摘要
目的:探讨经皮肾镜碎石取石术(PCNL)对肾结石患者肾功能指标、并发症发生率及生活质量的影响。方法:选取2021年3月—2023年3月贵阳贵航医院收治的520例肾结石患者,按随机数字表法分为两组,各260例。对照组行开放式取石术治疗,观察组予以PCNL治疗。比较两组手术指标、肾功能指标、应激反应、生活质量及并发症发生情况。结果:观察组手术时间、术后下床活动时间及住院时间分别为(78.96±5.37)min、(3.02±0.36)d、(7.62±1.12)d,均优于对照组的(102.41±10.35)min、(6.57±1.22)d、(12.35±1.24)d,术中出血量为(85.41±6.38)mL,少于对照组的(149.85±12.54)mL,差异均有统计学意义(P<0.05)。术后24 h,观察组血尿素氮(BUN)、肌酐(Cr)、半胱氨酸蛋白酶抑制剂C(Cys C)水平分别为(10.95±1.23)mmol/L、(89.04±7.75)μmol/L、(622.41±50.28)μg/L,均低于对照组的(14.98±1.31)mmol/L、(96.85±7.82)μmol/L、(693.68±50.75)μg/L,差异均有统计学意义(P<0.05)。术后24 h,观察组肾上腺皮质激素(ACTH)、去甲肾上腺素(NE)、皮质醇(Cor)水平分别为(88.63±7.35)μg/L、(23.56±2.31)pmol/L、(748.65±50.34)nmol/L,均低于对照组的(96.78±8.53)μg/L、(27.63±3.15)pmol/L、(803.41±52.54)nmol/L,差异均有统计学意义(P<0.05)。术后3个月,观察组生活质量各领域评分分别为(87.86±5.62)、(89.44±5.93)、(90.33±4.39)、(91.52±4.23)分,均高于对照组的(82.23±5.31)、(83.14±5.52)、(83.68±5.12)、(85.46±5.59)分,差异均有统计学意义(P<0.05)。观察组并发症发生率较对照组低,差异有统计学意义(P<0.05)。结论:PCNL治疗肾结石效果更佳,可降低机体应激反应,减轻肾功能损害,减少并发症发生。
Objective:To investigate the effect of percutaneous nephrolithotomy(PCNL)on renal function indicators,incidence of complications and quality of life in patients with kidney stones.Method:A total of 520 cases of kidney stones admitted to Guiyang Guihang Hospital from March 2021 to March 2023 were selected,and were divided into two groups by the random number table method,with 260 cases in each group.The control group was treated with open lithotomy,and the observation group with PCNL.Surgical index,renal function index,stress response,quality of life,and incidence of complications were compared between the two groups.Result:The surgical time,postoperative mobilization time,and hospital stay in the observation group were(78.96±5.37)min,(3.02±0.36)d,and(7.62±1.12)d,which were better than(102.41±10.35)min,(6.57±1.22)d,and(12.35±1.24)d in the control group,the intraoperative blood loss was(85.41±6.38)mL,which was lower than(149.85±12.54)mL in the control group,the differences were statistically significant(P<0.05).24 hours after surgery,the levels of blood urea nitrogen(BUN),creatinine(Cr),and cystatin C(Cys C)in the observation group were(10.95±1.23)mmol/L,(89.04±7.75)μmol/L,and(622.41±50.28)μg/L,which were lower than(14.98±1.31)mmol/L,(96.85±7.82)μmol/L,and(693.68±50.75)μg/L in the control group,the differences were statistically significant(P<0.05).24 hours after surgery,the levels of adrenocortical hormone(ACTH),norepinephrine(NE),and cortisol(Cor)in the observation group were(88.63±7.35)μg/L,(23.56±2.31)pmol/L,and(748.65±50.34)nmol/L,which were lower than(96.78±8.53)μg/L,(27.63±3.15)pmol/L,and(803.41±52.54)nmol/L in the control group,the differences were statistically significant(P<0.05).Three months after surgery,the quality of life scores in various fields in the observation group were(87.86±5.62),(89.44±5.93),(90.33±4.39),and(91.52±4.23)points,which were higher than(82.23±5.31),(83.14±5.52),(83.68±5.12),and(85.46±5.59)points in the control group,the differences were statistically significant(P<0.05).The incidence of complications in the observation group was lower than that in the control group,the difference was statistically significant(P<0.05).Conclusion:PCNL has better results in the treatment of kidney stones,which can reduce the body stress response,reduce renal function damage,and reduce complications.
作者
张恒志
ZHANG Hengzhi(Department of Urology,Guiyang Guihang Hospital,Guiyang 550009,China)
出处
《中国医学创新》
CAS
2024年第17期33-37,共5页
Medical Innovation of China
关键词
肾结石
经皮肾镜碎石取石术
肾功能
生活质量
并发症
Kidney stones
Percutaneous nephrolithotomy
Renal function
Quality of life
Complications
