| 郭崇波,李文华,张武合,季金涛,樊 婕.超声引导下微通道与标准通道经皮肾镜取石术治疗肾结石的前瞻性对照研究[J].,2023,(19):3655-3659 |
| 超声引导下微通道与标准通道经皮肾镜取石术治疗肾结石的前瞻性对照研究 |
| A Prospective Comparative Study of Ultrasound-guided Mini-invasive Percutaneous Nephrolithotomy and Standard Channel Percutaneous Nephrolithotomy in the Treatment of Renal Calculi |
| 投稿时间：2023-03-07 修订日期：2023-03-29 |
| DOI：10.13241/j.cnki.pmb.2023.19.011 |
| 中文关键词: 超声引导下微通道经皮肾镜取石术 标准通道经皮肾镜取石术 疗效 肾结石 前瞻性研究 |
| 英文关键词: Ultrasound-guided mini-invasive percutaneous nephrolithotomy Standard channel percutaneous nephrolithotomy Curative effect Renal calculi Prospective study |
| 基金项目:陕西省创新能力支撑计划项目（2021TD-39） |
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| 中文摘要: |
| 摘要 目的：对比超声引导下微通道经皮肾镜取石术（mPCNL）与标准通道经皮肾镜取石术（sPCNL）治疗肾结石的疗效。方法：选择空军第九八六医院2020年1月~2022年5月期间收治的肾结石患者127例，根据随机数字表法将患者分为sPCNL组（63例）和mPCNL组（64例）。对比两组临床指标、结石清除率、疼痛情况、肾功能、应激情况、炎症因子水平和并发症发生率。结果：mPCNL组的肾盂结石、肾盏结石清除率均高于sPCNL组（P<0.05）。两组肾铸形结石、鹿角形结石清除率比较无差异（P>0.05）。mPCNL组的手术时间长于sPCNL组，术中出血量、术中输液量少于sPCNL组，住院时间短于sPCNL组（P<0.05）。两组术前、术后3 d尿素氮（BUN）、血肌酐（Scr）组间及组内对比，差异均无统计学意义（P>0.05）。mPCNL组术后3 d皮质醇（Cor）、促肾上腺皮质激素（ACTH）低于sPCNL组（P<0.05）。mPCNL组术后3 d白介素-6（IL-6）、肿瘤坏死因子（TNF-α）、降钙素原（PCT）低于sPCNL组（P<0.05）。mPCNL组术后3 d视觉疼痛模拟评分（VAS）评分和P物质（SP）、前列腺素E2（PGE2）水平低于sPCNL组（P<0.05）。两组并发症发生率对比无统计学差异（P>0.05）。结论：与sPCNL相比，超声引导下mPCNL治疗肾结石虽会延长手术时间，但可降低术中出血量、术中输液量，缩短住院时间，减轻患者疼痛反应、应激反应和炎性反应，同时对患者的肾功能影响较小。 |
| 英文摘要: |
| ABSTRACT Objective: To compare the efficacy of ultrasound-guided mini-invasive percutaneous nephrolithotomy (mPCNL) and standard channel percutaneous nephrolithotomy (sPCNL) in the treatment of renal calculi. Methods: 127 patients with renal calculi who were admitted to Air Force 986 Hospital from January 2020 to May 2022 were selected, and the patients were divided into sPCNL group (63 cases) and mPCNL group (64 cases) according to random number table method. The clinical indexes, calculi clearance rate, pain condition, renal function, stress condition, inflammatory factors levels and incidence rate of complications were compared in the two groups. Results: The clearance rates of renal pelvis calculus and caliceal calculus in the mPCNL group were higher than those in the sPCNL group (P<0.05). There was no significant difference in the clearance rates of renal cast stone and staghorn calculus in the two groups (P>0.05). The operative time in the mPCNL group was longer than that in the sPCNL group, the intraoperative blood loss and intraoperative infusion volume were less than those in the sPCNL group, and the length of hospital stay was shorter than that in the sPCNL group (P<0.05). There were no significant differences in urea nitrogen (BUN) and serum creatinine (Scr) between and within two groups before operation and 3 d after operation (P>0.05). The cortisol (Cor) and adrenocorticotropic hormone (ACTH) in the mPCNL group at 3 d after operation were lower than those in the sPCNL group(P<0.05). The interleukin-6 (IL-6), tumor necrosis factor (TNF-?琢) and procalcitonin (PCT) in the mPCNL group at 3 d after operation were lower than those in the sPCNL group (P<0.05). The visual pain simulation score (VAS) and substance P (SP) and prostaglandin E2 (PGE2) levels in the mPCNL group at 3 d after operation were lower than those in the sPCNL group (P<0.05). There was no significant difference in the incidence rate of complications in the two groups (P>0.05). Conclusion: Compared with sPCNL, although ultrasound-guided mPCNL in the treatment of renal calculi can prolong the operation time, it can reduce intraoperative blood loss and intraoperative infusion volume, shorten length of hospital stay, reduce patients' pain response, stress response and inflammatory response, and it has little influence on patients' renal function. |
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