摘要
目的 探讨CT三维重建辅助经皮肾镜碎石术治疗复杂性输尿管上段结石的效果及安全性。方法 选取符合纳入及排除标准的复杂性输尿管上段结石153例,采用随机数字表法随机将其分为观察组77例和对照组76例,观察组采用CT三维重建辅助经皮肾镜碎石术治疗,对照组采用B超引导经皮肾镜碎石术治疗。观察比较两组术后3 d临床治疗效果、手术相关指标(1次穿刺成功率、1次手术取净率、术中出血量及手术时间)、术前和术后24 h创伤相关指标[C反应蛋白(CRP)、白细胞介素6(IL-6)、皮质醇(Cor)及去甲肾上腺素(NE)]以及术后1周并发症发生情况。结果 术后3 d,观察组总有效率100.00%高于对照组总有效率86.84%,差异有统计学意义( P <0.05)。观察组1次穿刺成功率及1次手术取净率高于对照组,术中出血量少于对照组,手术时间短于对照组,差异均有统计学意义( P <0.05)。术前,两组血清CRP、IL-6、Cor及NE水平比较差异均无统计学意义( P >0.05)。术后24 h,两组血清CRP、IL-6、Cor及NE水平均较术前升高,观察组血清CRP、IL-6、Cor及NE水平均低于对照组,差异有统计学意义( P <0.05)。术后1周,观察组并发症总发生率6.49%低于对照组并发症总发生率26.32%,差异有统计学意义( P <0.05)。结论 CT三维重建辅助经皮肾镜碎石术治疗复杂性输尿管上段结石效果良好,可提高1次穿刺成功率及1次手术取净率,且手术创伤小、手术时间短、安全性高。
Objective To evaluate the efficacy and safety of CT three-dimensional reconstruction assisted percutaneous nephrolithotomy in the treatment of complex upper ureteral calculi (UUC). Methods A total of 153 patients with complex UUC who met the inclusion and exclusion criteria were divided into observation group ( n =77) and control group ( n =76) by random table method. The observation group was treated with CT three-dimensional reconstruction assisted percutaneous nephrolithotomy, while the control group was treated with B-ultrasound guided percutaneous nephrolithotomy. The clinical effects of the two groups were compared on the 3rd day after operation, and the operation-related indexes of the two groups were compared, including the initial success rate of puncture, initial stone free rate, intraoperative bleeding volume and duration of operation. In addition, the levels of trauma-related indicators including C-reactive protein (CRP), interleukin-6 (IL-6), cortisol (Cor) and norepinephrine (NE) as well as incidence of complications within one week after operation were recorded before and 24 h after operation. Results At 3 d after treatment, the total effective rate of the observation group was 100.00%, which was higher than that (86.84%) of the control group ( P <0.05). The initial success rate of puncture and initial stone free rate in the observation group were higher than those in the control group, while the amount of bleeding during operation and duration of operation were less or shorter than those in the control group, suggesting significant difference ( P <0.05). There were no significant differences in serum CRP, IL-6, Cor and NE levels between the two groups before operation ( P >0.05). At 24 h after operation, the levels of CRP, IL-6, Cor and NE in serum of the two groups were higher than those before operation, but the levels of the above-mentioned indexes in the observation group were lower than those in the control group, suggesting significant difference ( P <0.05). The incidence of complications in
作者
李斌
唐洪渠
LI Bin;TANG Hong-qu(Department of Imaging,General Hospital of Beijing Jingmei Group,Beijing 102300,China)
出处
《临床误诊误治》
2019年第8期66-70,共5页
Clinical Misdiagnosis & Mistherapy
基金
首都卫生发展科研专项课题项目(2016-1-5092)
