摘要
目的探讨经皮肾镜EMS碎石清石术在复杂性肾结石治疗中的作用分析。方法将2014年1月~2019年1月在我院泌尿外科治疗的复杂性肾结石患者60例随机分为两组,对照组采用经皮肾镜钬激光碎石术,观察组采用经皮肾镜EMS碎石清石术,比较两组患者的碎石清除率及结石残留率、各项手术指标、并发症发生率、不同时间点肾功能指标变化。结果观察组碎石清除率为96.67%、结石残留率为3.33%,与对照组的93.33%、6.67%比较,差异无统计学意义(P>0.05);观察组手术时间、术中用水量、术中出血量明显少于对照组(P<0.05),而两组住院时间差异无统计学意义(P>0.05);观察组术后出血、术后感染发热、术中肾盂穿孔、术中肾盏颈出血等并发症发生率与对照组差异无统计学意义(P>0.05),且两组均无肾切除、大出血、气胸、肠穿孔等严重并发症发生(P>0.05);两组术后2、24h的BUN、Scr、Cys C均较术前升高(P<0.05)。结论经皮肾镜EMS碎石清石术在复杂性肾结石治疗效果显著,结石清除率高,手术对肾功能有一过性影响,并发症发生率低,具有较高的临床应用价值。
Objective To explore the role of percutaneous nephrolithotomy with EMS lithotripsy in the treatment of complicated kidney stones.Methods 60 patients with complicated kidney stone admitted to urology department of our hospital from January 2014 to January 2019 were randomly divided into an observation group and a control group.The control group was treated with percutaneous nephrolithotomy holmium laser lithotripsy,while the observation group was treated with percutaneous nephrolithotripsy EMS lithotripsy.The removal rate,residual stone rate,surgical index,complication rate,renal function index at different time points were compared between the two groups.Results The removal rate of lithotripsy in the observation group was 96.67%,and the residual rate of calculi was 3.33%,which was not significantly different of 93.33%and 6.67%in the control group(P>0.05).The operation time,intraoperative water consumption and intraoperative blood loss in the observation group were significantly lower than those in the control group(P<0.05),while the length of hospital stay between the two groups was not significantly different(P>0.05).The incidence of postoperative bleeding,postoperative infection and fever,intraoperative renal pelvis perforation and intraoperative calyx neck bleeding in the observation group was not significantly different from that in the control group,and there were no serious complications such as nephrectomy,massive bleeding,pneumothorax and intestinal perforation in the two groups(P>0.05).BUN,Scr and Cys C were increased in both groups 2 and 24 hours after surgery(P<0.05).Conclusion Percutaneous nephrolithotomy with EMS lithotripsy is effective in the treatment of complicated kidney stones,which has a transient effect on renal function,low incidence of complications and high clinical value.
作者
王健
刘建华
侯国良
罗飞
WANG Jian;LIU Jianhua;HOU Guoliang;LUO Fei(First Department of Urology Surgery,Foshan First People's Hospital,Foshan 528000,China)
出处
《中国医药科学》
2020年第7期283-286,共4页
China Medicine And Pharmacy
关键词
复杂性肾结石
经皮肾镜EMS碎石清石术
碎石清除率
并发症
肾功能
Complicated kidney stones
Percutaneous nephrolithotomy with EMS lithotripsy
Gravel clearance rate
Complications
Renal function
