摘要
目的探讨输尿管软镜碎石术(FURL)结合可视穿刺式微创经皮肾镜取石术(MPCNL)治疗肾盏憩室结石的临床效果,并对术后结石残余的影响因素进行logistic回归分析。方法选取2019年7月至2021年2月在本院收治的118例肾盏憩室结石患者作为研究对象。按照随机数字表法将患者分成对照组和研究组,每组各59例。对照组采用可视穿刺式MPCNL治疗,研究组采用可视穿刺式MPCNL结合FURL治疗。观察并比较两组患者的手术时间、术中出血量、结石清除率、术后留置肾造瘘管时间、术后住院时间以及并发症发生情况,采用logistic回归分析影响结石残余的独立危险因素。结果研究组的手术时间、术中出血量、结石清除率、术后留置肾造瘘管时间以及术后住院时间等指标均优于对照组,差异均有统计学意义(均P<0.001)。研究组的术后并发症总发生率低于对照组[11.86%(7/59)vs.32.20%(19/59),P<0.05]。logistic回归分析结果显示,结石最大截面积、结石累计盏数、既往结石手术治疗史、先天解剖结构异常、肾功能不全、术中出血均为影响肾盏憩室结石术后结石残余的独立危险因素(均P<0.05)。结论相较于单一可视穿刺式MPCNL,FURL结合可视穿刺式MPCNL治疗肾盏憩室结石的疗效更好,安全性更高。结石最大截面积、结石累计盏数、既往结石手术治疗史、先天解剖结构异常、肾功能不全以及术中出血均是影响肾盏憩室结石术后结石残余的重要因素。
Objective To investigate the clinical effect of flexible ureteroscopic lithotripsy(FURL)combined with visual puncture micro-invasive percutaneous nephrolithotomy(MPCNL)in the treatment of calyceal diverticulum calculi,and to analyze the influencing factors of postoperative calculi residual by logistic regression.MethodsA total of 118 patients with calyceal diverticulum calculi admitted to our hospital from July 2019 to February 2021 were selected as the research subjects.According to the random number table method,the patients were divided into a control group and a research group,with 59 cases in each group.The control group was treated with visual puncture MPCNL,and the study group was treated with visual puncture MPCNL and FURL.The operation time,intraoperative blood loss,stone clearance rate,postoperative indwelling nephrostomy tube time,postoperative hospital stay and the incidence of complications were observed and compared between the two groups,and the independent risk factors of residual stones were analyzed by logistic regression.Results The operation time,intraoperative blood loss,stone clearance rate,postoperative indwelling nephrostomy tube time,and postoperative hospital stay in the study group were better than those in the control group,and the dfferences were statistically significant(all P<0.001).The total incidence of postoperative complications in the study group was lower than that in the control group[11.86%(7/59)vs.32.20%(19/59),P<0.05].The results of logistic regression analysis showed that the largest crosssectional area of calculi,the cumulative number of calculi,the history of previous calculi surgery,abnormal congenital anatomical structure,renal insufficiency,and intraoperative bleeding were all independent risk factors for residual calculi after calyceal diverticulum calculi surgery(P<0.05).Conclusions Compared with single visual puncture MPCNL,FURL combined with visual puncture MPCNL has better curative effect and higher safety in the treatment of calyceal diverticulum calculi.The la
作者
彭永明
纪海霞
Peng Yongming;Ji Haixia(Department of Urology,the Sixth People's Hospital of Nantong City,Nantong 226000,China;Department of Internal Medicine,the Sixth People's Hospital of Nantong City,Nantong 226000,China)
出处
《国际泌尿系统杂志》
2022年第6期1026-1030,共5页
International Journal of Urology and Nephrology
关键词
肾结石
输尿管镜检查
肾造口术
经皮
碎石术
Kidney Calculi
Ureteroscopy
Nephrostomy,Percutaneous
Lithotripsy
