同期与分期单通道经皮肾镜取石术联合输尿管软镜钬激光碎石术治疗复杂性肾结石的效果比较  

Comparison of the effects of simultaneous and staged single-channel percutaneous nephrolithotomy combined with flexible ureteroscopic holmium laser lithotripsy in the treatment of complex renal calculi

作　　者：李静凯 施量 LI Jingkai;SHI Liang(the First People's Hospital of Xianyang,Xianyang 712000,China)

机构地区：[1]咸阳市第一人民医院,陕西咸阳712000

出　　处：《临床医学研究与实践》2024年第35期70-73,共4页Clinical Research and Practice

摘　　要：目的比较同期与分期单通道经皮肾镜取石术(PCNL)联合输尿管软镜钬激光碎石术治疗复杂性肾结石的临床效果。方法回顾性选取2020年2月至2022年2月本院治疗的60例复杂性肾结石患者作为研究对象,根据治疗方法不同将其分为同期组(29例)和分期组(31例)。同期组采用PCNL联合输尿管软镜钬激光碎石术同期治疗,分期组采用一期PCNL,二期PCNL联合输尿管软镜钬激光碎石术治疗。比较两组的临床效果。结果同期组的住院时间短于分期组,住院总费用低于分期组,术后12个月结石复发率高于分期组(P<0.05)。术前、术后,两组的血肌酐(SCr)、胱抑素C(Cys-C)、尿肾损伤分子-1(KIM-1)水平无显著差异(P>0.05)。术后,同期组的C反应蛋白(CRP)、皮质醇(Cor)水平低于分期组,超氧化物歧化酶(SOD)水平高于分期组(P<0.05)。结论同期单通道PCNL联合输尿管软镜钬激光碎石术治疗复杂性肾结石可缩短治疗时间和降低费用,应激反应小,但在近期结石清除率、对肾功能影响及并发症发生率方面与分期手术疗效相当,临床应根据实际情况合理选择手术方法。Objective To compare the clinical effects of simultaneous and staged single-channel percutaneous nephrolithotomy(PCNL)combined with flexible ureteroscopic holmium laser lithotripsy in the treatment of complex renal calculi.Methods A total of 60 patients with complex renal calculi treated in our hospital from February 2020 to February 2022 were retrospectively selected as the research objects.According to different treatment methods,the patients were divided into simultaneous group(29 cases)and staging group(31 cases).The simultaneous group was treated with PCNL combined with flexible ureteroscopic holmium laser lithotripsy at the same time,and the staging group was treated with one-stage PCNL and two-stage PCNL combined with flexible ureteroscopic holmium laser lithotripsy.The clinical effects of the two groups were compared.Results The hospitalization time of the simultaneous group was shorter than that of the staging group,the total cost of hospitalization was lower than that of the staging group,and the recurrence rate of stones at 12 months after operation was higher than that of the staging group(P<0.05).There were no significant differences in serum creatinine(SCr),cystatin C(Cys-C)and urinary kidney injury molecule-1(KIM-1)between the two groups before and after operation(P>0.05).After operation,the levels of C-reactive protein(CRP)and cortisol(Cor)in the simultaneous group were lower than those in the staging group,and the level of superoxide dismutase(SOD)was higher than that in the staging group(P<0.05).Conclusion Simultaneous single-channel PCNL combined with flexible ureteroscopic holmium laser lithotripsy in the treatment of complex renal calculi can shorten treatment time and decrease cost,and the stress response is small.However,the recent stone clearance rate,the influence on renal function and the incidence of complications are comparable to those of staged surgery.Clinically,the surgical method should be reasonably selected according to the actual situation.

关 键 词：单通道经皮肾镜取石术 输尿管软镜钬激光碎石术 复杂性肾结石 

分 类 号：R692.4[医药卫生—泌尿科学]