肾结石经皮肾镜碎石取石术与开放手术的比较
|
摘要
目的比较经皮肾镜碎石取石术(PCNL)与开放手术治疗肾结石的临床效果与安全性。方法选取2016年1月至2017年10月收治的63例肾结石患者,按手术方法分为PCNL组33例和开放组30例。对比两组患者的手术前后血红蛋白变化(tHb),术后C反应蛋白(CRP)及肌酐(Cr)水平,并对手术时间、住院费用、住院时间、结石清除率及术后并发症发生情况进行分析。结果 PCNL组tHb、CRP、Cr水平低于开放组,手术时间短于开放组,差异有统计学意义(P<0.01);两组住院时间及住院费用比较差异无统计学意义(P>0.05)。PCNL组结石取净率明显高于开放组(87.88%vs 66.67%,χ~2=4.091,P=0.043)。PCNL组并发症发生率低于开放组(6.06%vs 30.00%,χ~2=6.249,P=0.012)。结论肾结石患者采取PCNL治疗,其各项手术指标优于开放性手术,且结石取净率较高,并发症发生率较低。
Objective To compare the clinical efficacy and safety of percutaneous nephrolithotripsy(PCNL) and open surgery in the treatment of renal calculi.Methods Sixty-three patients with renal calculi admitted to hospital from January 2016 to October 2017 were enrolled and divided into PCNL group(n=33) and open group(n=30)according to the operation method.The changes of total hemoglobin(tHb),C-reactive protein(CRP) and creatinine(Cr) levels before and after operation were compared between two groups.The operation time,hospitalization cost,hospitalization time,stone clearance rate and complications were observed and analyzed.Results The levels of tHb,CRP and Cr in PCNL group were lower than those in open group,and the operation time was shorter than that in open group(P<0.01).There were no significant differences in hospitalization time and cost between two groups(P>0.05).The stone-clearing rate in PCNL group was significantly higher than that in open group(87.88% vs 66.67%,χ~2=4.091,P=0.043),and the incidence of complications was lower than that in open group(6.06% vs 30.00%,χ~2=6.249,P=0.012).Conclusion In the treatment of renal calculi,PCNL has better curative effects compared with open surgery with higher stone-clearing rate and lower incidence of complications.
Objective To compare the clinical efficacy and safety of percutaneous nephrolithotripsy(PCNL) and open surgery in the treatment of renal calculi.Methods Sixty-three patients with renal calculi admitted to hospital from January 2016 to October 2017 were enrolled and divided into PCNL group(n=33) and open group(n=30)according to the operation method.The changes of total hemoglobin(tHb),C-reactive protein(CRP) and creatinine(Cr) levels before and after operation were compared between two groups.The operation time,hospitalization cost,hospitalization time,stone clearance rate and complications were observed and analyzed.Results The levels of tHb,CRP and Cr in PCNL group were lower than those in open group,and the operation time was shorter than that in open group(P<0.01).There were no significant differences in hospitalization time and cost between two groups(P>0.05).The stone-clearing rate in PCNL group was significantly higher than that in open group(87.88% vs 66.67%,χ~2=4.091,P=0.043),and the incidence of complications was lower than that in open group(6.06% vs 30.00%,χ~2=6.249,P=0.012).Conclusion In the treatment of renal calculi,PCNL has better curative effects compared with open surgery with higher stone-clearing rate and lower incidence of complications.
引文
[1] Ziemba JB,Matlaga BR.Epidemiology and economics of nephrolithiasis[J].Investig Clin Urol,2017,58(5):299-306.
[2] 刘光香,费夏玮,张士伟,等.X线联合B超定位下微创经皮肾镜碎石术治疗复杂性肾结石286例分析[J].现代泌尿外科杂志,2015,20(1):18-20.
[3] 吴名浪.经皮肾镜碎石取石术与输尿管软镜钬激光碎石术治疗肾结石的效果分析[J].中外医学研究,2018,16(13):158-160.
[4] 唐浩,陈松宁,杨水华.经皮肾镜联合输尿管软镜钬激光碎石术治疗复杂性肾结石的临床疗效分析[J].安徽医药,2016,20(2):341-343.
