【摘要】 目的探讨微创经皮肾镜取石术(mPCNL)治疗肾结石的临床效果。方法选取2018年3月～2019年2月我院收治的106例肾结石患者为研究对象,应用随机数字表法将其分为观察组和对照组,每组各53例。观察组患者给予m PCNL治疗,对照组患者接受标准通道经皮肾镜取石术(SPCNL)治疗。比较两组患者一次性结石清除率、围术期相关指标、疼痛情况、肾功能指标[β2-微球蛋白(β2-MG)、尿素氮(BUN)、血肌酐(Cr)]及并发症发生情况。结果观察组患者术中出血量[(107.63±22.19)ml]少于对照组[(153.41±26.38)ml],住院时间[(8.36±1.29)d]短于对照组[(12.36±1.87)d],视觉模拟量表(VAS)评分[(2.42±0.68)分]低于对照组[(3.36±0.79)分],手术时间[(129.64±20.53)min]长于对照组[(102.41±18.76)min],差异均有统计学意义(P<0.05)。术前,两组患者的β2-MG、BUN、Cr水平比较,差异无统计学意义(P>0.05);术后,观察组患者的β2-MG[(2.13±0.80)ng/L]、BUN[(8.37±2.13)mmol/L]、Cr[(92.53±9.57)mmol/L]水平低于对照组[(3.45±0.87)ng/L、(14.51±2.24)mmol/L、(106.92±10.43)mmol/L],差异有统计学意义(P<0.05)。观察组患者的并发症总发生率(3.77%)低于对照组(15.09%),差异有统计学意义(P<0.05);观察组患者的一次性结石清除率(90.57%)与对照组(86.79%)比较,差异无统计学意义(P>0.05)。结论 mPCNL治疗肾结石具有创伤小、结石清除率高、并发症少等优势,可减轻患者术后疼痛,缩短住院时间,对肾功能损伤小,具有临床应用推广价值。更多还原

【Abstract】 Objective To investigate the clinical effect of minimally invasive percutaneous nephrolithotomy(mPCNL) in the treatment of renal calculi. Methods A total of 106 patients with renal calculi admitted to our hospital from March2018 to February 2019 were selected as research objects, and were divided into observation group and control group by random number table method, 53 cases in each group. Patients in the observation group were treated with mPCNL,while patients in the control group were treated with standard channel percutaneous nephrolithotomy(SPCNL). The disposable stone clearance rate, perioperative related indexes, pain, renal function indexes(β2-microglobulin [β2-MG], urea nitrogen [BUN], serum creatinine [Cr]) and complications were compared between the two groups. Results The intraoperative blood loss in the observation group([107.63±22.19] ml) was less than that in the control group([153.41±26.38]ml),the hospitalization time([8.36±1.29] d) wass shorter than that in the control group([12.36±1.87] d), and the visual analogue scale(VAS) score([2.42±0.68] points) was lower than that in the control group([3.36±0.79] points), the operation time([129.64±20.53] min) was longer than that of the control group([102.41 ±18.76] min), with statistically significant differences(P<0.05). Before operation, there were no significant difference in β2-MG, BUN and Cr levels between the two groups(P>0.05). After operation, the β2-MG([2.13±0.80] ng/L), BUN([8.37±2.13] mmol/L), Cr([92.53±9.57] mmol/L)levels in the observation group were lower than those in the control group([3.45 ±0.87] ng/L, [14.51±2.24] mmol/L,[106.92±10.43] mmol/L), the differences were statistically significants(P<0.05). The total incidence of complications in the observation group(3.77%) was lower than that in the control group(15.09%), and the difference was statistically significant(P>0.05). The removal rate of one-off stones in the observation group(90.57%) was not significantly different from that in the control group(86.79%)(P>0.05). Conclusion MPCNL has the advantages of less trauma, high stone clearance rate and fewer complications in the treatment of renal calculi, it can reduce postoperative pain, shorten hospitalization time, reduce renal damage and has clinical application and popularization value.更多还原