexible ureteroscope(FURS),and the observation group underwent smPCNL.The preoperative,intraoperative and postoperative clinical indicators between the two groups were further compared.Results:There were no significant differences between the two groups in the incidence of single renal calculi,calculus shape,the proportion of infection and hydronephrosis(x^(2)=0.159,x^(2)=0.310,x^(2)=0.342,x^(2)=0.288,P>0.05).And the difference of calculus size between two groups was no significant(t=0.273,P>0.05).The duration of surgery and calculus clearance rate of observation group(61.25±24.70min,93.33%)were superior to those of control group(78.49±27.05 min,78.33%),and the differences of them between the two groups were statistically significant(t=2.102,x^(2)=5.551,P<0.05).The differences of length of hospitalization and the time of independent activity between observation group(3.74±1.31 d,1.13±0.15 d)and control group(5.29±1.86 d,1.47±0.26 d)were significant(t=2.929,t=2.674,P<0.05).And the proportion of patients with complications in observation group(13.33%)was significantly better than that in control group(21.67%)(x^(2)=4.183,P<0.05).Conclusions:Ultrasoundguided smPCNL can effectively improve the quality of surgery,and reduce the risk of surgery,and improve the effect of surgery,and it has higher clinical application value in the surgical treatment of pyelolithiasis.

关 键 词：肾盂结石 经皮肾镜碎石术(PCNL) 经输尿管镜取石术(FURS) 超声引导 手术治疗 

分 类 号：R445.1[医药卫生—影像医学与核医学]