经皮肾镜超声联合钬激光气压弹道碎石治疗复杂性肾结石的临床疗效及对患者肾功能的影响
|
摘要
目的探讨经皮肾镜超声联合钬激光气压弹道碎石治疗复杂性肾结石的临床疗效及对患者肾功能的影响。方法选择复杂性肾结石患者100例,随机分为观察组和对照组各50例。观察组行经皮肾镜超声联合钬激光气压弹道碎石治疗;对照组行开放性肾切开治疗。对比两组治疗疗效以及不同治疗方案对于患者肾功能的影响。结果观察组术中出血量及术后住院时间均显著少于对照组,结石清除率高于对照组,差异均有统计学意义(均P<0.05)。观察组患者术后并发症发生率显著低于对照组,差异均有统计学意义(均P<0.05)。两组在行不同术式进行治疗后,肾盂集合系统分离指数,肌酐以及尿素氮均有所下降,但是观察组下降程度更加明显,差异具有统计学意义(P<0.05)。结论经皮肾镜超声联合钬激光气压弹道碎石治疗复杂性肾结石疗效较好,并且能够有效缓解患者肾功能水平,安全性较高,值得临床推荐使用。
Objective To study the clinical effect of percutaneous nephrolithotomy combined with holmium laser lithotripsy for the treatment of complex renal calculi and the effect on renal function in patients.Methods Total of100 cases of complex renal calculi patients in the hospital were selected from May in 2012-March in 2014,and which were randomly divided into observation group(50cases)and control group(50cases).The observation group underwent percutaneous nephrolithotomy combined with holmium laser lithotripsy treatment.The control group underwent extracorporeal shock wave lithotripsy.Results In the observation group of volume of hemorrhage and postoperative hospitalization time was significantly less than the control group,the stone free rate was higher than the control group(P<0.05).The observation group of patients,the incidence of postoperative complications was significantly lower than the control group(P<0.05).The two group underwent different surgical treatment,the renal pelvis separation of the collection system index,creatinine and urea nitrogen were decreased,but the observation group decreased more significantly,and there were statistical significantly differences in two groups(P<0.05).Conclusion Percutaneous nephrolithotomy combined with holmium laser lithotripsy for the treatment of complex renal calculi curative effect is better,and can effectively alleviate the level of renal function of patients,high safety,and is worthy of clinical use recommended.
Objective To study the clinical effect of percutaneous nephrolithotomy combined with holmium laser lithotripsy for the treatment of complex renal calculi and the effect on renal function in patients.Methods Total of100 cases of complex renal calculi patients in the hospital were selected from May in 2012-March in 2014,and which were randomly divided into observation group(50cases)and control group(50cases).The observation group underwent percutaneous nephrolithotomy combined with holmium laser lithotripsy treatment.The control group underwent extracorporeal shock wave lithotripsy.Results In the observation group of volume of hemorrhage and postoperative hospitalization time was significantly less than the control group,the stone free rate was higher than the control group(P<0.05).The observation group of patients,the incidence of postoperative complications was significantly lower than the control group(P<0.05).The two group underwent different surgical treatment,the renal pelvis separation of the collection system index,creatinine and urea nitrogen were decreased,but the observation group decreased more significantly,and there were statistical significantly differences in two groups(P<0.05).Conclusion Percutaneous nephrolithotomy combined with holmium laser lithotripsy for the treatment of complex renal calculi curative effect is better,and can effectively alleviate the level of renal function of patients,high safety,and is worthy of clinical use recommended.
引文
[1]鲁栋梁,崔曙,邓显忠,等.输尿管管路封堵器联合钬激光治疗输尿管中上段结石32例效果分析[J].重庆医科大学学报,2014,39(6):842-844.
[2]郑会忠.输尿管镜钬激光碎石术后泌尿系统感染的细菌分布及药敏分析[J].重庆医学,2014,43(7):850-852.
[3]庄其辉,朱黄辉,黄晓东.输尿管镜钬激光碎石治疗输尿管结石[J].江苏医药,2014,40(11):1328-1329.
[4]王磊,徐学军,尹海军,等.微创经皮肾镜钬激光碎石术与开放性肾切开取石术治疗复杂性肾结石临床疗效比较[J].中国内镜杂志,2014,20(1):72-75.
[5]曾传兴,史南,沈仕兴.两种经输尿管镜碎石术治疗泌尿系结石的对比分析[J].重庆医学,2013,42(31):3812-3814.