[5] Yang YH,Wen YC,Chen KC,et al.Ultrasound-guided versus fluoroscopy-guided percutaneous nephrolithotomy:a systematic review and meta-analysis[J].World J Urol,2018.[Epub ahead of print]
[6] Wang Q,Guo JC,Hu HL,et al.Rigid ureteroscopic lithotripsy versus percutaneous nephrolithotomy for large proximal ureteral stones:a meta-analysis[J].PLoS One,2017,12(2):e0171478.
[7] Mourmouris P,Berdempes M,Markopoulos T,et al.Patient positioning during percutaneous nephrolithotomy:what is the current best practice?[J].Res Rep Urol,2018,10:189-193.
[8] Zanetti SP,Talso M,Palmisano F,et al.Comparison among the available stone treatment techniques from the first European Association of Urology Section of Urolithiasis(EULIS) Survey:do we have a Queen?[J].PLoS One,2018,13(11):e0205159.
[9] He Z,Tang F,Lei H,et al.Risk factors for systemic inflammatory response syndrome after percutaneous nephrolithotomy[J].Prog Urol,2018,28(12):582-587.
[10] Lorenzo Soriano L,Ordaz Jurado DG,Pérez Ardavín J,et al.Predictive factors of infectious complications in the postoperative of percutaneous nephrolithotomy[J].Actas Urol Esp,2018.[Epub ahead of print]
[11] Kati B,Buyukfirat E,Pelit ES,et al.Percutaneous nephrolithotomy with different temperature irrigation and effects on surgical complications and anesthesiology applications[J].J Endourol,2018,32(11):1050-1053.
[12] 吴荣佩,李晓飞,郭颖,等.肾盂内高压灌流对肾单位结构影响的实验研究[J].中华泌尿外科杂志,2006,27(3):162-165.
[2] 刘光香,费夏玮,张士伟,等.X线联合B超定位下微创经皮肾镜碎石术治疗复杂性肾结石286例分析[J].现代泌尿外科杂志,2015,20(1):18-20.
[3] 吴名浪.经皮肾镜碎石取石术与输尿管软镜钬激光碎石术治疗肾结石的效果分析[J].中外医学研究,2018,16(13):158-160.
[4] 唐浩,陈松宁,杨水华.经皮肾镜联合输尿管软镜钬激光碎石术治疗复杂性肾结石的临床疗效分析[J].安徽医药,2016,20(2):341-343.
[5] Yang YH,Wen YC,Chen KC,et al.Ultrasound-guided versus fluoroscopy-guided percutaneous nephrolithotomy:a systematic review and meta-analysis[J].World J Urol,2018.[Epub ahead of print]
[6] Wang Q,Guo JC,Hu HL,et al.Rigid ureteroscopic lithotripsy versus percutaneous nephrolithotomy for large proximal ureteral stones:a meta-analysis[J].PLoS One,2017,12(2):e0171478.
[7] Mourmouris P,Berdempes M,Markopoulos T,et al.Patient positioning during percutaneous nephrolithotomy:what is the current best practice?[J].Res Rep Urol,2018,10:189-193.
[8] Zanetti SP,Talso M,Palmisano F,et al.Comparison among the available stone treatment techniques from the first European Association of Urology Section of Urolithiasis(EULIS) Survey:do we have a Queen?[J].PLoS One,2018,13(11):e0205159.
[9] He Z,Tang F,Lei H,et al.Risk factors for systemic inflammatory response syndrome after percutaneous nephrolithotomy[J].Prog Urol,2018,28(12):582-587.
[10] Lorenzo Soriano L,Ordaz Jurado DG,Pérez Ardavín J,et al.Predictive factors of infectious complications in the postoperative of percutaneous nephrolithotomy[J].Actas Urol Esp,2018.[Epub ahead of print]
[11] Kati B,Buyukfirat E,Pelit ES,et al.Percutaneous nephrolithotomy with different temperature irrigation and effects on surgical complications and anesthesiology applications[J].J Endourol,2018,32(11):1050-1053.
[12] 吴荣佩,李晓飞,郭颖,等.肾盂内高压灌流对肾单位结构影响的实验研究[J].中华泌尿外科杂志,2006,27(3):162-165.