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摘要: 目的:探讨无管化微通道经皮肾镜取石术(mPCNL)治疗上尿路结石的疗效性及安全性。方法:选取我院2018年9月—2019年12月100例上尿路结石病例,根据手术方案不同分为无管化mPCNL(观察组)与标准mPCNL(对照组)两组,每组各50例。研究比较两组手术相关指标、术后疼痛、术后并发症发生率及术后住院相关指标。结果:两组患者年龄、性别、结石直径和部位、基础疾病等一般临床资料比较差异均无统计学意义(P＞0.05)。观察组相比对照组的手术时间[(61.57±4.52) min vs.(64.27±5.21) min]、术后尿管留置时间[(3.10±0.71) d vs.(4.17±1.68) d]、术后住院时间[(3.73±0.94) d vs.(5.00±1.84) d]均明显缩短,并且住院费用也比对照组减少[(21 469.76±2 940.37)元vs.(24 384.67±3 307.71)元],差异有统计学意义(P＜0.05)。观察组患者术后第1天的VAS评分比对照组低[(2.53±0.68)分vs.(3.97±0.77)分],术后镇痛药物使用率也较对照组低,差异有统计学意义(P＜0.05)。而两组的手术相关指标及术后并发症发生率差异无统计学意义(P＞0.05)。结论:无管化mPCNL治疗上尿路结石是安全有效的手术方式,具有减少术后疼痛、缩短住院时间及降低住院费用等优势。
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关键词:
- 无管化 /
- 微通道经皮肾镜取石术 /
- 上尿路结石
Abstract: Objective: To investigate the efficacy and safety of tubeless microchannel percutaneous nephrolithotomy(mPCNL) in the treatment of upper urinary calculi.Methods: From Sep. 2018 to Dec. 2019, 100 cases of upper urinary calculi in our hospital were selected. According to the different operation plans, they were divided into two groups: the tubeless mPCNL(observation group) and the standard mPCNL(control group). Each group had 50 cases. The operation related indexes, postoperative pain, postoperative complications and hospitalization related indexes of the two groups were compared with each other.Results: There was no significant difference in general clinical data of age, gender, stone diameter or location, basic diseases between the two groups(P＞0.05). The operation time [(61.57±4.52) min vs.(64.27±5.21) min], the indwelling time [(3.10±0.71) d vs. (4.17±1.68)d] and the postoperative hospitalization time [(3.73±0.94) d vs. (5.00±1.84) d] were shorter in observation group than those in control group(P＜0.05), and the hospitalization cost [(21 469.76±2 940.37)yuan vs.(24 384.67±3 307.71)yuan]was also significantly lower in observation group compared with control group(P＜0.05). Furthermore, the pain score of first day after operation in observation group was lower than that in control group [(2.53±0.68)vs. (3.97±0.77)], in that case the utilization rate of analgesic drugs in observation group was also lower than that in control group(P＜0.05). However, there was no significant difference in operation related indexes or postoperative complications between the two groups(P＞0.05).Conclusion: Tubeless mPCNL is a safe and effective method for the treatment of upper urinary calculi, which has the advantages of reducing postoperative pain, shortening hospital stay and reducing hospital costs. -
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