肾穿刺微造瘘联合丁溴东莨菪碱在软镜碎石术中对肾结石的治疗有效性及安全性研究  

Study on the Efficacy and Safety of Percutaneous Nephrostomy Combined with Scopolamine Bromide in the Treatment of Renal Calculi During Soft Lens Lithotripsy

作　　者：杜风[1] Du Feng(Department of Kaiyuan Surgery,The First Affiliated Hospital of Henan University of Science and Technology,Luoyang,Henan,471300,China)

机构地区：[1]河南科技大学第一附属医院开元手术部,河南洛阳471300

出　　处：《黑龙江医学》2024年第14期1704-1706,共3页Heilongjiang Medical Journal

摘　　要：目的:探析经皮肾穿刺微造瘘取石术(MPCNL)联合丁溴东莨菪碱在输尿管软镜碎石术(FURL)中对肾结石的治疗有效性及安全性。方法:选取2021年7月—2022年11月河南科技大学第一附属医院开元手术部收治的80例肾结石患者作为研究对象,采用随机数表法将其分为对照组和观察组,每组各40例。对照组给予FURL联合丁溴东莨菪碱,观察组在对照组基础上联合MPCNL治疗。对比两组患者临床有效率、疗效及康复指标、术前术后肾损伤相关因子[丛生蛋白(CLU)、肾损伤分子-1(KIM-1)、血清肌酐(SCr)]、并发症风险情况。结果:观察组患者临床有效率(97.50%)明显高于对照组(80.00%),差异有统计学意义(χ^(2)=6.135,P<0.05);观察组患者手术时间长于对照组,住院、结石清除及肾绞痛缓解时间均短于对照组,差异有统计学意义(t=15.090、5.755、8.596、6.043,P<0.05);术后两组患者CLU、KIM-1、SCr水平明显升高,且观察组上升幅度低于对照组,差异有统计学意义(t=2.761、6.704、3.079,P<0.05);观察组患者并发症发生率(5.00%)明显低于对照组(20.00%),差异有统计学意义(χ^(2)=4.114,P<0.05)。结论:MPCNL联合丁溴东莨菪碱应用于肾结石FURL治疗中效果显著,可提高结石清除有效率及安全性,缩短康复时间,降低肾损伤风险。Objective:To explore the efficacy and safety of minimally invasive percutaneous nephrolithotomy(MPCNL)combined with scopolamine bromide in flexible ureteroscopic lithotripsy(FURL)in the treatment of renal stones.Methods:A total of 80 patients with renal stones admitted to the Kaiyuan Operation Department,the First Affiliated Hospital of Henan University of Science and Technology from July 2021 to November 2022 were randomly divided into two groups,with 40 patients in each group.The control group was treated with FURL combined with scopolamine bromide,while the observation group was treated with MPCNL on the basis of the control group.The clinical efficacy,efficacy and rehabilitation indicators,factors related to renal injury[cluster protein(CLU),kidney injury molecule-1(KIM-1),serum creatinine(SCr)]and risk of complications were compared between the two groups before and after surgery.Results:The clinical effective rate in the observation group(97.50%)was significantly higher than that in the control group(80.00%)with statistically significant difference(χ^(2)=6.135,P<0.05).The operation time in the observation group was longer than that in the control group,while the hospitalization,stone removal,and renal colic relief time in the observation group were shorter than those in the control group(t=15.090,5.755,8.596,6.043;P<0.05).After surgery,CLU,KIM-1,and SCr increased significantly in both groups,and the ascensional range in the observation group was lower than that in the control group(t=2.761,6.704,3.079;P<0.05).The risk of complications in the observation group(5.00%)was significantly lower than that in the control group(20.00%)with statistically significant difference(χ^(2)=4.114,P<0.05).Conclusion:MPCNL combined with scopolamine bromide is effective in the treatment of renal calculi with FURL,which can improve the efficiency and safety of stone removal,shorten the recovery time,and reduce the risk of renal injury.

关 键 词：肾结石 输尿管软镜碎石术 肾穿刺微造瘘取石术 丁溴东莨菪碱 疗效 安全性 

分 类 号：R692.4[医药卫生—泌尿科学]