摘要
目的比较经皮肾镜超声碎石术(percutaneous nephroscope ultrasonic lithotripsy,PNUL)与经皮肾镜钬激光碎石术(percutaneous nephrolithotomy,PCNL)治疗直径≤3 cm肾结石的疗效及分析术后并发症发生的危险因素。方法选择2018年1月—2022年9月江苏省邳州市人民医院收治的138例直径≤3 cm肾结石患者作为研究对象,随机分为对照组和观察组,各69例。对照组予以PCNL治疗,观察组予以PNUL治疗,比较两组围术期指标差异。根据所有患者并发症发生情况,分为并发症组(34例)与非并发症组(104例),使用单因素分析和多因素Logistic回归分析术后并发症的影响因素。结果观察组手术碎石时间、术后住院时间均短于对照组,术后血红蛋白下降发生率低于对照组,Ⅰ期手术结石清净率、Ⅱ期手术后总清净率均高于对照组,差异有统计学意义(P<0.05)。两组术后并发症发生率比较,差异无统计学意义(P>0.05)。经单因素和多因素Logistic回归分析均表明,年龄大(OR=7.763)、伴有共病(OR=3.947)、肾积水(OR=8.563)、术前肾功能差(OR=7.323)是直径≤3 cm肾结石患者术后发生并发症的独立危险因素(P<0.05)。结论与PCNL相比,PNUL治疗直径≤3 cm肾结石的疗效较好,具有手术碎石时间短、碎石效率高的优点,但二者并发症发生情况相近,术后并发症主要受年龄、伴有共病、肾积水、术前肾功能的影响,值得临床予以重视。
Objective To compare the efficacy of percutaneous nephroscope ultrasonic lithotripsy(PNUL)with percutaneous nephrolithotomy(PCNL)in the treatment of renal stones≤3 cm in diameter and analyze the risk factors for postoperative complications.Methods 138 patients with Kidney stone disease with a diameter of≤3 cm who were admitted to Pizhou People´s Hospital from January 2018 to September 2022 were selected as research objects and randomly divided into control group and observation group,with 69 cases in each group.The control group was treated with PCNL,while the observation group was treated with PNUL.The differences in perioperative indicators between the two groups were compared.According to the incidence of complications in all patients,they were divided into a complication group(34 cases)and a non complication group(104 cases),and the influencing factors of postoperative complications were analyzed using univariate analysis and multivariate logistic regression.Results The observation group had shorter surgical lithotripsy time and postoperative hospitalization time compared to the control group,the incidence of postoperative hemoglobin decrease was lower than that in the control group,and the stone clearance rate in stageⅠsurgery and the total clearance rate after stageⅡsurgery were both higher than those in the control group,and the difference was statistically significant(P<0.05).There was no statistically significant difference in the incidence of postoperative complications between the two groups(P>0.05).Both univariate and multifactorial logistic regression analyses showed that older age(OR=7.763),concomitant co-morbidity(OR=3.947),hydronephrosis(OR=8.563),and poor preoperative renal function(OR=7.323)were independent risk factors for postoperative complications in patients with renal stones≤3 cm in diameter(P<0.05).Conclusion Compared with PCNL,PNUL has a better effect in the treatment of kidney stone disease with a diameter of≤3 cm.It has the advantages of short operation time and high litho
作者
杨海生
YANG Haisheng(Department of Urology,Pizhou People´s Hospital,Pizhou,Jiangsu Province,221300 China)
出处
《系统医学》
2023年第8期15-19,共5页
Systems Medicine
关键词
肾结石
经皮肾镜
超声碎石术
术后并发症
Kidney stones
Percutaneous nephrolithoscopy
Ultrasonic lithotripsy
Postoperative complications
