三种不同微创碎石方式治疗肾结石的疗效及安全性研究  

Clinical efficacy and safety of three different minimally invasive lithotripsy methods in the treatment of renal calculi

作　　者：李国 黄英 谢建湖 甘露[1] 黄桂晓[1] LI Guo;HUANG Ying;XIE Jian-hu;GAN Lu;HUANG Gui-xiao(Department of Urinary Surgery,Shenzhen Luohu District People's Hospital,Shenzhen 518001,Guangdong,CHINA)

机构地区：[1]深圳市罗湖区人民医院泌尿外科,广东深圳518001

出　　处：《海南医学》2022年第14期1821-1824,共4页Hainan Medical Journal

摘　　要：目的比较钬激光碎石、弹道碎石和超声联合弹道碎石三种方式治疗肾结石的疗效及安全性。方法选择2018年2月至2021年2月在深圳市罗湖区人民医院泌尿外科院接受治疗的90例肾结石患者进行研究,按照随机数表法分为对照组、研究组和联合组各30例,分别采用弹道碎石术、钬激光碎石术和超声联合弹道碎石术治疗。比较三组患者碎石时间、手术时间、术中出血量、住院时间以及肾造瘘管留置时间,比较三组患者术前及术后的肾盂集合系统分离指数、肌酐、尿素氮指标以及术后并发症发生情况。结果联合组患者的碎石时间、手术时间分别为(70.02±8.72)min、(105.02±12.19)min,明显短于研究组的(99.87±12.76)min、(139.61±17.62)min和对照组的(81.23±10.85)min、(120.83±15.97)min,研究组患者的碎石时间、手术时间明显短于对照组,差异均具有统计学意义(P<0.05);联合组患者的肾盂集合系统分离指数、肌酐、尿素氮分别为(33.60±8.02)mm、(7.36±0.85)mmol/L、(187.72±36.01)mmol/L,明显低于研究组的(36.28±9.12)mm、(8.05±0.90)mmol/L、(195.37±39.79)mmol/L和对照组的(39.76±10.57)mm、(8.92±1.03)mmol/L、(192.39±38.63)mmol/L,研究组患者的肾盂集合系统分离指数、肌酐、尿素氮明显低于对照组,差异均具有统计学意义(P<0.05);三组患者的并发症发生率比较差异无统计学意义(P>0.05)。结论三种微创碎石术在治疗肾结石均具有一定的治疗效果,但超声联合弹道碎石可有效缩短手术时间,促进术后恢复,且不增加术后并发症。Objective To study the clinical efficacy and safety of three different minimally invasive lithotripsy methods in the treatment of renal calculi.Methods Ninety patients with renal calculus who received treatment in Department of Urology,Shenzhen Luohu District People's Hospital from February 2018 to February 2021 were selected for this study.They were divided into control group,study group,and combined group by random lottery,with 30 patients in each group,which were treated with ballistic lithotripsy,holmium laser lithotripsy,and ultrasound combined ballistic lithotripsy,respectively.The lithotripsy time,operation time,intraoperative bleeding,length of hospital stay,and retention time of nephrostomy were compared.The separation index of renal pelvis collection system,creatinine,urea nitrogen,and postoperative complications were compared before and after operation.Results After treatment,lithotripsy time and operation time of the combined group were(70.02±8.72)min and(105.02±12.19)min,significantly lower than(99.87±12.76)min and(139.61±17.62)min of the study group and(81.23±10.85)min and(120.83±15.97)min of the control group;the lithotripsy time and operation time in the study group were significantly shorter than those in the control group;the differences were statistically significant(P<0.05).Separation index of collecting system of renal pelvis,creatinine,and urea nitrogen in the combined group were(33.60±8.02)mm,(7.36±0.85)mmol/L,(187.72±36.01)mmol/L,respectively,which were significantly lower than(36.28±9.12)mm,(8.05±0.90)mmol/L,(195.37±39.79)mmol/L in the study group and(39.76±10.57)mm,(8.92±1.03)mmol/L,(192.39±38.63)mmol/L in the control group;the levels in the study group were significantly lower than those in the control group;the differences were statistically significant(P<0.05).There was no significant difference in the incidence of complications among the three groups(P>0.05).Conclusion Three kinds of minimally invasive lithotripsy have certain therapeutic effects in the treatment of re

关 键 词：钬激光碎石 弹道碎石 超声联合弹道碎 肾结石 疗效 

分 类 号：R692.4[医药卫生—泌尿科学]