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目的比较微创经皮肾镜与经尿道输尿管镜治疗上尿路结石的临床疗效。方法选取十堰市郧阳区人民医院太和郧阳分院2015年3—10月收治的上尿路结石患者56例,根据治疗方法不同分为经尿道输尿管镜组与微创经皮肾镜组,各28例。经尿道输尿管镜组采用经尿道输尿管镜治疗,微创经皮肾镜组采用微创经皮肾镜治疗。比较两组患者取石手术时间、术后疼痛评分、术后康复住院时间和上尿路结石清除率、并发症发生率及生活质量评分。结果微创经皮肾镜组患者取石手术时间、术后康复住院时间短于经尿道输尿管镜组,术后疼痛评分低于经尿道输尿管镜组(P<0.05)。微创经皮肾镜组结石清除率高于经尿道输尿管镜组,并发症发生率低于经尿道输尿管镜组(P<0.05)。治疗前两组患者生活质量评分比较,差异无统计学意义(P>0.05);治疗后微创经皮肾镜组生活质量评分高于经尿道输尿管镜组(P<0.05)。结论微创经皮肾镜与经尿道输尿管镜治疗上尿路结石均具有确切疗效,但微创经皮肾镜具有更高的结石清除率,可缩短手术时间及康复时间,减轻患者痛苦,减少术后并发症的发生,提升患者术后生活质量。
Objective To compare the clinical effects of minimally invasive percutaneous nephrolithotomy and transurethral ureteroscopy in the treatment of upper urinary tract calculi. Methods Fifty-six patients with upper urinary tract stones admitted in Taihe Yunyang Branch of People’s Hospital of Yunyang District in Shiyan City were divided into transurethral ureteroscopy group and minimally invasive percutaneous nephrolithotomy group according to different treatment methods. 28 cases each. Transurethral ureteroscopic transurethral ureteroscopic treatment, minimally invasive percutaneous nephrolithotomy with minimally invasive percutaneous nephrolithotomy. The operation time, postoperative pain score, postoperative recovery hospitalization time, upper urinary tract stone clearance rate, complication rate and quality of life were compared between the two groups. Results The operation time of patients who underwent minimally invasive percutaneous nephrolithotomy was shorter than that of transurethral ureteroscopy and postoperative pain scores were lower than that of transurethral ureteroscopy (P <0.05). The minimally invasive percutaneous nephrolithotomy group stone clearance rate higher than the transurethral ureteroscopy group, the complication rate was lower than the transurethral ureteroscopy group (P <0.05). There was no significant difference in quality of life between the two groups before treatment (P> 0.05). The quality of life score of minimally invasive percutaneous nephrolithotomy group was higher than that of transurethral ureteroscopy group after treatment (P <0.05). Conclusion Minimally invasive percutaneous nephrolithotomy and transurethral ureteroscopic treatment of upper urinary tract calculi have the exact effect, but minimally invasive percutaneous nephrolithotomy has a higher stone clearance, which can shorten the operation time and rehabilitation time, reduce patient pain and reduce Postoperative complications occurred, improve postoperative quality of life.