一次性输尿管软镜与微通道经皮肾镜取石术治疗肾下盏结石的临床研究  

Comparison of treatment effect between single-use digital flexible ureteroscope and mini percutaneous nephrolithotomy on lower calyceal calculus

作　　者：娄禄[1,2] 徐觉剑 陈伟[1,2] 曹希亮 孙方浩[1,2] Lou Lu;Xu Juejian;Chen Wei;Cao Xiliang;Sun Fanghao(Department of Urology,Xuzhou First People's Hospital,Xuzhou,Jiangsu 221000,China;Department of Urology,Xuzhou Municipal Hospital Affiliated to Xuzhou Medical University,Xuzhou,Jiangsu 221000,China)

机构地区：[1]徐州市第一人民医院泌尿外科,江苏徐州221000 [2]徐州医科大学附属徐州市立医院泌尿外科,江苏徐州221000

出　　处：《泌尿外科杂志（电子版）》2024年第1期17-20,共4页Journal of Urology for Clinicians(Electronic Version)

基　　金：徐州市医科大学附属医院科技发展基金项目(XYFM2020032);徐州医科大学附属市立医院2022年拔尖人才项目。

摘　　要：目的探讨采用一次性输尿管软镜(single-use digital flexible ureteroscope,SDFU)与微通道经皮肾镜手术(mini percutaneous nephrolithotomy,mPCNL)治疗肾下盏结石的临床效果。方法选取2021年7月至2023年7月在徐州市第一人民医院接受治疗的80例肾下盏结石患者作为研究对象,按照随机数字表法分为对照组(n=38)与研究组(n=42)。对照组采用mPCNL,研究组采用SDFU。比较两组手术时间、术后4周一次性结石清除率、手术前后24 h血红蛋白下降值、住院时间、手术前后C反应蛋白(C-reactive protein,CRP)、降钙素原(procalcitonin,PCT)、白细胞介素-6(interleukin-6,IL-6)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、术后1周并发症发生率、术后1周生活质量量表(short form survey-36,SF-36)评分。结果研究组手术时间长于对照组,一次性结石清除率、血红蛋白下降值均低于对照组,住院时间短于对照组,差异均有统计学意义(P<0.05)。术前,两组IL-6、CRP、PCT、TNF-α比较,差异无统计学意义(P>0.05);术后24 h,研究组IL-6、CRP、PCT、TNF-α均低于对照组,差异有统计学意义(P<0.05)。研究组并发症发生率低于对照组,差异有统计学意义(P<0.05)。术后1周,研究组认知、躯体、情感、角色、社会功能评分均高于对照组,差异有统计学意义(P<0.05)。结论采用mPCNL治疗肾下盏结石可提高结石清除率并缩短手术时间,SDFU能够降低血红蛋白下降值,消除炎性反应,减少并发症发生,可加快患者术后康复。Objective To compare the clinical efficacy of using single-use digital flexible ureteroscope(SDFU)and mini percutaneous nephrolithotomy(mPCNL)for the treatment of lower calyceal calculus.Methods A total of 80 patients with lower calyceal calculus admitted to Xuzhou First People's Hospital from July 2021 to July 2023 were selected as the study subjects.They were randomly divided into a control group(n=38)and a study group(n=42).The control group underwent mPCNL,while the study group underwent SDFU.Surgical time,one-time stone clearance rate at 4 weeks postoperatively,hemoglobin decrease within 24 hours,hospitalization duration,pre-and postoperative levels of C-reactive protein(CRP),procalcitonin(PCT),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),postoperative complications rate at 1 week,and postoperative 1-week quality of life scores(short form survey-36,SF-36)were compared between the two groups.Results The surgical time in the study group was longer than that in the control group.The one-time stone clearance rate and hemoglobin decrease were lower in the study group compared to the control group.However,the hospitalization duration was shorter in the study group,and these differences were statistically significant(P<0.05).There were no statistically significant differences in IL-6,CRP,PCT,and TNF-αlevels between the two groups before surgery(P>0.05).Twenty four hours after surgery,IL-6,CRP,PCT,and TNF-αlevels in the study group were lower than those in the control group,with statistically significant differences(P<0.05).The incidence of complications in the study group was lower than that in the control group,showing statistical significance(P<0.05).One week postoperatively,the study group had higher scores in cognitive,physical,emotional,role,and social functioning compared to the control group,and these differences were statistically significant(P<0.05).Conclusion The use of mPCNL for the treatment of lower calyceal calculus can improve stone clearance rates and shorten surgical time,while SDFU can r

关 键 词：肾下盏结石 一次性输尿管软镜 微通道经皮肾镜取石术 

分 类 号：R692.4[医药卫生—泌尿科学]