无管化微创经皮肾镜取石术治疗嵌顿性输尿管上段结石疗效分析  

Analysis of the clinical efficacy of tubeless mini-percutaneous nephrolithotomy in the treatment of impacted upper ureteral calculi

作　　者：张新军[1] 赵志刚[1] 王涛 Zhang Xinjun;Zhao Zhigang;Wang Tao(Anyang Second People's Hospital,Anyang 455000,Henan,China)

机构地区：[1]安阳市第二人民医院,河南安阳455000

出　　处：《临床心身疾病杂志》2022年第1期142-145,共4页Journal of Clinical Psychosomatic Diseases

基　　金：安阳市科技攻关计划项目(编号20170023155)。

摘　　要：目的探讨无管化微创经皮肾镜取石术治疗嵌顿性输尿管上段结石的临床疗效。方法将62例嵌顿性输尿管上段结石患者根据手术方式不同分为研究组32例及对照组30例。研究组行无管化微创经皮肾镜取石术,对照组行后腹腔镜下输尿管取石术,术后观察3d。比较两组手术时间、术中出血量、结石清除率、术后血尿时间、住院时间;比较两组术后视觉模拟评分及镇痛泵使用时间;比较两组手术并发症发生情况;术前及术后3d比较两组丙二醛及晚期氧化蛋白产物水平。结果两组结石清除率比较差异无统计学意义(P>0.05);研究组手术时间、住院时间显著短于对照组(P<0.01),术中出血量显著少于对照组(P<0.01),术后血尿时间显著长于对照组(P<0.01),视觉模拟评分显著低于对照组(P<0.01),术后镇痛泵使用时间显著短于对照组(P<0.01);两组发热及尿漏发生率比较差异无统计学意义(P>0.05);术后3d两组丙二醛及晚期氧化蛋白产物水平均较术前显著上升(P<0.01),研究组显著低于对照组(P<0.01)。结论无管化微创经皮肾镜取石术治疗嵌顿性输尿管上段结石疗效显著,患者术后疼痛感较轻,机体应激反应较小,住院时间短,并发症发生率低。Objective To investigate the clinical efficacy of tubeless mini-percutaneous nephrolithotomy(TMPCNL) in the treatment of impacted upper ureteral calculi.Methods A total of 62 patients with impacted upper ureteral calculi were divided into study group(32 cases) and control group(30 cases) according to different surgical methods.The study group underwent TMPCNL,and the control group underwent retroperitoneoscopic ureterolithotomy(RPUL).Postoperative observation lasted for 3 days.The operation time,intraoperative bleeding,stone clearance rate,postoperative hematuria time and hospital stay were compared between the two groups.The postoperative visual analogue scale(VAS) and the use time of analgesic pump were compared between the two groups,and the incidence of surgical complications were compared between the two groups.The levels of malondialdehyde(MDA) and advanced oxidation protein product(AOPP) were compared between the two groups before operation and 3 days after operation.Results There was no significant difference in the stone clearance rate between the two groups(P>0.05).The operative time and hospital stay of the study group were significantly shorter than that of the control group(P<0.01),and the intraoperative bleeding was significantly less than that of the control group(P<0.01).The postoperative hematuria time was significantly longer than that of the control group(P<0.01),the VAS score was significantly lower than that of the control group(P<0.01),and the use time of postoperative analgesic pump was significantly shorter than that of the control group(P<0.01).There was no significant difference in the incidence of fever and urinary leakage between the two groups(P>0.05).Three days after operation,the levels of MDA and AOPP of the two groups were significantly higher than those before operation(P<0.01),and the levels in the study group were significantly lower than those in the control group(P<0.01).Conclusions TMPCNL has a significant efficacy on the treatment of impacted upper ureteral calculi.The pati

关 键 词：嵌顿性输尿管上段结石 无管化微创经皮肾镜取石术 后腹腔镜下输尿管取石术 临床疗效 

分 类 号：R691.4[医药卫生—泌尿科学]