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微通道经皮肾镜与逆行性输尿管软镜碎石术治疗直径<2.0cm肾下盏结石的效果分析 认领

Differences in the efficacy of two surgical methods for the treatment of hypothalamic stones with diameter<2.0 cm
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摘要 目的探讨微通道经皮肾镜碎石术(mPCNL)与逆行性输尿管软镜碎石术治疗直径<2.0 cm肾下盏结石的效果。方法选取2015年1月至2017年10月在本院行肾结石碎石手术的105例直径<2.0 cm的肾下盏结石患者,其中45例采用逆行性输尿管软镜碎石术治疗(A组),另外60例患者采用mPCNL治疗(B组)。对比两组患者的一期结石清除率、总结石清除率、手术时间、手术出血量、住院时间及手术并发症发生率;对比两组患者术前、术后24 h的血清白细胞介素-6(IL-6)、白细胞介素-10(IL-10)、C反应蛋白(CRP)和白细胞(WBC)等指标。结果B组患者的一期结石清除率、手术时间、手术出血量均低于A组(P<0.05),但总结石清除率与A组比较,差异无统计学意义(P>0.05);B组的住院时间长于A组(P<0.05);术前,两组患者的IL-6、IL-10、CRP、WBC水平比较,差异无统计学意义(P>0.05);术后24 h,B组患者的IL-6、IL-10、CRP、WBC水平均显著高于A组,差异有统计学意义(P<0.05);B组患者的并发症发生率[10.00%(6/60)]与A组[15.56%(7/45)]比较,差异无统计学意义(P=0.392)。结论mPCNL与逆行性输尿管软镜碎石术治疗直径<4.0 cm肾下盏结石患者的效果差异不大,且mPCNL手术引起的炎症应激反应更小,手术创伤更小。 Objective To investigate the effect of microchannel percutaneous nephrolithotomy(mPCNL)and retrograde ureteroscopic lithotripsy in the treatment of diarrhea with diameter<2.0 cm.Methods We selected 90 patients with renal artery calculi who underwent renal calculi from January 2015 to October 2017,45 of whom underwent retrograde ureteroscopic lithotripsy(group A)and sixty patients were treated with mPCNL(group B).The first-stage stone clearance rate,summary stone clearance rate,operation time,surgical bleeding volume,hospitalization time,and surgical complication rate were compared between the two groups.Serum interleukin-6(IL-6),interleukin-10(IL-10),C-reactive protein(CRP),white blood cells(WBC)and surgical complication rate at 24 hours after surgery were analyzed.Results The first-stage stone clearance rate,summary stone clearance rate,operation time,surgical bleeding volume,and hospitalization time in group B were lower than those in group A(P<0.05).There was no significant difference between group B patients in summary stone clearance rate and group A(P>0.05).The length of hospital stay in group B was longer than that in group A(P<0.05).There was no significant difference in the levels of IL-6,IL-10,CRP and WBC between group A and group B before surgery(P>0.05).The levels of IL-6,IL-10,CRP and WBC in group B were significantly lower than those in group A at 24 hours after operation(P<0.05).There was no significant difference in complication rate between group B and group A(6.67%vs.15.56%,P>0.05).Conclusions The effect of mPCNL and retrograde ureteroscopic lithotripsy in the treatment of patients with inferior sacral calculi<2.0 cm in diameter is not significant,and the inflammatory stress response caused by mPCNL surgery is smaller and the surgical trauma is smaller.
作者 郑红春 王龙刚 刘伟 Zheng Hongchun;Wang Long gang;Liu Wei(Department of Urology,the Third People's Hospital of Suining,Suining 629000,China;Department of Urology,Hejiang County Hospital of Traditional Chinese Medicine,Luzhou 646200,China)
出处 《国际泌尿系统杂志》 2021年第1期12-15,共4页 International Journal of Urology and Nephrology
关键词 肾结石 肾造口术 经皮 输尿管镜检查 Kidney Calculi Nephrostomy,Percutaneous Ureteroscopy
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