Clinical study on the treatment of renal and upper ureteral calculi by
tubeless and traditional PCNL

doi:10.3760/cma.j.issn.1007-1245.2022.10.011

Abstract

Abstract:

Objective　To analyze the safety and efficacy of tubeless and traditional percutaneous nephrolithotomy (PCNL) in the treatment of renal and upper ureteral calculi. Methods　A total of 72 patients with upper ureteral calculi and/or renal calculi with comparable calculus burden who were admitted to Yingde People's Hospital from May 2019 to November 2021 were prospectively collected and were simply randomly divided into two groups, with 36 cases in the tubeless group and 36 cases in the traditional group. The stone clearance rate, operation time, postoperative complications, hospitalization cost, and postoperative pain were compared between the two groups. t test was used for the measurement data, and Chi-square test or Fisher's exact test was used for the count data. Results　There were statistically significant differences in the operation time [(81.67±3.02) min vs. (95.56±5.17) min], hospital stay [(6.33±0.20) d vs. (9.52±0.22) d], hospitalization cost [(12 580±269.7) yuan vs. (14 199±208.6) yuan], time of extubation [(2.75±0.13) d vs. (6.06±0.07) d], postoperative ambulation time [(14.33±1.98) h vs. (70.00±2.40) h], and postoperative pain score [(1.72±0.18) points vs. (4.06±0.29) points] between the tubeless group and the traditional group (all P<0.05), while there were no statistically significant differences in the decrease of hemoglobin and rates of perirenal hematoma, fever, and stone clearance (all P>0.05). Conclusion　Tubeless PCNL is safe and effective in the treatment of renal and upper ureteral calculi, and has the advantages of reducing the postoperative pain, early out of bed activity, early removal of urinary catheters, promoting the postoperative rehabilitation, shortening the hospital stay, and reducing the hospitalization cost compared with traditional PCNL.

Key words: Percutaneous nephrolithotomy, , Tubeless, , Renal calculi, , Upper ureteral calculi, Safety, Efficacy

摘要： 目的　分析无管化经皮肾镜取石术（PCNL）和传统PCNL治疗肾、输尿管上段结石的安全性和有效性。方法　前瞻性收集英德市人民医院2019年5月至2021年11月期间收治的72例结石负荷相当的输尿管上段结石和/或肾结石的患者，简单随机分为两组，无管化组36例、传统组36例，比较两组患者手术的结石清除率、手术时间、术后并发症、住院费用、术后疼痛等。计量资料采用t检验，计数资料采用卡方检验或Fisher确切概率法。结果　无管化组与传统组分别在手术时间［（81.67±3.02）min比（95.56±5.17）min］、住院时间［（6.33±0.20）d比（9.52±0.22）d］、住院费用［（12 580±269.7）元比（14 199±208.6）元］、拔尿管时间［（2.75±0.13）d比（6.06±0.07）d］、术后下床活动时间［（14.33±1.98）h比（70.00±2.40）h］、术后疼痛评分［（1.72±0.18）分比（4.06±0.29）分］方面差异均有统计学意义（均P<0.05）；而在血红蛋白下降值、肾周血肿率、发热率、结石清除率方面差异均无统计学意义（均P>0.05）。结论　无管化PCNL治疗肾、输尿管上段结石安全有效，相对于传统PCNL具有减轻患者术后疼痛感、早期下床活动、早期拔除尿管、促进患者术后康复、缩短住院时间、减少住院费用的优势。

关键词: 经皮肾镜取石术, 无管化, 肾结石, 输尿管上段结石, 安全性, 有效性

Pan Xiaolong, Li Xiao, Heng Baoli, Zhu Guangjian, Huang Zhen, Wu Fanyu. Clinical study on the treatment of renal and upper ureteral calculi by tubeless and traditional PCNL[J]. International Medicine and Health Guidance News, 2022, 28(10): 1377-1380.

潘小龙, 李晓, 衡宝利, 朱光建, 黄振, 吴凡宇. 无管化与传统PCNL治疗肾、输尿管上段结石的临床研究[J]. 国际医药卫生导报, 2022, 28(10): 1377-1380.

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Clinical study on the treatment of renal and upper ureteral calculi by tubeless and traditional PCNL

无管化与传统PCNL治疗肾、输尿管上段结石的临床研究

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