微创经皮肾镜碎石取石术治疗肾结石的效果研究  

Study on the Effect of Minimally Invasive Percutaneous Nephrolithotripsy in the Treatment of Renal Calculi

作　　者：赵骥 ZHAO Ji(Department of Urology,Zibo Zichuan District Hospital,Zibo 255100,Shandong,China)

机构地区：[1]淄博市淄川区医院泌尿外科,山东淄博255100

出　　处：《系统医学》2024年第24期138-142,共5页Systems Medicine

摘　　要：目的 探讨微创经皮肾镜碎石取石术治疗肾结石的效果。方法 非随机选取2021年2月—2023年2月淄博市淄川区医院收治的90例肾结石患者为研究对象,根据治疗方法不同分为两组,各45例。微创组应用微创经皮肾镜碎石取石术治疗,大通道组应用大通道经皮肾镜气压碎石取石术治疗。比较两组患者手术相关指标比较、炎性因子水平、中性粒细胞明胶酶相关载脂蛋白水平和一期结石取尽率。结果 与大通道组进行比较,微创组手术时间更长,术中出血量更少,胃肠功能恢复时间、首次下床活动时间、住院时间更短,差异有统计学意义(P均<0.05)。术后微创组C反应蛋白、白细胞介素6、肿瘤坏死因子α分别为(16.56±2.43)mg/L、(17.41±1.54)ng/L、(137.31±24.34)pg/mL,均低于大通道组(24.76±4.11)mg/L、(26.78±5.46)ng/L、(157.91±27.43)pg/mL,差异有统计学意义(t=11.320、11.079、3.768,P均<0.05)。与大通道组进行比较,微创组术后中性粒细胞明胶酶相关载脂蛋白水平更低,差异有统计学意义(P均<0.05)。两组患者一期结石取尽率对比,差异无统计学意义(P>0.05)。结论 微创经皮肾镜碎石取石术和大通道经皮肾镜碎石取石术在结石清除方面均能发挥较好的效果,但前者可减小患者创伤,降低术中出血量,减轻应激反应,术后恢复较快。Objective To investigate the effect of minimally invasive percutaneous nephrolithotomy in the treatment of renal calculi.Methods From February 2021 to February 2023,ninety patients with renal calculi admitted to Zibo Zi‐chuan District Hospital were non-randomly selected as the research objects.According to the different treatment meth‐ods,they were divided into two groups,forty-five cases in each group.The minimally invasive group was treated with minimally invasive percutaneous nephrolithotomy,and the large channel group was treated with large channel percuta‐neous nephrolithotomy.The operation-related indicators,inflammatory factor levels,neutrophil gelatinase-related apo‐lipoprotein levels,and one-stage stone removal rate were compared between the two groups.Results Compared with the large channel group,the minimally invasive group had longer operation time,less intraoperative blood loss,shorter recovery time of gastrointestinal function,first ambulation time and hospitalization time,and the differences were sta‐tistically significant(all P<0.05).The levels of C-reactive protein,interleukin 6 and tumor necrosis factor-αin the minimally invasive group were(16.56±2.43)mg/L,(17.41±1.54)ng/L and(137.31±24.34)pg/mL,which were lower than(24.76±4.11)mg/L,(26.78±5.46)ng/L and(157.91±27.43)pg/mL in the large channel group,the differences were statistically significant(t=11.320,11.079,3.768,all P<0.05).Compared with the large channel group,the levels of neutrophil gelatinase-associated apolipoprotein in the minimally invasive group were lower,and the differences were statistically significant(all P<0.05).There was no significant difference in the first-stage stone removal rate between the two groups(P>0.05).Conclusion Minimally invasive percutaneous nephrolithotomy and large channel percutane‐ous nephrolithotomy can play a good role in stone removal,but the former can reduce the trauma of patients,reduce the amount of bleeding during operation,reduce the stress response,and recover quickly after opera

关 键 词：肾结石 微创治疗 经皮肾镜取石术 效果 

分 类 号：R4[医药卫生—临床医学]