mPCNL和RIRS治疗复杂性肾结石的效果研究  

EFFECT OF MPCNL AND RIRS IN TREATMENT OF COMPLEX RENAL CALCULI

作　　者：李小滨[1] LI Xiaobin(The First Peopled Hospital of Zigong City,Zigong 643000,China)

机构地区：[1]四川省自贡市第一人民医院,643000

出　　处：《中国煤炭工业医学杂志》2021年第6期606-610,共5页Chinese Journal of Coal Industry Medicine

基　　金：四川省卫生健康委员会科研课题(编号:17PJ035)。

摘　　要：目的探讨微通道经皮肾镜碎石取石术(mPCNL)和输尿管软镜取石术(RIRS)治疗复杂性肾结石的效果。方法选取2018年1月—2019年3月在该院治疗的复杂性肾结石患者110例,分为mPCNL组(n=62)和RIRS组(n=48),观察二组结石清除率、手术时间、并发症等,检测手术前后应激指标及肾功能。结果mPCNL组一期结石清除率、住院时间分别为85.48%和(8.72±0.91)d,明显多于RIRS组(P<0.05),而手术时间为(86.60±20.11)min,明显短于RIRS组(P<0.05);mPCNL组术后24h时皮质醇(Cor)、去甲肾上腺素(NE)和促肾上腺皮质激素(ACTH)分别为(162.11±19.28)g/L、(234.29±35.50)g/L和(30.01±5.00)ng/L,明显低于RIRS组(P<0.05),以上差异均有统计学意义;mPCNL组和RIRS组手术前后尿素氮(BUN)、血肌酐(Scr)和胱抑素C(CysC)比较差异无统计学意义(P>0.05);mPCNL组和RIRS组并发症发生率比较差异无统计学意义(P>0.05)。结论 mPCNL和RIRS治疗复杂性肾结石均有较好的效果。Objective To investigate the effect of microchannel percutaneous nephrolithotomy(mPCNL) and retrograde intrarenal surgery(RIRS) in the treatment of complex renal calculi.Methods One hundred and ten patients with complex renal calculi treated in our hospital from January 2018 to March 2019 were selected, they were divided into mPCNL group(n=62) and RIRS group(n=48),the stone clearance rate, operation time and complications and so on were observed, and stress index and renal function were measured before and after operation.Results The stone clearance rate and hospital stay in mPCNL group were 85.48% and(8.72±0.91) d, which were significantly higher than those in PCNL group(P<0.05),while the operation time was(86.60±20.11) min which was significantly shorter than that in RIRS group(P<0.05);The cortisol(Cor),norepinephrine(NE) and adrenocorticotropic Hormone(ACTH) in mPCNL group at 24 hours after operationwere(162.11±19.28),(234.29±35.50),(30.01±5.00) ng/L,which were lower than those in RIRS group(P<0.05),the above differences were statistically significant;There were no significant difference in blood urea nitrogen(BUN),serum creatinine(Scr) and cystatin C(CysC) between mPCNL group and RIRSgroup before and after operation(P>0.05);There was no significant difference in the incidence of complications between mPCNL group and RIRS group(P>0.05).Conclusion MPCNL and RIRS are effective in the treatment of complex renal calculi.

关 键 词：微通道经皮肾镜碎石取石术 输尿管软镜取石术 复杂性肾结石 

分 类 号：R586[医药卫生—内分泌]