腔内泌尿外科微创技术治疗结石性脓肾的临床效果  

Clinical Effect of Minimally Invasive Technique in the Treatment of Calculous Purulent Kidneys in Intracavitary Urology

作　　者：张建龙 黄新化 余丰 钟德文 ZHANG Jianlong;HUANG Xinhua;YU Feng;ZHONG Dewen(Department of Urology,Longyan First Hospital Affiliated to Fujian Medical University,Longyan,Fujian Province,364000 China)

机构地区：[1]福建医科大学附属龙岩第一医院泌尿外科,福建龙岩364000

出　　处：《中外医疗》2021年第29期78-81,共4页China & Foreign Medical Treatment

基　　金：自然科学基金项目(2018J01410)。

摘　　要：目的探讨腔内泌尿外科微创技术在结石性脓肾临床治疗中的应用效果,根据患者的预后,对于腔内泌尿外科微创治疗的疗效、安全性做出评价。方法便利选取该院泌尿外科2018年1月—2020年9月期间收治的76例结石性脓肾患者作为研究对象,应用随机数字表法,分为观察组和对照组,各38例。观察组患者接受腔内泌尿外科微创技术,引流肾积液后,实施行经皮肾镜或经尿道输尿管镜碎石取石术。对照组患者接受传统泌尿外科肾切除术治疗,在腰腹部经第十一肋间作手术切口,完整切除患肾。经过手术治疗后,对比两组患者的治疗有效率、并发症(发热、出血、感染等)发生率、术中出血量、住院时间及血清C反应蛋白(CRP)、血沉(ESR)、降钙素原(PCT)炎症因子。结果观察组患者的治疗有效率(94.74%)高于对照组(76.32%),差异有统计学意义(χ^(2)=5.208,P<0.05),观察组患者的术中出血量(49.26±5.72)mL、术后并发症(2.63%)、CRP水平(36.09±5.14)mg/L、ESR水平(13.82±4.09)mm/h、PCT水平(4.12±1.54)ng/mL低于对照组的(113.82±12.94)mL、21.05%、(42.81±4.93)mg/L、(39.67±3.82)mm/h、(5.98±1.39)ng/mL,差异有统计学意义(P<0.05)。结论手术是治疗结石性脓肾的有效选择,在结石性脓肾患者的手术治疗中,应用腔内泌尿外科微创技术,能够安全、有效地治疗疾病,减轻手术的创伤性,保护残存的肾功能,帮助患者快速、良好的恢复,获得良好的预后,可广泛应用于临床。Objective To explore the application effect of endovascular minimally invasive technique in the clinical treatment of calculous purulent kidney,and to evaluate the efficacy and safety of minimally invasive endovascular treatment based on the patient's prognosis.Methods Conveniently selected 76 patients with calculous purulent kidney who were admitted to the department of urology in the hospital from January 2018 to September 2020 were selected as the research objects.They were divided into an observation group and a control group used the random number table method.38 cases in each group.Patients in the observation group underwent minimally invasive techniques in endovascular urology.After drainage of the renal effusion,they underwent percutaneous nephroscope or transurethral ureteroscopic lithotripsy.Patients in the control group received traditional urological nephrectomy,and a surgical incision was made in the waist and abdomen through the eleventh intercostal space to completely remove the kidney.After surgical treatment,the treatment effectiveness,the incidence of complications(fever,bleeding,infection,etc.),intraoperative blood loss,length of hospital stay and the,serum C-reactive protein(CRP)and erythrocyte sedimentation rate(ESR),procalcitonin(PCT)and other inflammatory factors were compared between the two groups of patients.Results The effective rate of treatment in the observation group(94.74%)was higher than that of the control group,and the difference was statistically significant(χ^(2)=5.208,P<0.05).The intraoperative blood loss of the observation group was(49.26±5.72)mL,postoperative complications 2.63%,CRP level(36.09±5.14)mg/L,ESR level(13.82±4.09)mm/h,PCT level(4.12±1.54)ng/mL was lower than the control group(113.82±12.94)mL,21.05%,(42.81±4.93)mg/L,(39.67±3.82)mm/h,(5.98,1.39)ng/mL,and the difference was statistically significant(P<0.05).Conclusion Surgery is an effective choice for the treatment of calculous purulent kidney.In the surgical treatment of patients with calculous purulent k

关 键 词：腔内泌尿外科 微创技术 结石性脓肾 

分 类 号：R5[医药卫生—内科学]