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目的:探究经皮肾镜下应用第四代EMS超声联合气压弹道碎石清石系统治疗肾结石患者的效果。方法:从2012年10月~2014年8月收治的肾结石患者中选取420例行经皮肾镜手术,均分为观察组和对照组。对照组采用传统的微创经皮肾镜穿刺气压弹道取石术治疗,观察组给以经皮肾镜应用第四代EMS超声联合气压弹道碎石清石系统治疗。比较术后两组患者的生存质量(生活满意度、健康指数、情感得分、一般感情指数)以及不良反应(严重术后出血、局部组织损伤、肾功能损伤),并评价疗效。结果:观察组Ⅰ期结石清除率为94.29%(198/210),对照组为84.76%(178/210),差异有统计学意义(t=10.15,P<0.05);术后两组患者生活满意度、健康指数、情感得分、一般感情指数比较差异有统计学意义(P<0.05),观察组与对照组术后分别与术前比较亦差异有统计学意义(P<0.05);观察组术后局部组织损伤发生率为1.90%(4/210),对照组为6.67%(14/210),差异有统计学意义(x~2=5.80,P<0.05),严重术后出血、肾功能损伤两组比较差异无统计学意义(P>0.05)。结论:经皮肾镜应用第四代EMS超声联合气压弹道碎石清石系统治疗肾结石患者临床疗效显著,安全性高,术后不良反应发生率低,适合在临床上推广。
Objective: To investigate the effect of percutaneous nephrolithotomy using fourth generation EMS combined with pneumatic lithotripsy in the treatment of patients with kidney stones. Methods: From January 2012 to August 2014, 420 patients with renal calculi underwent percutaneous nephrolithotomy, which were divided into observation group and control group. The control group was treated by conventional minimally invasive percutaneous nephrolithotomy with pneumatic lithotripsy. The observation group was treated with the fourth generation of EMS combined with pneumatic lithotripsy by percutaneous nephrolithotomy. The quality of life (life satisfaction, health index, emotional score, general affective index) and adverse reactions (severe postoperative bleeding, local tissue injury and renal dysfunction) in both groups were compared and evaluated. Results: The stone clearance rate of stage Ⅰ in the observation group was 94.29% (198/210) and in the control group was 84.76% (178/210), the difference was statistically significant (t = 10.15, P <0.05) There were significant differences in satisfaction, health index, emotional score and general affective index between the observation group and the control group (P <0.05), and the difference between the two groups was statistically significant (P <0.05) The incidence of postoperative local tissue injury was 1.90% (4/210) in the control group and 6.67% (14/210) in the control group, with significant difference (x ~ 2 = 5.80, P <0.05) There was no significant difference between the two groups in functional impairment (P> 0.05). Conclusion: Percutaneous nephrolithotomy using the fourth generation of EMS combined with pneumatic lithotripsy clear stone system in the treatment of patients with renal stones significant clinical efficacy, high safety, low incidence of postoperative adverse reactions, suitable for clinical promotion.