摘要
目的研究无管化微创经皮肾镜取石术(PCNL)治疗嵌顿性输尿管上段结石患者的临床疗效。方法回顾性分析2017年1月至2020年1月辽健集团阜新矿总医院收治的86例嵌顿性输尿管上段结石患者的临床资料,根据治疗方法不同分为对照组(40例)和观察组(46例)。对照组采用微创PCNL治疗,观察组采用无管化微创PCNL治疗。比较两组患者的手术时间、术中出血量、住院时间、疼痛程度、结石清除率、肾功能[血尿素氮(BUN)、血清肌酐(Scr)、中性粒细胞明胶酶相关脂质运载蛋白(NGAL)]、炎性因子[C反应蛋白(CRP)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)]及并发症发生率。结果观察组患者的手术时间和住院时间短于对照组(P<0.05),术中出血量少于对照组(P<0.05);观察组术后48、60及72 h的疼痛程度数字量表(NRS)评分均低于对照组(均P<0.05);治疗后,观察组患者的NGAL、CRP、IL-6、IL-8水平均低于对照组(均P<0.05);观察组的并发症发生率低于对照组(6.52%vs.22.50%,P<0.05)。结论无管化微创PCNL治疗嵌顿性输尿管上段结石的疗效显著,可缓解患者疼痛程度,降低炎性因子水平和并发症发生率,且不损伤肾脏。
Objective To study the clinical effects of tubeless minimally invasive percutaneous nephrolithotomy(PCNL)in treatment of impacted upper ureteral calculi.Methods Clinical data of 86 patients with impacted upper ureteral calculi treated in the Fuxin mining general hospital of Liaojian group hospital from January 2017 to January 2020 were retrospectively analyzed.The patients were divided into control group(40 cases)and observation group(46 cases)according to the treatment methods.The control group was treated with minimally invasive PCNL,and the observation group was treated with tubeless minimally invasive PCNL.The operation time,intraoperative blood loss,hospital stay,pain degree,stone clearance rate,renal function[blood urine nitrogen(BUN),creatinine(Scr),neutrophil gelatinase-associated lipocalin(NGAL)],inflammatory factors[C-reactive protein(CRP),interleukin-6(IL-6),interleukin IL-8(IL-8)]and incidence of complications were compared between the two groups.Results The operation time and hospital stay of observation group were shorter than those of control group,and the intraoperative blood loss was less than that of control group(P<0.05).NRS scores of observation group at 48,60 and 72 h after operation were lower than those of control group(all P<0.05).NGAL,CRP,IL-6 and IL-8 levels inobservation group after treatment were lower than those in control group(all P<0.05).The incidence of complications in observation group was lower than that in control group(6.52%vs.22.50%)(P<0.05).There was no statistically significant difference in stone clearance rate between the two groups(P>0.05).Conclusions Tubelessminimally invasive PCNL is markedly effect in treatment of patients with impacted upper ureteral calculi,which can relieve pain,reduce levels of inflammatory factors and the incidence of complications,without damage to the kidney.
作者
张博
程大鹏
韦怡光
Zhang Bo;Cheng Dapeng;Wei Yiguang(Department of Urology,Fuxin Mining General Hospital of Liaojian Group,Fuxin 123000,China;Department of Urology,Tianlin People's Hospital,Baise City,Guangxi Province,Baise 533300,China)
出处
《国际泌尿系统杂志》
2022年第3期426-429,共4页
International Journal of Urology and Nephrology
关键词
输尿管结石
肾造口术
经皮
最小侵入性外科手术
Ureteral Calculi
Nephrostomy,Percutaneous
Minimally Invasive Surgical Procedures