[6]Mutlu B,Ilbey YO,Bitkin A,et al.Abdominoscrotal hydrocele with bilateral hydronephrosis in an adult:case report[J].Archivio italiano di urologia,andrologia:organo ufficialAssociazione ricerche in urologia,2013,85(1):44-46.
[7]肖仁举,陈伟,王时龙.经皮肾镜超声气压弹道碎石清石术治疗肾结石及输尿管上段结石(附217例报告)[J].贵州医药,2010,34(4)314-316.
[8]郭环宇,赵谦,席兰,等.不同体位多镜联合治疗复杂性肾结石[J].现代泌尿外科杂志,2014,19(1):33-35.
[9]李先承,李秀男,郑伟,等.超声引导下微创经皮肾镜治疗上尿路结石152例临床分析[J].大连医科大学学报,2014,2(1):137-139.
[10]许景东,陈冠峰,耿杰,等.经皮肾镜下气压弹道联合超声碎石与钬激光碎石治疗肾结石的对比研究[J].临床外科杂志,2011,19(8):577-577.
[11]Hadj-Moussa M,Nepple KG,Brown JA.Comparison of a single center,academic surgeon real-world experience with three percutaneous nephrolithotomy lithotripters[J].Can J Urol.2014Oct;21(5):7470-7474.
[12]Assimos DG.Re:comparison between spinal and general anesthesia in percutaneous nephrolithotomy[J].J Urol,2014,192(5):1458.
[13]Aydogdu O,Karakose A,Celik O,et al.Recent management of urinary stone disease in a pediatric population[J].World J Clin Pediatr,2014,3(1):1-5.
[14]Patil NA,Kundargi VS,Patil SB,et al.Conservative management of accidental gall bladder puncture during percutaneous nephrolithotomy[J].Cent European J Urol,2014,67(2):191-192.
[2]郑会忠.输尿管镜钬激光碎石术后泌尿系统感染的细菌分布及药敏分析[J].重庆医学,2014,43(7):850-852.
[3]庄其辉,朱黄辉,黄晓东.输尿管镜钬激光碎石治疗输尿管结石[J].江苏医药,2014,40(11):1328-1329.
[4]王磊,徐学军,尹海军,等.微创经皮肾镜钬激光碎石术与开放性肾切开取石术治疗复杂性肾结石临床疗效比较[J].中国内镜杂志,2014,20(1):72-75.
[5]曾传兴,史南,沈仕兴.两种经输尿管镜碎石术治疗泌尿系结石的对比分析[J].重庆医学,2013,42(31):3812-3814.
[6]Mutlu B,Ilbey YO,Bitkin A,et al.Abdominoscrotal hydrocele with bilateral hydronephrosis in an adult:case report[J].Archivio italiano di urologia,andrologia:organo ufficialAssociazione ricerche in urologia,2013,85(1):44-46.
[7]肖仁举,陈伟,王时龙.经皮肾镜超声气压弹道碎石清石术治疗肾结石及输尿管上段结石(附217例报告)[J].贵州医药,2010,34(4)314-316.
[8]郭环宇,赵谦,席兰,等.不同体位多镜联合治疗复杂性肾结石[J].现代泌尿外科杂志,2014,19(1):33-35.
[9]李先承,李秀男,郑伟,等.超声引导下微创经皮肾镜治疗上尿路结石152例临床分析[J].大连医科大学学报,2014,2(1):137-139.
[10]许景东,陈冠峰,耿杰,等.经皮肾镜下气压弹道联合超声碎石与钬激光碎石治疗肾结石的对比研究[J].临床外科杂志,2011,19(8):577-577.
[11]Hadj-Moussa M,Nepple KG,Brown JA.Comparison of a single center,academic surgeon real-world experience with three percutaneous nephrolithotomy lithotripters[J].Can J Urol.2014Oct;21(5):7470-7474.
[12]Assimos DG.Re:comparison between spinal and general anesthesia in percutaneous nephrolithotomy[J].J Urol,2014,192(5):1458.
[13]Aydogdu O,Karakose A,Celik O,et al.Recent management of urinary stone disease in a pediatric population[J].World J Clin Pediatr,2014,3(1):1-5.
[14]Patil NA,Kundargi VS,Patil SB,et al.Conservative management of accidental gall bladder puncture during percutaneous nephrolithotomy[J].Cent European J Urol,2014,67(2):191-192.