论文部分内容阅读
目的:探索彩超定位下一步法扩张技术在经皮肾穿刺治疗上尿路结石的疗效、安全性及经济学价值。方法:224例肾结石患者随机分为一步组106例及序贯组118例,一步组采用一步法扩张技术,序贯组采用逐步扩张法,比较两组的术中情况、术后并发症、手术前后的心理及社会学指标、治疗费用及远期效果。结果:两组患者术中出血量和结石清除率比较,差异均无统计学意义(P>0.05),一步组的手术耗时显著短于序贯组,差异具有统计学意义(P<0.05)。两组患者的发热例数构成比较,差异均无统计学意义(P>0.05),但出血及尿漏发生率以一步组显著低于序贯组,差异具有统计学意义(P<0.05)。与术前比较,两组的整体生活质量评分均显著升高,差异具有统计学意义(P<0.05)。组间比较,两组术前后的整体生活质量评分比较,差异均无统计学意义(P>0.05)。一步组患者平均治疗费用为(11535.01±1102.31)元,明显低于序贯组(14235.05±1210.40)元,差异具有统计学意义(P<0.05)。随访1年,两组患者的复发率比较,差异均无统计学意义(P>0.05)。结论:一步扩张法可明显减少手术耗时,治疗费用低,较序贯法有显著的优势。
Objective: To explore the efficacy, safety and economic value of ultrasound-guided next-step expansion in the treatment of upper urinary calculi by percutaneous nephrolithotomy. Methods: A total of 224 patients with nephrolithiasis were randomly divided into one-step group (n = 106) and sequential group (n = 118). The one-step procedure was performed by one-step dilation technique and the sequential group by stepwise dilation method. The postoperative complications, Psychological and sociological indicators before and after surgery, treatment costs and long-term effects. Results: There was no significant difference between the two groups in the amount of bleeding and the rate of stone removal (P> 0.05). The operation time of one step group was significantly shorter than that of sequential group (P <0.05) . There was no significant difference in the number of fever between the two groups (P> 0.05), but the incidence of hemorrhage and urinary leakage in one-step group was significantly lower than that in the sequential group (P <0.05). Compared with preoperative, the overall quality of life scores of the two groups were significantly increased, the difference was statistically significant (P <0.05). There was no significant difference in overall quality of life between the two groups before and after operation (P> 0.05). The average cost of one-step treatment was (11535.01 ± 1102.31) yuan, significantly lower than the sequential group (14235.05 ± 1210.40) yuan, the difference was statistically significant (P <0.05). Follow-up of 1 year, the recurrence rate of two groups of patients, the difference was not statistically significant (P> 0.05). Conclusion: One-step dilation method can significantly reduce the time-consuming operation, low cost of treatment, compared with the sequential method has significant advantages.