陈智慧 罗惠兰 邓有强

【摘要】 目的 探析在上尿路结石的治疗中， 部分无管化经皮肾镜（PCNL）的有效性及安全性。

方法 62例上尿路结石患者作为研究对象， 随机分为参照组和研究组， 每组31例。研究组采取部分无管化（不置肾造瘘管， 单置双J管）经皮肾镜治疗， 参照组采取标准经皮肾镜（放置肾造瘘管及双J管）治疗。比较两组结石清除率、术后不良反应发生率及手术时间、平均住院时间、医疗费用、术后恢复时间。结果 研究组的结石清除率96.77%明显高于参照组的61.29%， 差异具有统计学意义（P<0.05）。研究组术后不良反应发生率9.68%明显低于参照组的48.39%， 差异具有统计学意义（P<0.05）。研究组手术时间、平均住院时间、医疗费用、术后恢复时间均优于参照组， 差异均具有统计学意义（P<0.05）。结论 在上尿路结石的治疗中， 部分无管化经皮肾镜的取石效果显著， 安全性高， 值得临床推广。

【关键词】 上尿路结石；部分无管化经皮肾镜；有效性；安全性

DOI：10.14163/j.cnki.11-5547/r.2018.10.006

【Abstract】 Objective To discuss and analyze the effectiveness and safety of partial tubeless percutaneous nephrolithotomy （PCNL） in the treatment of upper urinary calculi. Methods A total of 62 upper urinary calculi patients as study subjects were randomly divided into control group and research group， with

31 cases in each group. The research group was treated with partial tubeless （without nephrostomy tube， but single double J tube） percutaneous nephrolithotomy， and the control group was treated with standard percutaneous nephrolithotomy （with nephrostomy tube and single double J tube）. Comparison were made on stone clearance rate， incidence of postoperative adverse reactions， operation time， mean hospitalization time， medical expenses， and postoperative recovery time between the two groups. Results The research group had obviously higher stone clearance rate as 96.77% than 61.29% in the control group， and the difference was statistically significant （P<0.05）. The research group had obviously lower incidence of postoperative adverse reactions as 9.68% than 48.39% in the control group， and the difference was statistically significant （P<0.05）. The research group had better operation time， mean hospitalization time， medical expenses， and postoperative recovery time than the control group， and their difference was statistically significant （P<0.05）. Conclusion Partial tubeless percutaneous nephrolithotomy shows remarkable effect with high safety in the treatment of upper urinary calculi， and it is worthy of clinical promotion.

【Key words】 Upper urinary calculi； Partial tubeless percutaneous nephrolithotomy； Effectiveness； Safety

上尿路結石是一种常见的泌尿系统疾病， 其主要在肾盏、输尿管连接部、肾盂、输尿管上段等部位结石， 临床多表现为腰腹部、肋脊角有持续性或阵发性疼痛， 且向外阴及下腹部放射， 常伴有呕吐、恶心， 疼痛后会出现血尿情况。该疾病的病情程度与结石活动、大小、部位及有无梗阻、感染和损伤等因素有关[1-3]。为此， 本院在上尿路结石的治

疗中， 通过采取部分无管化经皮肾镜取石治疗的方案， 并分析其有效性和安全性， 旨在为临床提供一种安全有效的治疗方法。……