输尿管软镜碎石术与微通道经皮肾镜碎石术在治疗肾下盏结石的临床效果分析

Clinical Effect Analysis of Ureteral Flexible Lithotripsy and Microchannel Percutaneous Nephrolithotripsy in the Treatment of Renal Lower Pole Stones

摘要: 目的：对比输尿管软镜碎石术与微通道经皮肾镜碎石术在治疗肾下盏结石的临床效果。方法：选取2021年12月至2022年12月期间在海南医学院第一附属医院泌尿外科接受治疗的100例肾下盏结石患者，按术式不同分为实验组与对照组各50例。实验组施行输尿管软镜碎石术，对照组则施行微通道经皮肾镜碎石术，对比两组间围手术期肾功能、术后炎症指标、手术时长、血红蛋白下降程度、术后住院时长、结石清除率及术后并发症情况。结果：实验组与对照组在术前、术后血肌酐、术前、术后血尿酸、血红蛋白下降程度等指标的差异无统计学意义(P > 0.05)，提示两种术式对患者的血容量、肾功能影响不具有差别。实验组的术后血白细胞、中性粒比率、超敏C蛋白、降钙素原等炎症指标比对照组上升的程度更低，差异具有统计学意义(P < 0.05)。实验组所需的手术时长、术后住院时长更短，结石清除率更高，术后并发症也更少，差异具有统计学意义(P < 0.05)。结论：与微通道经皮肾镜碎石术相比，输尿管软镜碎石术能够降低肾下盏结石患者术后感染、出血、发热等并发症的风险，同时也能缩短手术时间以及术后住院时长，获得更好的结石清除率，减少二次手术的可能，提高患者生活质量。

Abstract: Objective: To compare the clinical effect of flexible ureteral lithotripsy and microchannel percuta-neous nephrolithotripsy in the treatment of renal lower pole stones. Methods: A total of 100 pa-tients with renal lower pole stones who received treatment in the Department of Urology, the First Affiliated Hospital of Hainan Medical College from December 2021 to December 2022 were selected and divided into the experimental group and the control group with 50 cases in each group accord-ing to different operation methods. The experimental group underwent flexible ureteral lithotripsis, while the control group underwent microchannel percutaneous nephrolithotripsis. Perioperative renal function, postoperative inflammation index, operation duration, hemoglobin decline, postop-erative hospital stay, stone clearance rate and postoperative complications were compared between the two groups. Results: There was no significant difference in serum creatinine, serum uric acid, hemoglobin and other indexes between the experimental group and the control group before and after surgery (P > 0.05), indicating that the two operation methods had no difference in blood vol-ume and renal function. The inflammation indexes such as white blood cells, neutrophil ratio, hy-persensitive C protein and procalcitonin in the experimental group increased less than those in the control group, and the difference was statistically significant (P < 0.05). In the experimental group, the operation duration and postoperative hospitalization duration were shorter, the stone clear-ance rate was higher, and the postoperative complications were less, the differences were statisti-cally significant (P < 0.05). Conclusions: Compared with microchannel percutaneous nephrolitho-tripsy, flexible ureteral lithotripsy can reduce the risk of postoperative complications such as infec-tion, bleeding and fever in patients with renal lower pole stones, shorten the operation time and postoperative hospital stay, obtain better stone clearance rate, reduce the possibility of secondary surgery, and improve the quality of life of patients.