摘要
目的:探讨微通道经皮肾镜取石术联合负压吸引清石鞘在复杂性肾结石治疗中的应用价值。方法:选取我院2018年1月~2019年1月收治的复杂性肾结石患者80例,根据随机数字表法将其分为观察组和对照组,每组40例,对照组患者采取微通道经皮肾镜取石术,观察组患者采取微通道经皮肾镜取石术联合负压吸引清石鞘,对比两组患者的治疗效果。结果:观察组患者的手术时间、术中出血量、住院时间明显优于对照组;两组患者手术前肾功能(Vmax、尿素氮、血肌酐)、肾血流指标(RI、S/D)对比无统计学差异,手术后,两组患者的尿素氮、血肌酐指标对比无统计学差异,观察组患者的Vmax、RI、S/D均明显优于对照组;观察组患者二次手术率和尿源性脓毒血症的发生率显著低于对照组,观察组结石清除率显著高于对照组,两组腹腔脏器损伤、术后出血、腹膜后血肿和感染的发生率比较无统计学差异。结论:微通道经皮肾镜取石术联合负压吸引清石鞘在复杂性肾结石治疗中具有显著的应用价值,清石率高、手术时间短,术中出血量少,二次手术率低,并发症少,有利于患者术后恢复,值得临床推广实施,但是在临床实际工作中,还需结合患者的实际情况选择针对性的手术方式,以进一步保证治疗效果。
Objective To investigate the application value of micro-channel percutaneous nephrolithotomy combined with negative pressure aspiration to clear the sheath in the treatment of complex renal calculi.Methods Eighty patients with complicated kidney stones who were treated in our hospital from January 20 to January 2019 were selected.According to the random number table method,they were divided into study group and control group,40 cases in each group.Patients in the control group received microchannel percutaneous nephrolithotomy,while those in the observation group received microchannel percutaneous nephrolithotomy combined with negative pressure suction to remove the stone sheath.The therapeutic effects of the two groups of patients were compared.Results The operation time,intraoperative bleeding volume and hospitalization time of the study group were significantly better than those of the control group.There was no significant difference in renal function(Vmax,urea nitrogen,serum creatinine)and renal blood flow index(RI,S/D)between the two groups before operation.After operation,there was no significant difference in urea nitrogen and serum creatinine between the two groups.Vmax,RI and S/D of the patients were significantly better than those of the control group;The rate of secondary surgery and the incidence of urinary sepsis in the observation group were significantly lower than those in the control group,Stone clearance rate in the observation group was significantly higher than that in the control group,and there were no statistically significant differences between the two groups in peritoneal organ injury,postoperative bleeding,retroperitoneal hematoma and infection.Conclusion Microchannel percutaneous nephrolithotomy combined with negative pressure aspiration to clear the sheath has significant application value in the treatment of complex renal calculi.High stone removal rate,short operation time,less intraoperative blood loss,low secondary operation rate,less complications,and the recovery of patients can be improved.It is worthy of clinical popularization and implementation.However,in the actual clinical work,it is necessary to select a specific operation mode according to the actual situation of patients.To further ensure the therapeutic effect.
作者
刘聪
陈冰
周文杰
胡振兴
Liu Cong;Chen Bing;Zhou Wen-jie;Hu Zhen-xing(Department of Urology Surgery,Leshan Shizhong District People’s Hospital,Leshan 614000,China)
出处
《湖南师范大学学报（医学版）》
2020年第3期14-17,共4页
Journal of Hunan Normal University(Medical Sciences)
基金
国家自然科学基金项目(30972894)
作者简介
通讯作者:刘聪,E-mail:leshan_197310@163.com
