摘要
目的:研究讨论输尿管软镜联合体外冲击波碎石在2 cm以上肾结石治疗的安全性及应用价值。方法:将确诊肾结石的80例患者(结石直径均>2 cm),随机分为输尿管软镜碎石术(URL)组和上尿路结石经皮肾镜技术(PCNL)组,每组40例。观察比较两组手术疗效、手术时间、术后住院天数及并发症发生情况,比较两组术前及术后3 d血中性粒细胞明胶酶相关载脂蛋白(NGAL)浓度水平以及肾损伤分子1(Kim-1)浓度水平变化。结果:URL组与PCNL组相比,URL组的手术疗效、手术时间及并发症均无明显差异,URL组住院天数较PCNL组少,差异具有统计学意义(t=8.433,P<0.05);PCNL组NGAL和Kim-1浓度水平术后1 d明显高于术前,差异有统计学意义(t=2.355,t=2.803;P<0.05),术后2 d与术前相比,差异无统计学意义;而URL组术后1 d NGAL明显高于术前,差异有统计学意义(t=3.319,P<0.05),术后2 d与术前相比,差异无统计学意义。结论:输尿管软镜联合体外冲击波碎石对于直径>2 cm单发肾结石的疗效肯定,且并发症发生率更低,故在条件允许情况下,可作为临床推荐选择术式。
Objective：To observe the reliability and clinical implement of flexible ureteroscope combined with extracorporeal shock wave lithotripsy to treat the kidney stones with a diameter of more than 2cm. Methods：The diagnosed 80 cases of kidney stones （all with a diameter of more than 2cm） patients in our hospital were chosen, randomly divided into two groups, URL group and PCNL group,each of them with 40 cases. Surgical curative effect, operation time, postoperative complications, hospitalization days and the change of NGAL levels and the change of urine levels Kim-1 preoperative and postoperative blood 3 days of two groups were observed and compared. Results： Comparing with the PCNL group, the surgical curative effect, operation time and postoperative complications of the URL group have no significant difference, but the hospitalization days between are significantly different（t=8.433, P〈0.05）;In terms of NGAL, Kim-1, the postoperative 1d of PCNL group is significantly higher than preoperative, NGAL postoperative 1d of URL group is significantly higher than preoperative （t=3.319, P〈0.05）. Conclusion：It was reliable that flexible ureteroscope combined with extracorporeal shock wave lithotripsy to treat the kidney stones with a diameter of more than 2cm, lower complication rate, worthy of clinical.
出处
《中国医学装备》
2015年第10期100-103,共4页
China Medical Equipment
关键词
肾结石
输尿管软镜
体外冲击波碎石
上尿路结石经皮肾镜技术
Renal calculus
Flexible ureteroscope
Extracorporeal shock wave lithotripsy
Percutaneous nephrostolitho tomy
