采用自制一体式输尿管肾导管与常规方式行PCNL治疗肾结石的疗效、安全性及患者满意度对比
Comparision of the efficacy,feasibility,safety and patient satisfaction of percutaneous nephrolithotomy integrated ureteric renal catheter and conventional PCNL
郭全斌 1穆拉迪力江·麦提图尔荪 1艾散江·麦麦提 1艾科拜尔江·麦麦提 1阿布力克木·扎克尔 1吾斯曼·阿力甫 1陆辉云 1艾尼瓦尔·阿不都卡德尔1
作者信息
- 1. 新疆和田地区人民医院泌尿外科,新疆和田 848000
- 折叠
摘要
目的 比较常规经皮肾镜碎石取石术(PCNL)与应用一体式输尿管肾导管的PCNL在治疗肾结石方面的安全性、疗效及患者满意度,为肾结石患者的临床治疗提供参考.方法 回顾性分析2022年4月-2023年5月新疆和田地区人民医院收治的154例肾结石(结石最大径为1.5～3.5 cm)患者资料.根据术中碎石结束后双J管和肾造瘘管的置入方式分为一体式组(应用一体式输尿管肾导管,n=77)和标准组(常规PCNL术式,n=77),比较两组患者的一般特征及术前、术后及随访资料.结果 一体式组和标准组术后住院时间[(5.78±2.50)d vs.(5.29±2.18)d,P=0.193]、术后疼痛评分[(2.22±0.42)分vs.(2.30±0.46)分,P=0.273]、术前及术后血红蛋白的变化值[(-4.13±10.11)g/L vs.(-2.96±9.39)g/L,P=0.459]、住院费用[(17 088.14±2 876.94)元 vs.(16 389.74±2 427.37)元,P=0.105]、结石清除率[65(84.4％)vs.66(85.7％),P=0.821]等数据差异均无统计学意义(P＞0.05).术后随访发现一体式组较标准组的不适症状发生率较低[36.4％(28/77)vs.90.9％(70/77),P=0.001],满意度更高(一体式组77例全部满意,标准组中64例满意、13例基本满意).所有患者均未出现术后脓毒血症及感染性休克,未发生转入重症监护室等情况.结论 一体式输尿管肾导管PCNL和常规PCNL安全性和疗效相当,但一体式组满意度更高,值得临床在把握适应证的情况下选择使用.
Abstract
Objective To compare the safety,efficacy,and patient satisfaction of conventional percutaneous nephrolithotomy(PCNL)and PCNL with integrated ureteric renal catheter in the treatment of kidney stones,so as to provide reference for the clinical application of this method.Methods A retrospective analysis were conducted on 154 patients with kidney stones(stone diameter 1.5-3.5 cm)admitted to our hospital during Apr.2022 and May 2023.Based on the method of placing the double-J stent and nephrostomy tube after stone fragmentation,the patients were divided into the integrated group(using PCNL with integrated ureteric renal catheter,n=77)and the standard group(conventional PCNL technique,n=77).The general characteristics,preoperative,postoperative.and follow-up data were compared between the two groups.Results There were no significant differences in postoperative hospital stay[(5.78±2.50)d vs.(5.29±2.18)d,P=0.193],postoperative pain score[(2.22±0.42)vs.(2.30±0.46),P=0.273],preoperative-postoperative change in hemoglobin[(-4.13±10.11)g/L vs.(-2.96±9.39)g/L,P=0.459],hospitalization costs[(17 088.14±2 876.94)yuan vs.(16 389.74±2 427.37)yuan,P=0.105],and stone clearance rate[65(84.4.6％)vs.66(85.7％),P=0.821]between the two groups(P＞0.05).The integrated group had significantly lower incidence of post-discharge discomfort symptoms than the standard group[36.4％(28/77)vs.90.9％(70/77),P=0.001].The integrated group reported higher satisfaction(77 satisfied vs.64 satisfied plus 13 basically satisfied).No postoperative sepsis,septic shock,or transfer to the intensive care unit occurred.Conclusion PCNL with integrated ureteric renal catheter and conventional PCNL demonstrate comparable safety and efficacy,but the integrated method yields higher satisfaction,suggesting its worthiness for clinical promotion and application under appropriate indications.
关键词
肾结石/经皮肾镜碎石取石术/一体式输尿管肾导管/安全性/满意度Key words
kidney stones/percutaneous nephrolithotomy/integrated ureteric renal catheter/safety/satisfaction引用本文复制引用
基金项目
和田地区本级技术研究与开发经费项目(202218)
出版年
2024
NETL
NSTL
万方数据