RIRS与mPCNL治疗肾结石的对比研究  

Comparative Study of RIRS and mPCNL in the Treatment of Kidney Stones

作　　者：刘昌全 李华 肖金国 林科毅 郑林 LIU Changquan;LI Hua;XIAO Jinguo;LIN Keyi;ZHENG Lin(Department of Urology,Dafang County People's Hospital,Dafang County,Bijie,Guizhou Province,551600 China)

机构地区：[1]大方县人民医院泌尿外科,贵州毕节551600

出　　处：《中外医疗》2024年第9期43-46,54,共5页China & Foreign Medical Treatment

摘　　要：目的探讨输尿管软镜(Retrograde Intrarenal Surgery,RIRS)碎石与微通道经皮肾镜碎石(Minipereutaneous Nephrolithotomy,mPCNL)在肾结石患者中的应用价值。方法回顾性选取2022年8月—2023年10月大方县人民医院收治的94例单发肾结石患者的临床资料,将手术治疗方法作为分组依据,采用RIRS碎石的47例患者为对照组,采用mPCNL的47例患者为观察组,比较两组手术相关指标、结石清除效果、血清β2-微球蛋白(β2-microglobulin,β2-MG)、血尿素氮(Blood Urea Nitrogen,BUN)、丙二醇(Malondialdehyde,MDA)、去甲肾上腺素(Norepinephrine,NE)以及术后并发症情况。结果观察组一期结石清除率为85.11%,高于对照组的65.96%,差异有统计学意义(χ^(2)=4.663,P=0.031)。观察组手术用时短于对照组,术后住院时间长于对照组,差异有统计学意义(P均<0.05),两组术后并发症、术中出血量、首次下床时间对比,差异无统计学意义(P均>0.05)。术后1 d,观察组β2-MG、BUN、MDA与NE水平高于对照组,差异有统计学意义(P均<0.05);术后3 d,两组β2-MG、BUN、MDA与NE对比,差异无统计学意义(P均>0.05)。结论RIRS与mPCNL对肾结石病例均有较好的手术效果,mPCNL的一次结石清除率高,手术用时较短,但可对患者的肾功能及应激指标造成短期影响。Objective To evaluate the application of retrograde intrarenal surgery(RIRS)lithotomy and micro-channel percutaneous nephrolithotomy(mini-pereutaneous mPCNL)in patients with kidney stones.Methods Retrospectively selected clinical data of 94 patients with single kidney stones admitted to Dafang County People's Hospital from Au⁃gust 2022 to October 2023.The surgical treatment method was used as the basis for grouping.47 patients receiving RIRS lithotripsis were used as the control group and 47 patients receiving mPCNL were used as the observation group.The operative related indexes,stone clearance effect,serumβ2-microglobulin(β2-MG),blood urea nitrogen(BUN),malondialol(MDA),Norepinephrine(NE)and postoperative complications were compared between the two groups.Re⁃sults The first stage stone clearance rate in the observation group was 85.11%,higher than 65.96%in the control group,the difference was statistically significant(χ²=4.663,P=0.031).The operation time in the observation group was shorter than that in the control group,and the postoperative hospitalization time was longer than that in the control group,the differences were statistically significant(both P<0.05).There were no significant differences in postopera⁃tive complications,intraoperative blood loss and first time to get out of bed between the two groups.1 d after opera⁃tion,the levels ofβ2-MG,BUN,MDA and NE in observation group were higher than those in control group,the differ⁃ences were statistically significant(all P<0.05).There were no significant differences inβ2-MG,BUN,MDA and NE between the two groups at 3 days after operation(all P>0.05).Conclusion Both RIRS and mPCNL have a good surgi⁃cal effect on patients with kidney stones.mPCNL has a high primary stone clearance rate and a short surgical time,but it can cause short-term effects on patients'kidney function and stress indexes.

关 键 词：肾结石 微通道经皮肾镜碎石 输尿管软镜 一次结石清除率 

分 类 号：R692.4[医药卫生—泌尿科学]