微创经皮肾镜取石术对上尿路结石患者的临床治疗分析
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摘要
目的探讨微创经皮肾镜取石术对上尿路结石患者的临床治疗。方法用"随机法"将方便选取的该院76例上尿路结石患者均分为对照组和观察组两组(2016年6月—2018年8月),其中对照组予以传统的输尿管切开取石术治疗,观察组采用微创经皮肾镜取石术治疗,对比两组患者的治疗情况、手术前后疼痛情况及术后并发症发生情况。结果观察组患者术中出血量(72.12±16.85)mL要比对照组(152.28±32.11)mL的低,手术时间(70.84±24.16)min、血尿转清时间(2.39±0.59)d和住院时间(6.24±1.81)d短于对照组(108.36±32.29)min、(3.41±0.86)d、(10.53±2.6)d (t=13.627、5.724、6.029、8.177,P<0.05),一次性结石清除率(97.37%)明显高于对照组(81.58%)(χ~2=5.029,P=0.025),术后1、3和5 d疼痛改善情况(4.89±1.05)分、(3.52±0.84)分、(1.81±0.52)分明显优于对照组(5.85±1.23)分、(4.22±1.02)分、(2.76±0.71)分(t=4.659、4.266、6.654,P=0.001、0.002、0.001),术后并发症总发生率(7.89%)明显低于对照组(26.32%)(χ~2=4.547,P=0.033 <0.05)。结论微创经皮肾镜取石术在治疗上尿路结石患者上具有较高的治疗效果,能有效减少对患者的伤害,降低患者的疼痛感,减少术后不良反应的出现,值得推广。
Objective To investigate the clinical treatment of minimally invasive percutaneous nephrolithotomy for patients with upper urinary tract stones. Methods With the method of "random", 76 cases of urinary stones of our hospital were convenient selected and divided into control group and observation group(from June 2016 to August 2018). The control group was treated with traditional ureterotomy and stone removal. The observation group was treated with minimally invasive percutaneous nephrolithotomy. Compared surgical pain and postoperative complications of the two groups before and after treatment. Results The intraoperative blood loss(72.12±16.85)mL in the observation group was lower than that in the control group(152.28±32.11)mL. The operation time(70.84±24.16)min, the hematuria clearing time(2.39±0.59)d and the hospitalization time(6.24±1.81)d were shorter than those in the control group(108.36±32.29)min,(3.41±0.86)d,(10.53±2.68)d(t=13.627, 5.724, 6.029, 8.177, P<0.05). One-time stone removal rate(97.37%) was significantly higher than that of the control group(81.58%)(χ~2=5.029, P=0.025). Pain improvement in one day, three days and five days after surgery(4.89±1.05)points,(3.52 ±0.84)points(1.81 ±0.52)points was significantly better than the control group(5.85 ±1.23)points,(4.22 ±1.02)points,(2.76±0.71)points(t=4.659, 4.266, 6.654, P=0.001, 0.002, 0.001). The total incidence of postoperative complications(7.89%)was significantly lower than the control group(26.32%)(χ~2=4.547, P=0.033<0.05). Conclusion Minimally invasive percutaneous nephrolithotomy has a high therapeutic effect on patients with upper urinary tract stones, which can effectively reduce the injury to patients, the pain of patients, and the occurrence of postoperative adverse reactions, which is worthy of promotion.
Objective To investigate the clinical treatment of minimally invasive percutaneous nephrolithotomy for patients with upper urinary tract stones. Methods With the method of "random", 76 cases of urinary stones of our hospital were convenient selected and divided into control group and observation group(from June 2016 to August 2018). The control group was treated with traditional ureterotomy and stone removal. The observation group was treated with minimally invasive percutaneous nephrolithotomy. Compared surgical pain and postoperative complications of the two groups before and after treatment. Results The intraoperative blood loss(72.12±16.85)mL in the observation group was lower than that in the control group(152.28±32.11)mL. The operation time(70.84±24.16)min, the hematuria clearing time(2.39±0.59)d and the hospitalization time(6.24±1.81)d were shorter than those in the control group(108.36±32.29)min,(3.41±0.86)d,(10.53±2.68)d(t=13.627, 5.724, 6.029, 8.177, P<0.05). One-time stone removal rate(97.37%) was significantly higher than that of the control group(81.58%)(χ~2=5.029, P=0.025). Pain improvement in one day, three days and five days after surgery(4.89±1.05)points,(3.52 ±0.84)points(1.81 ±0.52)points was significantly better than the control group(5.85 ±1.23)points,(4.22 ±1.02)points,(2.76±0.71)points(t=4.659, 4.266, 6.654, P=0.001, 0.002, 0.001). The total incidence of postoperative complications(7.89%)was significantly lower than the control group(26.32%)(χ~2=4.547, P=0.033<0.05). Conclusion Minimally invasive percutaneous nephrolithotomy has a high therapeutic effect on patients with upper urinary tract stones, which can effectively reduce the injury to patients, the pain of patients, and the occurrence of postoperative adverse reactions, which is worthy of promotion.
