【摘要】 目的探究经皮肾镜碎石术不同通道治疗上尿路结石的临床效果。方法选取2017年1月至2020年1月本院收治的80例上尿路结石患者,按照随机数字表法分为对照组与观察组,每组40例。对照组给予标准通道经皮肾镜碎石术治疗,观察组采用微通道经皮肾镜碎石术治疗。比较两组手术相关指标、结石清除率、并发症发生率及手术前后肾功能变化。结果观察组手术时间明显长于对照组,但术中出血量少于对照组,住院时间短于对照组,差异均有统计学意义(P<0.05)。两组结石清除率比较差异无统计学意义。术前,两组BUN、SCr水平比较差异无统计学意义;术后,两组BUN、SCr水平均明显高于术前,但对照组明显优于观察组,差异有统计学意义(P<0.05)。两组术后并发症发生率比较差异无统计学意义。结论微通道经皮肾镜碎石术和标准通道经皮肾镜碎石术治疗上尿路结石疗效相当,各有优势,前者术中出血量及住院时间较短,后者对肾功能影响更小,临床可根据患者具体情况选择合适的手术方案。更多还原

【Abstract】 Objective To explore the clinical effects of different channels of percutaneous nephrolithotomy in the treatment of upper urinary tract stones. Methods 80 patients with upper urinary tract stones admitted to our hospital from January 2017 to January 2020 were divided into control group and observation group according to random number table method, with 40 cases in each group. The control group was treated with standard channel percutaneous nephrolithotomy, and the observation group was treated with microchannel percutaneous nephrolithotomy. The operation-related indicators, stone removal rate, complication rate, and changes in renal function before and after the operation were compared between the two groups. Results The operation time of the observation group was significantly longer than that of the control group, but the intraoperative blood loss was less than that of the control group, and the hospital stay was shorter than that of the control group, the difference was statistically significant(P<0.05). There was no statistically significant difference in the stone clearance rate between the two groups. Before surgery, there was no significant difference in the levels of BUN and SCr between the two groups. After operation, the BUN and SCr levels of the two groups were significantly higher than those before the operation, but the control group was significantly better than the observation group, and the difference was statistically significant(P<0.05). There was no statistically significant difference in the incidence of postoperative complications between the two groups. Conclusion Micro-channel percutaneous nephrolithotomy and standard-channel percutaneous nephrolithotomy have the same curative effect on the treatment of upper urinary tract stones, and each has it’ s own advantages. The former has less intraoperative blood loss and shorter hospital stay, while the latter has less impact on renal function. The clinic can choose the appropriate surgical plan according to the specific situation of the patient.更多还原