超声引导微创经皮肾镜取石术与肾窦内肾盂切开取石术治疗肾结石疗效分析

目的:探讨超声引导微创经皮肾镜取石术与肾窦内肾盂切开取石术治疗肾结石疗效的对比及安全性。方法:选取76例有手术指征的肾结石患者,按照入院先后顺序及其患者对手术术式的选择意愿分为研究组及对照组,各38例,对照组采取肾窦内肾盂切开取石术治疗,研究组采取超声引导微创经皮肾镜取石术治疗,观察两组治疗疗效及安全性。结果:(1)两组患者术前Cr、βMG、eGFR、RBP比较差异无统计学意义(P>0.05),术后对照组分别为(102.38±18.34)μmol/L、(83.23±32.25)mL/min/1.73m2、(3.13±1.42)ng/L、(64.42±33.42)mg/L,研究组分别为(103.68±17.59)μmol/L、(84.17±30.65)mL/min/1.73m2、(3.15±1.38)ng/L、(62.82±32.15)mg/L,两组治疗前后组内比较差异无统计学意义(P>0.05),治疗后各指标在组间比较差异无统计学意义(P>0.05),结石清除率、残留率对照组分别为84.21%(32/38)、15.79%(6/38),研究组分别为89.47%(34/38)、10.53%(4/38),两组比较无显著性差异(P>0.05)。(2)不良反应及并发症:无1例发生损失周围脏器情况,对照组术后2例患者出血量达到400mL以上,给予输血治疗,7例患者发生术后高热(对照组5例,研究组2例),后证实存在感染,经过合理抗感染治疗后恢复正常。结论:超声引导微创经皮肾镜取石术治疗肾结石较肾窦内肾盂切开取石术创伤小、术后恢复快、结石清除率高,使用安全,并发症少。

Ultrasound guided minimally invasive percutaneous nephrolithotomy and kidney transinusal pyelolithotomy for treatment of renal calculi : A comparative clinical study

Objective: To explore the effects of ultrasound guided minimally invasive percutaneous nephrolithotomy and kidney transinusal pyelolithotomy for treatment of renal calculi comparison and to evaluate its safety.Methods: A total of 76 renal calculi cases showed operation indications were divided to study group and control group according to the sequence of admission and the operation mode they selected,with 38 cases in each group.The control group and study group were scheduled for kidney transinusal pyelolithotomy and ultrasound guided minimally invasive percutaneous nephrolithotomy,respectively.Results:(1) Before undergoing the operation,Cr,beta βMG,eGFR,RBP levels of the control group were(102.38±18.34) μmol/L,(83.23±32.25)mL/min / 1.73 m2,(3.13±1.42)ng/L,(64.42±33.42)MG/L,not significantly different from the(103.68±17.59) μmol/L,(84.17±30.65) mL/min/1.73 m2,(3.15±.38)ng/L,(62.82±32.15)MG/L of the study group(P>0.05).No significant difference was found for both groups before and after treatment(P>0.05).Stone clearance,residual rate of the control group were 84.21%(32/38),15.79%(6/38),not significant different from the 89.47%(34/38),10.53%(4/38) of the treatment group.(2) No peripheral organs injury was found;bleeding volume exceeded 400 mL for two cases in the control group.Postoperative hyperthermia occurred in 5 cases of the control group and 2 cases of the study group,which were confirmed as infection.Conclusion: Ultrasound guided minimally invasive percutaneous nephrolithotomy shows advantages of less trauma,faster postoperative recovery,higher stone-free rate,great safety and less less complications.