摘要
目的探讨可拆卸式输尿管软镜联合微通道经皮肾镜治疗复杂性肾结石的疗效。方法选取河北省沧州中西医结合医院2017年3月至2019年2月复杂性肾结石患者150例,按抽签法分为A组、B组和C组,每组50例。A组患者采用可拆卸式输尿管软镜治疗,B组患者采用标准通道经皮肾镜治疗,C组患者采用可拆卸式输尿管软镜联合微通道经皮肾镜治疗。比较三组手术时间、术中出血量、住院时间,术后1和3个月结石清除率,术前2 h及术后1和3 d降钙素原(PCT)和C反应蛋白(CRP)。结果C组手术时间、术中出血量和住院时间明显少于A组和B组[(65.25±7.90)min比(99.73±8.52)和(96.11±9.92)min、(33.22±3.70)ml比(41.54±3.62)和(45.17±3.30)ml、(3.90±0.90)d比(4.77±1.17)和(5.70±1.19)d],术后1和3个月结石清除率明显高于A组和B组[94.00%(47/50)比80.00%(40/50)和82.00%(41/50)、98.00%(49/50)比84.00%(42/50)和86.00%(43/50)],差异均有统计学意义(P<0.05)。三组术前2 h PCT和CRP比较差异无统计学意义(P>0.05);C组术后1和3 d PCT和CRP明显低于A组和B组,差异有统计学意义(P<0.05)。A组与B组各指标比较差异均无统计学意义(P>0.05)。结论复杂性肾结石应用可拆卸式输尿管软镜联合微通道经皮肾镜治疗,可有效提高结石清除率,减少术中创伤,缩短治疗时间,促进恢复,治疗效果显著。
Objective To evaluate the efficacy of modular flexible ureteroscopy combined with minimally invasive percutaneous nephrolithotomy in patients with complex kidney stones.Methods From March 2017 to February 2019 in Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine,Hebei Province,150 patients with complex kidney stones were selected.The patients were divided into group A,group B and group C by sortition method with 50 cases each.Group A was treated with modular flexible ureteroscopy,group B was treated with standard percutaneous nephrolithotomy,and group C was treated with modular flexible ureteroscopy combined with minimally invasive percutaneous nephrolithotomy.The operation time,transoperative bleeding,hospitalization time,calculi clearance 1-and 3-month after operation,procalcitonin(PCT)and C-reactive protein(CRP)2 h before operation and 1 and 3 d after operation were compared among 3 groups.Results The operation time,transoperative bleeding and hospitalization time in group C were significantly lower than those in group A and group B:(65.25±7.90)min vs.(99.73±8.52)and(96.11±9.92)min,(33.22±3.70)ml vs.(41.54±3.62)and(45.17±3.30)ml,(3.90±0.90)d vs.(4.77±1.17)and(5.70±1.19)d,the calculi clearance 1-and 3-month after operation was significantly higher than that in group A and group B:94.00%(47/50)vs.80.00%(40/50)and 82.00%(41/50),98.00%(49/50)vs.84.00%(42/50)and 86.00%(43/50),and there were statistical differences(P<0.05).There were no statistical differences in PCT and CRP 2 h before operation among 3 groups(P>0.05);the PCT and CRP 1 and 3 d after operation in group C were significantly lower than those in group A and group B,and there were statistical differences(P<0.05).There were no statistical differences in all indexes between group A and group B(P>0.05).Conclusions Modular flexible ureteroscopy combined with minimally invasive percutaneous nephrolithotomy can effectively improve calculi clearance,reduce surgical trauma,shorten operation time,promote recovery,and have significant therapeutic effects in the treatment of complex kidney stones.
作者
顾鑫
景立伟
王岸迪
代永强
祝亚楠
赵建勇
Gu Xin;Jing Liwei;Wang Andi;Dai Yongqiang;Zhu Yanan;Zhao Jianyong(Department of Urology,Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine,Hebei Cangzhou 061001,China;Department of Operating Room,Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine,Hebei Cangzhou 061001,China;Department of Hand Microsurgery,Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine,Hebei Cangzhou 061001,China)
出处
《中国医师进修杂志》
2020年第9期840-844,共5页
Chinese Journal of Postgraduates of Medicine
基金
河北省卫生和计划生育委员会科研课题(20180973)。
关键词
肾结石
输尿管镜
微通道经皮肾镜
Kidney calculi
Ureteroscopes
Minimally invasive percutaneous nephrolithotomy
作者简介
通信作者:顾鑫,Email:guxin2078706@163.com,电话:0317-2078211。
