[1]聂岳龙,欧阳汛,周 亮,等.微创经皮肾镜取石术治疗肾积水合并肾结石的临床实践及结石清除率观察[J].医学信息,2023,36(13):95-98.[doi:10.3969/j.issn.1006-1959.2023.13.018]
 NIE Yue-long,OUYANG Xun,ZHOU Liang,et al.Clinical Practice and Stone Clearance Rate of Minimally Invasive Percutaneous Nephrolithotomy in the Treatment of Nephrolithiasis Complicated with Renal Calculi[J].Journal of Medical Information,2023,36(13):95-98.[doi:10.3969/j.issn.1006-1959.2023.13.018]
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微创经皮肾镜取石术治疗肾积水合并肾结石的临床实践及结石清除率观察()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
36卷
期数:
2023年13期
页码:
95-98
栏目:
论著
出版日期:
2023-07-01

文章信息/Info

Title:
Clinical Practice and Stone Clearance Rate of Minimally Invasive Percutaneous Nephrolithotomy in the Treatment of Nephrolithiasis Complicated with Renal Calculi
文章编号:
1006-1959(2023)13-0095-04
作者:
聂岳龙欧阳汛周 亮
(吉水县人民医院泌尿外科,江西 吉水 331600)
Author(s):
NIE Yue-longOUYANG XunZHOU Lianget al.
(Department of Urology,People’s Hospital of Jishui County,Jishui 331600,Jiangxi,China)
关键词:
微创经皮肾镜取石术肾积水肾结石结石清除率
Keywords:
Minimally invasive percutaneous nephrolithotomyNephrolithiasisRenal calculiStone clearance rate
分类号:
R691.4
DOI:
10.3969/j.issn.1006-1959.2023.13.018
文献标志码:
A
摘要:
目的 观察微创经皮肾镜取石术治疗肾积水合并肾结石的效果及结石清除率。方法 选取2020年1月-2022年2月我院诊治的80例肾积水合并肾结石患者为研究对象,采用随机数字表法分为对照组和观察组,各40例。对照组采用常规尿路输尿管镜取石术治疗,观察组采用微创经皮肾镜取石术治疗,比较两组临床手术相关指标(手术时间、术中出血量、住院时间、住院费用)、结石清除率、疼痛(VAS)评分、炎性因子指标[C反应蛋白(CRP)、白细胞介素-6(IL-6)]水平、肾功能指标[血清肌酐(Scr)、半胱氨酸蛋白酶抑制剂C(Cys-C)]以及术后并发症发生率。结果 观察组手术时间、住院时间短于对照组、术中出血量少于对照组、住院费用高于对照组(P<0.05);观察组结石清除率为92.50%,高于对照组的80.00%(P<0.05);两组术后2 h VAS评分比较,差异无统计学意义(P>0.05),而观察组术后12、24 h VAS评分低于对照组(P<0.05);两组术后24 h CRP、IL-6比较,差异无统计学意义(P>0.05);两组术后24 h Scr比较,差异无统计学意义(P>0.05),而观察组Cys-C高于对照组(P<0.05);观察组并发症发生率低于对照组(P<0.05)。结论 微创经皮肾镜取石术治疗肾积水并肾结石可实现较理想的治疗效果,不仅可提高结石清除率、缩短手术和住院时间、减少术中出血量、减轻患者疼痛度、降低术后并发症发生几率,同时对肾功能损伤及炎症反应无明显影响。虽然住院费用相对提高,但具有以上优势,值得临床应用。
Abstract:
Objective To observe the effect and stone clearance rate of minimally invasive percutaneous nephrolithotomy in the treatment of nephrolithiasis complicated with renal calculi.Methods A total of 80 patients with nephrolithiasis complicated with renal calculi diagnosed and treated in our hospital from January 2020 to February 2022 were selected as the research objects. They were divided into control group and observation group by random number table method, with 40 patients in each group. The control group was treated with conventional ureteroscopic lithotripsy, and the observation group was treated with minimally invasive percutaneous nephrolithotomy. The clinical operation related indexes (operation time, intraoperative blood loss, hospitalization time, hospitalization cost), stone clearance rate, pain (VAS) score, inflammatory factor indexes [C-reactive protein (CRP), interleukin-6 (IL-6)], renal function indexes [serum creatinine (Scr), cysteine protease inhibitor C (Cys-C)] and postoperative complication rate were compared between the two groups.Results The operation time and hospitalization time of the observation group were shorter than those of the control group, the intraoperative blood loss was less than that of the control group, and the hospitalization cost was higher than that of the control group (P<0.05). The stone clearance rate of the observation group was 92.50%, which was higher than 80.00% of the control group (P<0.05). There was no significant difference in VAS score between the two groups at 2 h after operation (P>0.05), while the VAS scores of the observation group at 12 and 24 h after operation were lower than those of the control group (P<0.05). There was no significant difference in CRP and IL-6 between the two groups at 24 h after operation (P>0.05). There was no significant difference in Scr 24 h after operation between the two groups (P>0.05), while Cys-C in the observation group was higher than that in the control group (P<0.05). The incidence of complications in the observation group was lower than that in the control group (P<0.05).Conclusion Minimally invasive percutaneous nephrolithotomy can achieve an ideal therapeutic effect in the treatment of nephrolithiasis complicated with renal calculi. It can not only improve the stone clearance rate, shorten the operation and hospitalization time, reduce the intraoperative blood loss, reduce the pain of patients, and reduce the incidence of postoperative complications, but also has no significant effect on renal function injury and inflammatory response. Although the hospitalization cost is relatively increased, it can realize the above application advantages and has clinical application value.

