摘要
目的:对比输尿管软镜术(RIRS)联合细针超微通道经皮肾穿刺激光碎石(SMP)、微通道经皮肾镜取石术(MPCNL)治疗复杂性肾结石的疗效。方法:采用随机数字表法将我院2022年3月至2024年5月期间收治的100例复杂性肾结石患者分成对照组50例,研究组50例。对照组患者接受MPCNL治疗,研究组患者接受细针SMP联合RIRS治疗。对比两组临床指标、疼痛情况、炎症应激指标、肾功能指标、并发症发生情况。结果:研究组手术时间长于对照组,术中出血量少于对照组,术后住院时间、术后下床时间短于对照组(P<0.05)。两组成功清石率组间对比未见统计学差异(P>0.05)。研究组术后6 h、24 h、48 h视觉模拟疼痛量表(VAS)评分低于对照组(P<0.05)。研究组术后3 d血清降钙素原(PCT)、超敏C反应蛋白(hs-CRP)、皮质醇(Cor)、去甲肾上腺素(NE)、尿素氮(BUN)、血肌酐(Scr)、胱抑素C(Cys C)低于对照组(P<0.05)。两组并发症发生率对比未见统计学差异(P>0.05)。结论:与MPCNL治疗复杂性肾结石相比,细针SMP联合RIRS可减少术中出血量,缩短术后下床时间、术后住院时间,减轻炎症应激反应,同时还可减轻对肾功能的损伤和术后疼痛,且不增加并发症发生率。
Objective:To compare the therapeutic effect of ureteroscopy(RIRS)combined with fine needle ultra fine channel percutaneous nephrolithotomy(SMP)and microchannel percutaneous nephrolithotomy(MPCNL)in the treatment of complex kidney stones.Methods:100 patients with complex kidney stones who were admitted to our hospital from March 2022 to May 2024 were divided into control group of 50 cases and study group of 50 cases by using random number table method.The control group patients received MPCNL treatment,while the study group patients received fine needle SMP combined with RIRS treatment.The clinical indicators,pain status,inflammatory stress indicators,renal function indicators,and incidence of complications between the two groups were compared.Results:Surgical time in the study group was longer than that in the control group,the intraoperative blood loss was less than that of the control group,the postoperative hospitalization time and time to get out of bed after surgery were shorter than those in the control group(P<0.05).There was no statistically significant difference in the success rate of stone removal between the two groups(P>0.05).The visual analog pain scale(VAS)scores in the study group were lower than those in the control group at 6 h,24 h,and 48 h after surgery(P<0.05).Serum procalcitonin(PCT),high-sensitivity C-reactive protein(hs-CRP),cortisol(Cor),norepinephrine(NE),urea nitrogen(BUN),serum creatinine(Scr),and cystatin C(Cys C)in the study group were lower than those in the control group at 3 d after surgery(P<0.05).There was no statistically significant difference in the incidence of complications between the two groups(P>0.05).Conclusion:Compared with MPCNL treatment for complex kidney stones,fine needle SMP combined with RIRS can reduce intraoperative bleeding,shorten time to get out of bed and hospitalization time,alleviate inflammatory stress response,and reduce damage to kidney function and postoperative pain without increasing the incidence of complications.
作者
郭祯远
贾君鸿
孙稳
阿地力·阿不都英
褚勇
GUO Zhen-yuan;JIA Jun-hong;SUN Wen;Adil·Abdiryim;CHU Yong(Department of Urology Surgery,Eighth Division Shihezi General Hospital,Shihezi,Xinjiang,832000,China)
出处
《现代生物医学进展》
2025年第10期1649-1657,共9页
Progress in Modern Biomedicine
基金
八师石河子市科技计划项目(2024ZDYL04)。
关键词
输尿管软镜术
细针超微通道经皮肾穿刺激光碎石
复杂性肾结石
微通道经皮肾镜取石术
疗效
Ureteroscopy
Fine needle ultra fine channel percutaneous nephrolithotomy
Complex kidney stones
Microchannel percutaneous nephrolithotomy
Therapeutic effect
