Curative efficacy of standardized single channel percutaneous nephrolithotomy in the treatment of renal cast stone
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摘要: 目的 分析标准单通道经皮肾镜取石术治疗肾脏铸型结石的疗效。 方法 选择本院80例肾脏铸型结石患者为研究对象。根据随机数表法将患者均分为对照组和观察组。对照组给予多通道微造瘘经皮肾镜取石术治疗,观察组给予标准单通道经皮肾镜取石术治疗。比较2组手术时间、术中出血量、住院时间、一期和二期术后残留结石直径、清除率及并发症情况。检测2组术前1 d、术后1 d和术后1个月的血肌酐水平。 结果 观察组手术时间和住院时间均显著短于对照组,术中出血量显著少于对照组(P<0.05)。观察组术前1 d、术后1 d和术后1个月的血肌酐水平比较,差异无统计学意义(P>0.05); 对照组以上时点血肌酐水平比较,差异有统计学意义(P<0.05); 观察组术后1d血肌酐水平显著低于对照组(P<0.05)。一期术后,观察组残留结石直径显著大于对照组,清除率显著低于对照组(P<0.05); 二期术后,观察组残留结石直径和清除率与对照组比较,差异无统计学意义(P>0.05)。2组并发症总发生率差异无统计学意义(P>0.05)。 结论 标准单通道经皮肾治疗肾脏铸型结石的疗效显著,患者创伤小,结石清除率较高,患者术后恢复快。Abstract: Objective To analyze the curative effect of standardized single channel percutaneous nephrolithotomy in the treatment of kidney cast stone. Methods A total of 80 kidney cast stone patients were selected as research objects. According to the method of random number table, the patients were equally divided into control group and observation group. The control group was treated with multi-channel percutaneous nephrolithotomy, while the observation group was treated with standard single channel percutaneous nephrolithotomy. The operation time, intraoperative hemorrhage, hospitalization time, diameter of residual stones in first and second stage surgeries, the clearance rate and complications of the two groups were compared. The blood creatinine levels of the two groups were measured at 1 d before surgery, 1 d and 1 month after surgery. Results The operation time and hospitalization time of the observation group were significantly shorter than that of the control group, and the amount of intraoperative bleeding was significantly less than that of the control group(P<0.05). There were no significant differences in the levels of serum creatinine at 1 d before surgery, 1 d and 1 month after surgery between the observation group and the control group(P>0.05), but the indicators above showed significant differences in the control group(P<0.05). Serum creatinine at 1 d after surgery in the observation group was significantly lower than that in the control group(P<0.05). After the first operation, the diameter of residual stone in the observation group was significantly larger, and the clearance rate was significantly lower than that of the control group(P<0.05); after the second operation, the above indicators showed no significant differences in the observation group and control group(P>0.05). There was no significant difference in the total incidence of complications between the two groups(P>0.05). Conclusion Single channel percutaneous nephrolithotomy in the treatment of kidney cast stone has significant effects, and the patients have less trauma, higher stone clearance rate and faster postoperative recovery.
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