微通道经皮肾镜碎石术与逆行输尿管软镜治疗复杂性肾结石的临床对比与安全性评价  

Clinical Comparison and Safety Evaluation of Microchannel Percutaneous Nephrolithotomy and Retrograde Flexible Ureteroscope in the Treatment of Complex Renal Calculi

作　　者：罗文龙 黄华 LUO Wenlong;HUANG Hua(Dahuan Hospital of Jianli City,Jianli 433300,China;不详)

机构地区：[1]监利市大垸医院,湖北监利433300

出　　处：《中外医学研究》2021年第18期140-143,共4页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:研究逆行输尿管软镜与微通道经皮肾镜碎石术治疗复杂性肾结石的临床对比与安全性评价。方法:选取笔者所在医院2018年9月-2020年9月收治的94例复杂性肾结石患者,将其依据双盲随机法分为对照组(47例)与观察组(47例)。对照组实施微通道经皮肾镜碎石术治疗,观察组实施逆行输尿管软镜碎石术治疗,比较两组手术指标、结石清除率、不同时间点血清NGAL水平、并发症发生情况。结果:与对照组相比,观察组手术时间更长,住院时间更短(P<0.05)。与观察组相比,对照组一期结石清除率更高(P<0.05);两组结石总清除率比较差异无统计学意义(P>0.05)。两组术前血清NGAL水平比较差异无统计学意义(P>0.05);术后2、12、48 h观察组血清NGAL水平均低于对照组,差异有统计学意义(P<0.05)。观察组并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论:逆行输尿管软镜与微通道经皮肾镜碎石术均能获得满意的碎石效果,但逆行输尿管软镜在住院时间与手术安全性方面优势更加明显。Objective:To study the clinical comparison and safety evaluation of retrograde flexible ureteroscope and microchannel percutaneous nephrolithotomy in the treatment of complex renal calculi.Method:A total of 94 patients with complex renal calculi admitted in our hospital from September 2018 to September 2020 were selected and divided into the control group (47 cases) and the observation group (47 cases)according to double-blind random method.The control group was treated with microchannel percutaneous nephrolithotripsy,and the observation group was treated with retrograde flexible ureteroscope.The surgical indexes,stone clearance rate,serum NGAL level at different time points and the incidence of complications were compared between the two groups.Result:Compared with the control group,the operation time of the observation group was longer and the hospital stay was shorter (P<0.05).Compared with the observation group,the first-stage stone clearance rate of the control group was higher (P<0.05).There was no significant difference in the total stone clearance rate between the two groups (P>0.05).There was no significant difference in serum NGAL level between the two groups before operation (P>0.05).The serum NGAL level in the observation group was lower than that in the control group at 2,12,48 h after operation,and the difference was statistically significant (P<0.05).The incidence of complications in the observation group was lower than that in the control group,the difference was statistically significant (P<0.05).Conclusion:Both retrograde flexible ureteroscopy and microchannel percutaneous nephrolithotripsy can achieve satisfactory lithotripsy effect,but retrograde flexible ureteroscopy has more obvious advantages in hospital stay and operation safety.

关 键 词：复杂性肾结石 逆行输尿管软镜 安全性 微通道经皮肾镜碎石术 

分 类 号：R699.2[医药卫生—泌尿科学]