摘要
目的 探讨部分无管化与留置肾造瘘管经皮肾镜碎石术治疗上尿路结石临床效果。方法 回顾性选取2021年1月-2022年8月厦门医学院附属第二医院收治的上尿路结石患者190例为研究对象,均行经皮肾镜取石术治疗,依据术后置管方案的不同将其分为对照组112例与研究组78例。对照组行留置肾造瘘管经皮肾镜碎石术治疗,研究组行部分无管化经皮肾镜碎石术治疗。比较两组手术指标,术后疼痛情况、止痛药使用率及并发症情况。结果 两组手术时间、术中出血量比较,差异无统计学意义(P>0.05),研究组术后首次下床时间(2.14±0.55)d、术后尿管留置时间(3.34±0.84)d、住院时间(6.24±1.63)d均短于对照组,差异有统计学意义(P<0.05)。研究组术后1 d VAS评分(5.31±0.42)分低于对照组的(6.32±0.56)分,差异有统计学意义(t=13.499,P<0.05)。研究组术后止痛药使用率为8.97%低于对照组的20.54%,差异有统计学意义(χ^(2)=4.622,P<0.05)。研究组并发症发生率为10.26%低于对照组的25.00%,差异有统计学意义(χ^(2)=6.508,P<0.05)。结论部分无管化经皮肾镜碎石术治疗上尿路结石患者可促进其康复效果,降低术后疼痛及止痛药使用率,且并发症相对较少,利于病症好转以及恢复。
Objective To investigate the clinical effects of partial tubeless versus indwelling nephrostomy tube percutaneous nephrolithotomy for upper urinary tract stones.Methods A retrospective study was conducted on 190 patients with upper urinary tract stones admitted to the Second Affiliated Hospital of Xiamen Medical College from January 2021 to August 2022.All patients underwent percutaneous nephrolithotomy and were divided into the control group consisted of 112 patients and the study group consisted of 78 patients,based on different postoperative catheterization plans.The control group received percutaneous nephrolithotripsy with indwelling nephrostomy tube,while the study group received partial non tubular percutaneous nephrolithotripsy.Compared the two groups of surgical indicators,postoperative pain,analgesic use rate,and complications.Results There was no statistically significant difference in surgical time and intraoperative bleeding between the two groups(P>0.05).The study group had shorter postoperative first time out of bed(2.14±0.55)days,postoperative urinary catheter retention time(3.34±0.84)days,and hospitalization time(6.24±1.63)days compared to the control group,the difference was statistically significant(P<0.05).The VAS score(5.31±0.42)points of the study group on the 1st postoperative day was lower than that of the control group(6.32±0.56)points,the difference was statistically significant(t=13.499,P<0.05).The postoperative use rate of painkillers in the study group was 8.97%lower than 20.54%in the control group,the difference was statistically significant(χ^(2)=4.622,P<0.05).The incidence of complications in the study group was 10.26% lower than that in the control group(25.00%),the difference was statistically significant(χ^(2)=6.508,P<0.05).Conclusion Partial tubeless percutaneous nephrolithotomy for upper urinary tract stone patients can promote their recovery,reduce postoperative pain and the use of painkillers,and relatively few complications,which is conducive to the improvement of the disease and recovery.
作者
黄旭锋
杨水法
洪德时
李康
HUANG Xufeng;YANG Shuifa;HONG Deshi;LI Kang(Department of Urology,the Second Affiliated Hospital of Xiamen Medical College,Xiamen,Fujian Province,361021 China)
出处
《中外医疗》
2023年第19期96-99,共4页
China & Foreign Medical Treatment
关键词
经皮肾镜碎石术
上尿路结石
留置肾造瘘管
部分无管化
Percutaneous nephrolithotomy
Upper urinary tract stone
Indwelling nephrostomy tube
Partial tubeless
