输尿管软镜碎石术与经皮肾镜碎石术应用于老年肾结石治疗的结石清除率及并发症发生率分析  

Stone Clearance Rate and Complication Rate of Flexible Ureteral Lithotripsy and Percutaneous Nephrolithotomy in the Treatment of Elderly Kidney Stones

作　　者：兰飞 黄诗海 廖平 LAN Fei;HUANG Shihai;LIAO Ping(Department of Urology,Ziyun Miao and Buyi Autonomous County People's Hospital,Anshun 550800,Guizhou,China)

机构地区：[1]紫云苗族布依族自治县人民医院泌尿外科,贵州安顺550800

出　　处：《世界复合医学(中英文)》2024年第10期102-106,共5页World Journal of Complex Medicine

摘　　要：目的 分析肾结石(kidney stone,KS)老年患者使用输尿管软镜碎石术(flexible ureteral lithotripsy,FUL)、经皮肾镜碎石术(percutaneous nephrolithotripsy,PN)的效果。方法 选择2022年5月—2024年5月紫云苗族布依族自治县人民医院泌尿外科治疗的100例KS老年患者,根据不同手术方法分为两组,A组(50例,PN)和B组(50例,FUL),对比两组手术指标、检验指标、结石清除率、并发症发生率、肾功能指标。结果 B组手术时间、术中出血量、术后24 h视觉模拟评分法评分、术后止痛药物使用次数、住院时间均优于A组,差异有统计学意义(P均<0.05)。B组术后白细胞介素-6、C反应蛋白、皮质醇、去甲肾上腺素、肾上腺皮质激素水平均低于A组,差异有统计学意义(P均<0.05)。B组结石清除率为96.00%(48/50),高于A组的82.00%(41/50),差异有统计学意义(χ^(2)=5.005,P<0.05)。B组并发症发生率为2.00%(1/50),低于A组的14.00%(7/50),差异有统计学意义(χ^(2)=4.891,P<0.05)。B组术后肌酐、尿素氮、血β2-微球蛋白、甲状旁腺激素均低于A组,差异有统计学意义(P均<0.05)。结论 KS老年患者使用FUL,能有效提高手术质量,改善炎症、应激功能和肾功能。Objective To analyze the effect of flexible ureteroscopic lithotripsy(FUL) and percutaneous nephrolithotripsy(PN) in elderly patients with kidney stone(KS).Methods A total of 100 elderly patients with KS treated in the Department of Urology in Ziyun Miao and Buyi Autonomous County People's Hospital from May 2022 to May 2024 were selected.According to different surgical methods,they were divided into two groups,group A(50 cases,PN) and group B(50 cases,FUL).The surgical indicators,test indicators,stone clearance rate,complication rate,and renal function indicators were compared between the two groups.Results The operation time,intraoperative blood loss,postoperative 24 h Visual Analogue Scale score,postoperative analgesic drug use times and hospitalization time of group B were better than those of group A,and the differences were statistically significant(all P<0.05).The levels of interleukin-6,C-reactive protein,cortisol,norepinephrine and adrenocortical hormone in group B were lower than those in group A,and the differences were statistically significant(all P<0.05).The stone clearance rate of group B was 96.00%(48/50),which was higher than 82.00%(41/50) of group A,and the difference was statistically significant(χ~2=5.005,P<0.05).The incidence of complications in group B was 2.00%(1/50),which was lower than 14.00 %(7/50) in group A,and the difference was statistically significant(χ~2=4.891,P<0.05).Postoperative creatinine,urea nitrogen,blood β2-microglobulin and parathyroid hormone in group B were lower than those in group A,and the differences were statistically significant(P<0.05).Conclusion The use of FUL in elderly patients with KS can effectively improve the quality of surgery,improve inflammation,stress function and renal function.

关 键 词：输尿管软镜碎石术 经皮肾镜碎石术 老年患者 肾结石 结石清除率 

分 类 号：R692[医药卫生—泌尿科学]