经输尿管导管逆行超声造影引导下经皮肾镜手术对复杂性肾结石患者结石清除率及肾功能的影响  

Influence of Percutaneous Nephrolithotomy Guided by Retrograde Contrast-Enhanced Ultrasound via Ureteral Catheter on Stone Clearance Rate and Renal Function in Patients with Complex Renal Calculi

作　　者：王飚 余志娟[2] WANG Biao;YU Zhi-juan(Department of Urinary Surgery,Xianning Central Hospital,Xianning Hubei 437100,China)

机构地区：[1]咸宁市中心医院/湖北科技学院附属第一医院泌尿外科,湖北咸宁437100 [2]湖北科技学院医学部公共卫生与健康学院

出　　处：《湖北科技学院学报（医学版）》2024年第4期319-322,共4页Journal of Hubei University of Science and Technology(Medical Sciences)

摘　　要：目的 探讨经输尿管导管逆行超声造影引导下经皮肾镜手术对复杂性肾结石患者结石清除率及肾功能的影响。方法 回顾性收集我院120例肾结石患者的临床资料,按手术方式分为两组,其中采用经输尿管导管逆行超声造影引导经皮肾镜手术的患者作为观察组(n=63),采用单纯超声引导经皮肾镜手术的患者作为对照组(n=57)。对比两组围术期指标(手术时间、失血情况、疼痛情况及住院时间)、术中穿刺情况、结石清除率、肾功能指标及并发症发生情况。结果 观察组手术时间及住院时间均较对照组短(P<0.05),手术后血红蛋白下降值及术后6h疼痛视觉模拟评分法(VAS)评分均低于对照组(P<0.05);观察组1次穿刺成功率及Ⅰ期清除率均较对照组高(P<0.05);观察组术后的血清胱抑素(Cys-C)、血尿酸(BUA)水平和血肌酐(Scr)均低于对照组(P<0.05);观察组并发症发生率低于对照组(P<0.05)。结论 经输尿管导管逆行超声造影引导在经皮肾镜手术治疗复杂性肾结石中应用价值显著,可提高1次穿刺成功率及Ⅰ期清除率,减少术中失血量,且对患者肾功能的影响较小,术后并发症少,可缩短患者术后住院时间,减轻术后疼痛。Objective To explore the influence of percutaneous nephrolithotomy under the guidance of retrograde contrast-enhanced ultrasound via urinary catheter on stone clearance rate and renal function in patients with complex renal calculi.Methods The clinical data of 120 patients with renal calculi were retrospectively collected,and divided into two groups according to the surgical methods.The patients who received retrograde contrast-enhanced ultrasound-guided percutaneous nephrolithotomy through ureteral catheter were regarded as observation group(n=63),and the patients who received simple ultrasound-guided percutaneous nephrolithotomy were included in control group(n=57).The perioperative indicators(surgical time,blood loss status,pain status and hospital stay),intraoperative puncture status,stone clearance rate,renal function indicators and the occurrence of complications were compared between these two groups.Results The surgical time and hospital stay in observation group were shorter than those in control group(P<0.05),and the decrease of hemoglobin after surgery and visual analogue scale(VAS) score at 6 hours after surgery were lower than those in control group(P<0.05).The success rate of one-time puncture and stage I clearance rate were higher in observation group(P<0.05).Compared with control group,the levels of serum cystatin(Cys-C),blood uric acid(BUA),serum creatinine(Scr),and the incidence rates of complications in observation group were lower(P<0.05).Conclusion Percutaneous nephrolithotomy guided by retrograde contrast-enhanced ultrasound via ureteral catheter has significant application value on complex renal calculi.It can enhance the success rate of one-time puncture and stage I clearance rate,reduce the intraoperative blood loss,decrease the influence on renal function and postoperative complications of patients,shorten the postoperative hospital stay,and relieve the postoperative pain.

关 键 词：复杂性肾结石 经皮肾镜手术 超声造影 结石清除率 肾功能 

分 类 号：R692.4[医药卫生—泌尿科学]