引文
[1]梁小绿.微创经皮肾镜取石术在上尿路结石中的应用[J].临床医学,2014,34(1):61-62.
[2]李巧星.微创经皮肾镜取石术治疗上尿路结石并重度肾积水的疗效探讨[J].中外医疗,2016,35(2):28-29.
[3]刘宏学.微创经皮肾镜取石术治疗上尿路结石并重度肾积水的疗效观察[J].中国医药指南,2017,15(22):125-126.
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[5]蒋华国.微创经皮肾镜取石术治疗上尿路结石患者的临床分析[J].当代医学,2018,24(12):148-149.
[6]任鹰.微创经皮肾镜取石术治疗上尿路结石并重度肾积水的疗效分析[J].中国实用医药,2018,13(7):49-50.
[7]乔光华.微创经皮肾镜取石术治疗上尿路结石合并感染的临床分析[J].数理医药学杂志,2017,30(12):1802-1803.
[8]钱卫良,陈永良.上尿路结石患者采用经皮肾镜取石术临床疗效观察[J].浙江创伤外科,2018,23(2):395-397.
[9] Kiyuna, Tomohiko,An, et al.“Black particles”, the major colonizers on the ceiling stone of the stone chamber interior of the Kitora Tumulus, Japan, are the bulbilliferous basidiomycete fungus Burgoa anomala[J].Mycoscience,2015,56(3):293-300.
[10]张启飞,吴保忠,李文钊,等.超声引导下超微通道经皮肾镜取石术治疗上尿路结石的临床应用[J].中国医学创新,2018, 15(11):54-57.
[11]胡国森.微创经皮肾镜取石术治疗上尿路结石合并重度肾积水患者的临床效果分析[J].河南医学研究,2017,26(13):2363-2364.
[12]邱兵勇.上尿路结石患者微创经皮肾镜取石术后血清及尿液炎性应激指标水平的变化[J].临床医学研究与实践,2018,3(16):55-56.
[13]李灿永.经皮微创肾镜碎石术对上尿路结石患者并发症及疼痛程度的影响[J].国际泌尿系统杂志,2017,37(5):688-691.
[2]李巧星.微创经皮肾镜取石术治疗上尿路结石并重度肾积水的疗效探讨[J].中外医疗,2016,35(2):28-29.
[3]刘宏学.微创经皮肾镜取石术治疗上尿路结石并重度肾积水的疗效观察[J].中国医药指南,2017,15(22):125-126.
[4]王胜勇.用微创经皮肾镜取石术治疗上尿路结石合并重度肾积水的效果分析[J].当代医药论丛,2018,16(2):134-135.
[5]蒋华国.微创经皮肾镜取石术治疗上尿路结石患者的临床分析[J].当代医学,2018,24(12):148-149.
[6]任鹰.微创经皮肾镜取石术治疗上尿路结石并重度肾积水的疗效分析[J].中国实用医药,2018,13(7):49-50.
[7]乔光华.微创经皮肾镜取石术治疗上尿路结石合并感染的临床分析[J].数理医药学杂志,2017,30(12):1802-1803.
[8]钱卫良,陈永良.上尿路结石患者采用经皮肾镜取石术临床疗效观察[J].浙江创伤外科,2018,23(2):395-397.
[9] Kiyuna, Tomohiko,An, et al.“Black particles”, the major colonizers on the ceiling stone of the stone chamber interior of the Kitora Tumulus, Japan, are the bulbilliferous basidiomycete fungus Burgoa anomala[J].Mycoscience,2015,56(3):293-300.
[10]张启飞,吴保忠,李文钊,等.超声引导下超微通道经皮肾镜取石术治疗上尿路结石的临床应用[J].中国医学创新,2018, 15(11):54-57.
[11]胡国森.微创经皮肾镜取石术治疗上尿路结石合并重度肾积水患者的临床效果分析[J].河南医学研究,2017,26(13):2363-2364.
[12]邱兵勇.上尿路结石患者微创经皮肾镜取石术后血清及尿液炎性应激指标水平的变化[J].临床医学研究与实践,2018,3(16):55-56.
[13]李灿永.经皮微创肾镜碎石术对上尿路结石患者并发症及疼痛程度的影响[J].国际泌尿系统杂志,2017,37(5):688-691.