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目的:观察分析微创经皮肾镜穿刺取石术治疗肾结石对患者肾小球滤过率(GFR)的影响。方法:采用微创经皮肾镜穿刺取石术治疗肾结石患者78例,分析术前、术后1天、3天、7天、14天的GFR的变化。结果:术后1天,患者肾脏GFR由术前的(71.656±35.395)ml·min-1·1.73m-2下降至(54.397±34.412)ml·min-1·1.73m-2,两者比较,差异有统计学意义(P=0.0199,t=2.371);术后3天,GFR为(65.317±33.419)ml·min-1·1.73m-2,与术前比较,差异无统计学意义(P=0.3795,t=0.883);术后7天,GFR为(73.452±32.129)ml·min-1·1.73m-2,与手术前比较,差异无统计学意义(P=0.7995,t=0.255)。术后14天,GFR为(89.818±36.539)ml·min-1·1.73m-2,与手术前比较,差异有统计学意义(P=0.0175,t=2.421)。结论:微创经皮肾镜穿刺取石术治疗泌尿系结石可以改善大部分患者的GFR,是一种安全有效的治疗方法。
Objective: To observe and analyze the effect of minimally invasive percutaneous nephrolithotomy on glomerular filtration rate (GFR) in patients with kidney stones. Methods: 78 cases of nephrolithiasis were treated with minimally invasive percutaneous nephrolithotomy, and the changes of GFR were analyzed before operation, 1 day, 3 days, 7 days and 14 days after operation. Results: At 1 day after operation, the GFR of kidney decreased from (71.656 ± 35.395) ml · min-1 · 1.73m-2 to (54.397 ± 34.412) ml · min-1 · 1.73m-2 , The difference was statistically significant (P = 0.0199, t = 2.371); GFR was (65.317 ± 33.419) ml · min-1 · 1.73m-2 at 3 days after operation, which showed no significant difference (P = 0.3795, t = 0.883). GFR was (73.452 ± 32.129) ml · min-1 · 1.73m-2 at 7 days after operation, showing no significant difference compared with those before operation (P = 0.7995, t = 0.255 ). GFR was (89.818 ± 36.539) ml · min-1 · 1.73m-2 at 14 days after operation, which was significantly different from that before operation (P = 0.0175, t = 2.421). Conclusion: Minimally invasive percutaneous nephrolithotomy for the treatment of urinary stones can improve the GFR in most patients, which is a safe and effective treatment.