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目的:比较输尿管软镜碎石术与经皮肾镜碎石术治疗肾结石的临床疗效及安全性。方法:选择2014年1月~2015年1月期间收治的肾结石患者110例,随机分为对照组和观察组,每组各55例。对照组给予经皮肾镜碎石术治疗,观察组给予输尿管软镜碎石术治疗。对两组患者的清石率、手术时间、术中出血量、术后住院时间、血清中性粒细胞明胶酶相关载脂蛋白(NGAL)水平及并发症发生率进行比较。结果:治疗后两组患者的清石率差异无统计学意义(P>0.05);观察组患者的手术时间、术中出血量及术后住院时间均明显少于对照组(P<0.05)。观察组患者术后24、48及72h的血清NGAL水平均明显低于对照组,差异有统计学意义(P<0.05);术后72h观察组患者的血清NGAL水平与术前相比较,差异无统计学意义(P>0.05)。术后观察组患者的肾绞痛、肾包膜下血肿及菌血症并发症发生率明显低于对照组,差异有统计学意义(P<0.05)。结论:对肾结石患者实施输尿管软镜碎石术,可明显缩短术后住院时间,减少手术时间、术中出血量和术后血清NGAL水平,降低术后并发症发生率,值得临床推广与应用。
Objective: To compare the clinical efficacy and safety of ureteroscopic lithotripsy and percutaneous nephrolithotripsy in the treatment of kidney stones. Methods: One hundred and ten patients with kidney stones admitted from January 2014 to January 2015 were randomly divided into control group and observation group, with 55 cases in each group. The control group was given percutaneous nephrolithotomy, and the observation group was given ureteroscopic lithotripsy. The rates of stone removal, operation time, intraoperative blood loss, postoperative hospital stay, levels of serum neutrophil gelatinase-associated apolipoprotein (NGAL) and complication rates were compared between the two groups. Results: There was no significant difference in the rate of clear stone between the two groups after treatment (P> 0.05). The operation time, intraoperative blood loss and postoperative hospital stay in the observation group were significantly less than those in the control group (P <0.05). The levels of serum NGAL in observation group at 24, 48 and 72 hours after operation were significantly lower than those in control group (P <0.05). The levels of serum NGAL in observation group at 72 hours after operation were significantly lower than those before operation Statistical significance (P> 0.05). Postoperative observation group patients with renal colic, renal subcapsular hematoma and bacteremia complications was significantly lower than the control group, the difference was statistically significant (P <0.05). Conclusion: The ureteroscopic lithotripsy in patients with kidney stones can shorten the postoperative hospital stay, reduce the operation time, intraoperative blood loss and postoperative serum levels of NGAL, and reduce the incidence of postoperative complications, which is worthy of clinical promotion and application .