经皮肾镜取石术治疗上尿路结石合并重度肾积水的疗效观察  

Observation on the Therapeutic Effect of Percutaneous Nephrolithotomy for Upper Urinary Tract Stones Combined With Severe Hydronephrosis

作　　者：龙久柱 伍骏锋 徐林潼 LONG Jiuzhu;WU Junfeng;XU Lintong(Department of Urology,Qiandongnan Prefecture People′s Hospital,Kaili Guizhou 556000,China)

机构地区：[1]黔东南州人民医院泌尿外科,贵州凯里556000

出　　处：《中国卫生标准管理》2024年第17期97-100,共4页China Health Standard Management

基　　金：贵州省科技计划项目(黔科合基础-ZK[2022]一般544)。

摘　　要：目的探讨微创经皮肾镜取石术应用于上尿路结石合并重度肾积水的临床治疗效果,分析该治疗方案的临床价值。方法选取2022年1月—2023年12月黔东南州人民医院用手术作为主要治疗方案的患者112例,所有患者在临床中均已确诊上尿路结石,并且表现出较为严重的肾积水情况。按随机双盲法分为2组,各56例。对照组应用常规经皮肾镜取石术治疗,观察组应用微创经皮肾镜取石术治疗。观察2组上尿路结石合并重度肾积水患者的结石清除率、结石复发率、手术治疗指标、炎症数据指标情况、并发症发生率情况。结果观察组结石清除率为96.43%,高于对照组的83.93%(P<0.05)。观察组结石复发率为3.57%,低于对照组的16.07%(P<0.05)。观察组手术时间为(41.24±3.60)min,短于对照组的(70.95±4.96)min(P<0.05)。观察组住院时间为(10.21±1.36)d,短于对照组的(18.59±2.45)d(P<0.05)。观察组胃肠功能恢复时间为(20.27±1.65)h,早于对照组的(38.63±3.68)h(P<0.05)。观察组术中出血量为(91.20±11.59)mL,少于对照组的(119.62±19.64)mL(P<0.05)。观察组患者的血清炎症因子低于对照组(P<0.05)。术后观察组并发症发生率为10.71%,低于对照组的26.79%(P<0.05)。结论对于合并患有重度肾积水与上尿路结石的患者而言,应用微创经皮肾镜取石术治疗的效果更为优越,可有效改善患者的手术指标情况,且患者的结石清除率较高,术后恢复情况可观,临床应用价值显著。Objective To explore the clinical efficacy of minimally invasive percutaneous nephrolithotomy in the treatment of upper urinary tract stones with severe hydronephrosis,and analyzing the clinical value of this treatment plan.Methods From January 2022 to December 2023,a total of 112 patients at Qiandongnan Prefecture People′s Hospital were selected and treated primarily with surgery.All patients had clinically confirmed upper urinary tract stones and significant hydronephrosis.Using randomization blinding,double-blind method,they were divided into two groups of 56 each.The control group received conventional percutaneous nephrolithotomy,while the observation group underwent minimally invasive percutaneous nephrolithotomy.The study observed stone clearance rates,recurrence rates,surgical parameters,inflammation markers,and complication rates in both groups of patients with upper urinary tract stones and severe hydronephrosis.Results The stone clearance rate in the observation group was 96.43%,which higher than 83.93%of the control group(P<0.05).The observation group had a stone recurrence rate was 3.57%,which was lower than 16.07%of the control group(P<0.05).The observation group underwent surgery for an average was(41.24±3.60)minutes,significantly less than(70.95±4.96)minutes of the control group(P<0.05).The observation group spent was(10.21±1.36)days in the hospital,which was shorter than(18.59±2.45)days of control group(P<0.05).The recovery time of gastrointestinal function in the observation group was(20.27±1.65)hours,which was earlier than that(38.63±3.68)hours of the control group(P<0.05).The intraoperative blood loss in the observation group was(91.20±11.59)mL,less than(119.62±19.64)mL of the control group(P<0.05).The serum inflammatory factors in the observation group were significantly lower than those in the control group,and the postoperative complication rate was 10.71%,which was lower than 26.79%of the control group(P<0.05).Conclusion For patients with severe hydronephrosis and upper urinary t

关 键 词：微创 经皮肾镜取石术 上尿路结石 重度肾积水 手术效果 结石清除率 

分 类 号：R695[医药卫生—泌尿科学]