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经皮肾镜与输尿管软镜治疗肾结石患者的临床疗效比较(1)
http://www.100md.com 2020年7月15日 《中国现代医生》 202020
     [摘要] 目的 探討经皮肾镜与输尿管软镜治疗肾结石患者的临床疗效。 方法 选择我院于2017年8月~2019年8月收治的83例患者随机分为观察组(n=42)和对照组(n=41)。对照组予经皮肾镜碎石术,观察组予输尿管软镜碎石术。观察比较两组的手术时间、术中出血量、尿管留置时间及住院时间等一般情况、肾功能指标、结石清除率及并发症发生情况。 结果 观察组手术时间(83.56±8.41) min,多于对照组的(68.47±7.34) min;术中出血量(19.38±2.77) mL、尿管留置时间(3.82±0.89) d、住院时间(4.53±0.78) d,各项指标均显著优于对照组;肌酐(58.37±9.45) μmol/L、血清胱抑素(0.67±0.14) mg/L、尿素氮(5.93±1.12) mmol/L,各项指标均明显低于对照组的(81.56±12.89) μmol/L、(1.09±0.26) mg/L和(8.84±1.65) mmol/L,各项比较结果差异有统计学意义(P<0.05)。观察组结石清除率92.86%,对照组结石清除率97.56%;两组比较差异无统计学意义(P>0.05);观察组的并发症发生率为4.76%,低于对照组的24.39%,差异有统计学意义(P<0.05)。 结论 经皮肾镜与输尿管软镜碎石术治疗肾结石患者疗效相当,输尿管软镜可明显减少术中出血,缩短尿管留置时间及住院时间,改善肾功能,安全性高,优势明显。

    [关键词] 经皮肾镜;输尿管软镜;肾结石;碎石;肾功能

    [Abstract] Objective To explore the clinical effect of percutaneous nephroscopy and ureteroscopy in the treatment of patients with kidney stones. Methods In this paper, 83 patients admitted to our hospital from August 2017 to August 2019 were randomly divided into an observation group (n=42) and a control group (n=41). The control group was given percutaneous nephrolithotripsy, and the observation group was given soft ureter lithotripsy. The general conditions including operation time, intraoperative blood loss, urinary indwelling time and hospitalization time, renal function indexes, stone clearance rate and complications of the two groups were observed and compared. Results The operation time of the observation group was(83.56±8.41) min, more than that(68.47±7.34) min of the control group. The intraoperative blood loss(19.38±2.77) ml, the urinary indwelling time (3.82±0.89) d, and the hospital stay (4.53±0.78) d in the observation group were significantly better than those of the control group(P=0.000). The creatinine (58.37±9.45) μmol/L, the serum cystatin(0.67±0.14) mg/L, and the urea nitrogen(5.93±1.12) mmol/L in the observation group were significantly lower than those(81.56±12.89) μmol/L, (1.09±0.26) mg/L and (8.84±1.65) mmol/L of the control group. The stone free rate in the observation group was 92.86%, and the stone removal rate in the control group was 97.56%. There was no statistical difference in the stone free ratebetween theobservation group and control group(P>0.05). The complication rate of the observation group was 4.76%, which was lower than that(24.39%) of the control group(P<0.05). Conclusion Percutaneous nephroscopy and soft ureteroscopy lithotripsy are equally effective in the treatment of patients with kidney stones, with a high stone clearance rate. Soft ureteroscopy can significantly reduce intraoperative bleeding, shorten ureter retention time and hospital stay, improve renal function, which has high safetyand obvious advantages., 百拇医药(薛长辉 王永顺)
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