无管化微创经皮肾镜取石术后留置输尿管外支架对术后疼痛和感染的预防效果

摘要

Objective To study the effect of postoperative pain and infection after non-tubulization minimally invasive percutaneous nephrolithotom with indwelling ureteral stents. Methods Eighty stone patients, were selected and randomly divided into the external support group(n = 40)and double J tube group(n = 40). The patients in the external support group were treated with non-tubulization minimally invasive percutaneous nephrolithotomy and ureteral stents.The double J tube group was treated by percutaneous nephrolithotomy and the double J tube. The duration of surgery, intraoperative blood loss, hospital stay, postoperative infection, VAS score and survival quality score of the two groups were compared. Results There was no significant difference in operation time between the two groups(P＞ 0.05). Significantly less intraoperative blood loss, shorter hospital stay, and lower postoperative infection rate were observed in external support group(P ＜ 0.05). There was no significant difference in VAS score or survival quality score between the two groups before operation(P＞ 0.05), whereas significantly lower VAS score and better survival quality scores were revealed in external support group than double J tube group(P ＜ 0.05). Conclusion Non-tubulization minimally invasive percutaneous nephrolithotomy with postoperative stent provides little trauma, quick recovery, low postoperative infection rate and postoperative pain for patients.%目的 对照研究无管化微创经皮肾镜取石术后留置输尿管外支架预防术后疼痛和感染的效果.方法 选取无管化微创经皮肾镜取石术符合条件者80例作为研究, 将患者随机分为外支架组(n=40)和双J管组(n=40).外支架组患者采取无管化微创经皮肾镜取石术后留置输尿管外支架, 双J管组采取无管化微通道经皮肾镜取石术留置双J管, 比较两组患者手术时间、术中血红蛋白下降量、住院时间、术后感染情况以及两组患者术前术后的VAS评分和生存质量评分.结果 两组患者相比, 两组患者在手术时间比较差异无统计学意义(P＞ 0.05), 外支架组患者血蛋白下降量明显较少, 住院时间较短, 术后感染率较低(P ＜0.05).两组患者术前的VAS评分和生存质量评分比较差异无统计学意义(P＞ 0.05), 外支架组患者术后的VAS评分明显较低, 各维度的生存质量评分也明显优于双J管组(P ＜0.05).结论 无管化微创经皮肾镜取石术后留置输尿管外支架创伤较小, 患者恢复较快, 术后感染较少, 术后疼痛较轻, 患者生存质量较高.