超声引导下微通道经皮肾镜或输尿管镜取石术在肾结石患者中的应用

目的 观察超声引导下微通道经皮肾镜或输尿管镜取石术在肾结石患者中的应用效果.方法 将我院2014年1月至2016年5月收治的80例肾结石患者按随机数字表法分为观察组和对照组,每组40例,观察组患者采用超声引导下微通道经皮肾镜(或输尿管镜)取石术,对照组采用肾盂切开取石术,比较两组患者术中出血量、手术时间、术后并发症、下床活动及住院时间,以及结石清除率和结石复发率.结果 观察组患者的术中出血和手术时间分别为(202.3±99.5)mL、(1.1±0.7)h,均明显少于对照组的(455.8±45.8)mL、(2.8±1.2)h,两组比较差异均有统计学意义(P<0.05);观察组并发症发生率、结石清除率及结石复发率分别为10.0%、95.0%及10.0%,均优于对照组的40.0%、90.0%、15.0%,两组患者的结石清除率及结石复发率差异无统计学意义(P>0.05),但并发症发生率比较差异有统计学意义(P<0.05);观察组患者下床活动平均时间和住院时间分别为(6.1±2.3)d、(13.6±5.3)d,均短于对照组的(12.6±5.1)d、(24.6±7.3)d,两组比较差异均有统计学意义(P<0.05).结论 超声引导下微通道经皮肾镜(或输尿管镜)取石术治疗肾结石创伤小、结石清除效果好.

Application of ultrasound-guided minimally invasive percutaneous nephrolithotomy or ureteroscopy in renal calculi

Objective To observe the effect of ultrasound-guided minimally invasive percutaneous nephroli-thotomy or ureteroscopy in renal calculi. Methods Eighty patients with kidney stones treated in our hospital from Janu-ary 2014 to May 2016 were divided into observation group and control group according to the random number table. The patients in the observation group were treated with ultrasound-guided minimally invasive percutaneous nephrolithotomy or ureteroscopy, and the control group applied pyelolithotomy. The intraoperative blood loss, operation time, postopera-tive complications, average off-bed time and length of hospital stay, stone clearance rate, and stone recurrence rate were compared between the two groups. Results The intraoperative blood loss and operation time were (202.3 ± 99.5) mL and (1.1 ± 0.7) h respectively in the observation group, which were significantly lower than (455.8 ± 45.8) mL and (2.8 ± 1.20) h in the control group (P<0.05). The incidence of postoperative complications was 10.0%in the observation group, significantly lower than 40.0%in the control group (P<0.05). The stone clearance rate and stone recurrence rate in the observation group were 95.0%and 10.0%, as compared with 90.0%and 15.0%in the control group (P>0.05). The aver-age off-bed time and length of hospital stay were (6.1 ± 2.3) d, (13.6 ± 5.3) d in the observation group, as compared with (12.6 ± 5.1), (24.6 ± 7.3) d in the control group (P<0.05). Conclusion Ultrasound-guided minimally invasive percutane-ous nephrolithotomy or ureteroscopy is effective in the treatment of renal calculi, and the effect of stone removal is good.