腹腔镜肾盂切开联合腔内碎石术治疗复杂性孤立肾结石的临床效果  

Clinical effect of Laparoscopic Pyelotomy Combined with Intracavitary Lithotripsy in the Treatment of Complex Solitary Kidney Stones

作　　者：梁其炎 何京伟 关文峰 冯能卓 黄亦欣 覃文超 梁健 LIANG Qiyan;HE Jingwei;GUAN Wenfeng;FENG Nengzhuo;HUANG Yixin;QIN Wenchao;LIANG Jian(Yangjiang People’s Hospital,Yangjiang 529500,China;不详)

机构地区：[1]阳江市人民医院,广东阳江529500

出　　处：《中外医学研究》2022年第31期121-124,共4页CHINESE AND FOREIGN MEDICAL RESEARCH

基　　金：阳江市医疗卫生类科技计划项目(SF2020017);阳江市人民医院2020年度院级科研基金项目(2020A3)。

摘　　要：目的:研究腹腔镜肾盂切开联合腔内碎石术治疗复杂性孤立肾结石的临床效果。方法:选取2020年5月-2022年4月阳江市人民医院收治的40例复杂性孤立肾结石患者。根据随机数字表法将其分为观察组和对照组,各20例。观察组给予腹腔镜肾盂切开联合腔内碎石术,对照组给予输尿管软镜手术。比较两组围手术期指标、术后并发症、炎症因子、肾功能及术后住院时间。结果:观察组手术时间短于对照组,术中出血量少于对照组(P<0.05)。观察组术后高热发生率低于对照组(P<0.05)。观察组术后3 d超敏C反应蛋白和降钙素原水平均显著低于对照组(P<0.05)。观察组术后3 d血肌酐、尿素氮均显著低于对照组(P<0.05)。观察组术后住院时间为(5.56±1.22)d,短于对照组的(7.48±1.06)d(t=5.313,P=0.000)。结论:腹腔镜肾盂切开联合腔内碎石治疗复杂性孤立肾结石的临床效果显著,可优化手术指标,降低术后并发症的发生率,且降低炎症因子水平,改善肾功能,缩短术后住院时间,故值得推广。Objective:To study the clinical effect of laparoscopic pyelotomy combined with intracavitary lithotripsy in the treatment of complex solitary kidney stones.Method:A total of 40 patients with complex solitary kidney stones admitted to Yangjiang People’s Hospital from May 2020 to April 2022 were selected.According to the method of random number table,they were divided into observation group and control group,20 cases in each group.The observation group was given the laparoscopic pyelotomy combined with intracavitary lithotripsy,and the control group was given the flexible ureteroscopic operation.The perioperative indexes,postoperative complications,inflammatory factors,renal function and postoperative hospital stay were compared between the two groups.Result:The operation time of the observation group was shorter than that of the control group,and the amount of intraoperative bleeding was less than that of the control group(P<0.05).The incidence of postoperative high fever in the observation group was lower than that in the control group(P<0.05).After 3 d of surgery,the levels of high sensitive C-reactive protein and procalcitonin in the observation group were significantly lower than those in the control group(P<0.05).After 3 d of surgery,the serum creatinine and urea nitrogen in the observation group were significantly lower than those in the control group(P<0.05).The postoperative hospital stay in the observation group was(5.56±1.22)days,which was shorter than(7.48±1.06)days in the control group(t=5.313,P=0.000).Conclusion:Laparoscopic pyelotomy combined with intracavitary lithotripsy has a significant clinical effect in the treatment of complex solitary kidney stones,which can optimize the surgical indicators,reduce the incidence of postoperative complications,and reduce the levels of inflammatory factors,improve renal function,and shorten the postoperative hospital stay,so it is worth promoting.

关 键 词：腹腔镜肾盂切开联合腔内碎石术 输尿管软镜手术 复杂性孤立肾结石 临床疗效 安全性 

分 类 号：R699.2[医药卫生—泌尿科学]