微通道经皮肾镜取石术治疗嵌顿性输尿管上段结石的安全性及有效性分析  

Safety and Efficacy of Minimally Invasive Percutaneous Nephrolithotmy in the Treatment of Impacted Upper Ureteral Calculi Analysis

作　　者：杜仁继 缪惠东[1] 薛亚岗 许立 袁晓林[1] DU Renji;MIAO Huidong;XUE Yagang;XU Li;YUAN Xiaolin(Affiliated Zhangjiagang Hospital of Soochow University,Zhangjiagang 215600,China;不详)

机构地区：[1]苏州大学附属张家港医院,江苏张家港215600

出　　处：《中外医学研究》2023年第1期57-61,共5页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:分析微通道经皮肾镜取石术(minimally invasive percutaneous nephrolithotomym,mPCNL)治疗嵌顿性输尿管上段结石的安全性及有效性。方法:回顾性选取2018年1月-2020年12月苏州大学附属张家港医院收治的142例嵌顿性输尿管上段结石患者作为研究对象,分为m PCNL组和输尿管镜钬激光碎石术(ureteroscopic holmium laser lithotripsy,URL)组(URL组),分析两组手术情况、治疗效果。结果:m PCNL组手术时间(90.74±21.08)min、术后住院天数(7.62±1.35)d,明显长于URL组的(61.82±22.12)min、(4.34±1.04)d,差异有统计学意义(P<0.001),m PCNL组术后血红蛋白下降值(12.53±9.05)g/L高于URL组的(9.19±8.35)g/L差异有统计学意义(P<0.05)。URL组的术后肌酐(78.22±24.40)μmol/L、全身炎症反应综合征(SIRS)发生率2.7%,与mPCNL组的(81.41±26.18)μmol/L、1.4%相比,差异无统计学意义(P>0.05);mPCNL组结石清除率100%,高于URL组的77%,mPCNL组术后狭窄发生率低于URL组,差异有统计学意义(P<0.05)。结论:mPCNL是一种安全有效治疗嵌顿性输尿管上段结石的手术方式,值得临床应用推广。Objective:To analyze the safety and efficacy of minimally invasive percutaneous nephrolithotomy(mPCNL)in the treatment of impacted upper ureteral calculi.Method:A total of 142 patients with impacted upper ureteral calculi treated in Affiliated Zhangjiagang Hospital of Soochow University from January 2018 to December 2020 were retrospectively selected and they were divided into mPCNL group and ureteroscopic holmium laser lithotripsy(URL)group(URL group).The operation and treatment effects of the two groups were analyzed.Result:The operative time and postoperative hospital stay in mPCNL group were(90.74±21.08)min and(7.62±1.35)d,which were significantly longer than those in URL group of(61.82±22.12)min and(4.34±1.04)d,the differences were statistically significant(P<0.001).The decrease value of hemoglobin after operation was(12.53±9.05)g/L of mPCNL group,which was higher than(9.19±8.35)g/L of URL group,and the difference was statistically significant(P<0.05).The postoperative creatinine of(78.22±24.40)μmol/L and systemic inflammatory response syndrome(SIRS)incidence of 2.7%in URL group were not statistically significant compared with those in mPCNL group of(81.41±26.18)μmol/L and 1.4%(P>0.05).The stone clearance rate in mPCNL group was 100%,which was higher than 77%in URL group,and the incidence of postoperative stenosis in mPCNL group was lower than that in URL group,the differences were statistically significant(P<0.05).Conclusion:mPCNL is a safe and effective surgical method for the treatment of impacted upper ureteral calculi,which is worthy of clinical application.

关 键 词：嵌顿性输尿管上段结石 微通道经皮肾镜取石术 输尿管镜 

分 类 号：R699.4[医药卫生—泌尿科学]