参考文献/References:

[1]严泉江,潘华锋,干雪峰,等.肾结石患者术后泌尿系感染的病原学特点及危险因素研究[J].中华医院感染学杂志,2017,27(22):5168-5171.[2]韩利忠,李明明,卢冠军,等.经皮肾镜联合腔内切开手术治疗肾结石合并肾盂输尿管连接部梗阻[J].中国微创外科杂志,2018,18(5):409-411.[3]Huang J,Song L,Xie D,et al.A Randomized Study of Minimally Invasive Percutaneous Nephrolithotomy (MPCNL) with the aid of a patented suctioning sheath in the treatment of renal calculus complicated by pyonephrosis by one surgery[J].BMC Urol,2016,16(1):71.[4]张寒.微创经皮肾镜与经输尿管镜治疗输尿管上段结石合并肾积水的临床疗效对比分析[J].山西医药杂志,2018,47(9):1026-1027.[5]Giusti G,Lisa A.Massive migration of embolization coils inside the renal pelvis. A rare complication that can be approached through percutaneous surgery[J].Cent European J Urol,2018,71(4):467-469.[6]焦志敏,王诚悦,周洋,等.3cm以内肾结石微创治疗方案的选择探索[J].中国内镜杂志,2019,25(9):25-29.[7]中华医学会泌尿外科分会,中国泌尿系结石联盟.软性输尿管镜术中国专家共识[J].中华泌尿外科杂志,2016,37(8):561-565.[8]董传江,谢宗兰,张路生,等.输尿管软镜与微通道经皮肾镜碎石术治疗肾结石的疗效比较[J].临床泌尿外科杂志,2016,31(5):453-455.[9]鲁守会,许洪礼,鲁守琳,等.微通道经皮肾镜碎石术与逆行输尿管镜治疗肾下盏小结石的疗效分析[J].现代泌尿外科杂志,2018,23(4):283-286.[10]王世先,杨水法,王飞,等.超微经皮肾镜与输尿管软镜治疗中等大小肾下盏结石的前瞻性对比研究[J].中华泌尿外科杂志,2018,39(3):209-213.[11]熊云鹤,余娅兰,宋超,等.采用软性输尿管镜术及经皮肾镜取石术治疗肥胖患者肾下盏结石的疗效分析[J].国际泌尿系统杂志,2017,37(6):818-820.[12]林海利,郑周达,杨明根,等.经皮肾镜与输尿管软镜在孤立肾结石的应用比较[J].中国微创外科杂志,2016,16(4):301-303.[13]王文,余忠.输尿管软镜碎石治疗脊柱畸形患者上尿路结石[J].重庆医学,2018,47(18):2437-2439.[14]王展,顾朝辉,贾占奎,等.套石篮联合输尿管软镜钬激光碎石术治疗马蹄肾肾结石23例报告[J].临床泌尿外科杂志,2018(1):61-63.[15]Lv G,Zhang Z,Du F,et al.Comparison of flexible ureteroscopy and mini-percutaneous nephrolithotomy in the treatment for multiple nephrolithiasis[J].Front Surg,2022,9:1004432.[16]谷翠芝,李清初,曾凝,等.急性肾损伤患者NGAL、KIM-1与血肌酐的相关性[J].广东医学,2017,36(20):3179-3181.[17]王福利,杨力军,刘飞,等.机器人辅助腹腔镜联合输尿管软镜治疗合并肾结石的肾盂输尿管连接部梗阻[J].微创泌尿外科杂志,2017,6(2):78-81.[18]王炳卫,杨国胜,张福霖,等.输尿管软镜与微创经皮肾镜治疗最大径2-3 cm肾结石的效果及对肾功能影响的比较[J].广东医学,2018,39(5):1525-1528.

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更新日期/Last Update: 1900-01-01