CAJ | 학술논문

目的：对比部分无管化经皮肾镜碎石取石术(不留置肾造瘘但留置双J管)与传统经皮肾镜碎石取石术(既留置肾造瘘管也留置双J管)治疗上尿路结石的临床疗效,评价部分无管化经皮肾镜碎石取石术的临床可行性及应用价值。方法选择2013年5月至2014年5月入住我院需行经皮肾镜碎石取石术治疗且符合入选标准的上尿路结石患者206例,按手术次序的奇偶分为观察组(部分无管化经皮肾镜碎石取石术组)与对照组(传统经皮肾镜碎石取石术组),观察比较2组患者手术时间、结石清除率、疼痛评分( VAS)、术后镇痛药需求量、术后血红蛋白下降值、术后输血、术后大出血、术后发热、漏尿时间、术后住院天数、住院费用、术后恢复正常生活工作时间等指标的区别。结果206例患者均顺利完成手术,2组手术时间、结石清除率、术后血红蛋白下降值、术后输血、术后大出血、术后发热病例比较差异均无统计学意义(P>0.05)；观察组术后疼痛评分(VAS)、术后镇痛药用量、漏尿时间、术后住院时间、住院费用、术后恢复正常生活工作时间均显著低于对照组(P<0.05)。结论部分无管化经皮肾镜碎石取石术与传统经皮肾镜碎石取石术相比,在减轻患者术后疼痛、减少漏尿时间、缩短患者术后住院时间、降低住院费用及加快患者术后恢复正常生活工作上具有明显的优势,具有很大的临床应用价值,值得推广应用。
목적：대비부분무관화경피신경쇄석취석술(불류치신조루단류치쌍J관)여전통경피신경쇄석취석술(기류치신조루관야류치쌍J관)치료상뇨로결석적림상료효,평개부분무관화경피신경쇄석취석술적림상가행성급응용개치。방법선택2013년5월지2014년5월입주아원수행경피신경쇄석취석술치료차부합입선표준적상뇨로결석환자206례,안수술차서적기우분위관찰조(부분무관화경피신경쇄석취석술조)여대조조(전통경피신경쇄석취석술조),관찰비교2조환자수술시간、결석청제솔、동통평분( VAS)、술후진통약수구량、술후혈홍단백하강치、술후수혈、술후대출혈、술후발열、루뇨시간、술후주원천수、주원비용、술후회복정상생활공작시간등지표적구별。결과206례환자균순리완성수술,2조수술시간、결석청제솔、술후혈홍단백하강치、술후수혈、술후대출혈、술후발열병례비교차이균무통계학의의(P>0.05)；관찰조술후동통평분(VAS)、술후진통약용량、루뇨시간、술후주원시간、주원비용、술후회복정상생활공작시간균현저저우대조조(P<0.05)。결론부분무관화경피신경쇄석취석술여전통경피신경쇄석취석술상비,재감경환자술후동통、감소루뇨시간、축단환자술후주원시간、강저주원비용급가쾌환자술후회복정상생활공작상구유명현적우세,구유흔대적림상응용개치,치득추엄응용。
Objective To compare the clinical curative effect of partial tubeless and traditional percutaneous nephrolithotomy ( PCNL) in treatment of upper urinary calculus and to evaluate the clinical feasibility and value. Methods 206 patients with upper urinary calculus were enrolled in a randomized clinical trial from May 2013 to May 2014 according to the inclusion and exclusion criteria. These patients were randomized into the observation group (tubeless PCNL group) and the control group (traditional PCNL group). The operation time,stone clearance rate,visual analogue scale (VAS) pain score,usage of analgesic drugs,hemoglobin decrease,blood transfusion,bleeding,fever, leakage of urine,postoperative hospital stay,hospitalization expenses and the time of patients return to normal life were compared. Results All the operations were successfully finished. There were no statistically significant difference in operation time,stone clearance rate,hemoglo-bin decrease,bleeding,blood transfusion and fever (P>0. 05),but the visual analogue scale (VAS) pain score,usage of analgesic drugs, leakage of urine,postoperative hospital stay,hospitalization expenses and the time of patients return to normal life of the observation group were evidently lower than those of the control group (P<0. 05). Conclusion As partial tubeless PCNL have a great advantage on ease post-operative pain,shorten postoperative hospital stay,reduce hospitalization expenses and accelerate patients return to normal life,it is safe and effective for the treatment of upper urinary calculus,and it should be popularized and applied.