微创经皮肾镜取石术联合输尿管软镜治疗复杂性肾结石疗效研究

摘要

目的:探讨微创经皮肾镜取石术联合输尿管软镜治疗复杂性肾结石的临床疗效.方法:选取复杂性肾结石患者86例,按随机数表法分为两组,各43例.对照组行经皮肾镜取石术治疗,观察组予微创经皮肾取石术联合输尿管软镜治疗,比较两组临床相关指标、肾功能指标、并发症及结石清除率.结果:观察组手术时间、排气时间及住院时间均明显短于对照组(P<0.05);两组术前半胱氨酸蛋白酶抑制剂C(Cys-C)、中性粒细胞明胶酶相关载脂蛋白(NGAL)、血肌酐(Scr)水平比较,差异无统计学意义(P>0.05);术后观察组Cys-C、NGAL、Scr水平均明显低于对照组(P<0.05);观察组并发症发生率6.98%(3/43)明显低于对照组的44.19%(19/43),结石清除率观察组高于对照组(97.67% 与81.40%),差异有统计学意义(P<0.05).结论:微创经皮肾取石术联合输尿管软镜治疗可缩短复杂性肾结石手术时间,减少对肾功能的影响,降低术后并发症发生,提高结石清除率.%Objective:To explore the clinical effect of minimally invasive percutaneous nephrolithotomy com-bined with ureteral soft mirror in the treatment of complex renal calculi.Methods:86 cases of patients with compli-cated renal calculi were selected as the subjects,all patients were divided into two groups according to the random number table,each group of 43 cases.The control group was treated with percutaneous nephrolithotomy,and the ob-servation group was treated with minimally invasive percutaneous nephrolithotomy combined with ureteroscopy.The clinical indicators,renal function,complications and calculus clearance were compared between the two groups.Resut-ls:The operation time,exhaust time and hospitalization time of the observation group were significantly shorter than the control group,the difference was statistically significant(P<0.05);there was no significant difference in the lev-els of Cys-C,neutrophil gelatin-related apolipoprotein(NGAL)and serum creatinine(Scr)between the two groups before and after operation(P>0.05);the levels of Cys-C,NGAL and Scr in the observation group were significantly lower than those in the control group(P<0.05).The incidence of complication was 6.98%(3/43)in the observa-tion group significantly lower than that in the control group(44.19%,19/43).The removal rate of stones was signif-icantly higher than that of the control group[97.67% vs 81.40%],the difference was statistically significant(P<0. 05).Conclusion:Minimally invasive percutaneous nephrolithotomy combined with ureteral softening can reduce the time of complex renal calculus surgery,reduce renal function,reduce postoperative complications,improve stone clearance,promote patient rehabilitation.