| Percutaneous nephrolithotripsy(PCNL)is one of the main treatments for kidney and upper ureteral calculi.Traditional percutaneous nephrolithotripsy often requires large skin-kidney access.With the development of science and technology and the renewal of surgical instruments,miniaturized surgical schemes with different channel sizes have emerged one after another,and corresponding channels can be selected according to patients' stone conditions.At present,the visual puncture lithotripsy with the outer sheath diameter of F4.8 is the smallest PCNL operation method in the cutaneous and renal channels.Because of the advantages of visible puncture process and no further expansion,it has become a hot topic for clinical workers in recent years.However,because of its thin outer sheath,lithotripsy can not be removed after lithotripsy,and lithotripsy can only be discharged through the ureter,so the choice of stones should not be too large,ancestor.Chinese medicine also has some experience in the prevention and treatment of urinary calculi.There are numerous prescriptions,and Chinese patent medicines for stone removal are often used in clinic.The combination of traditional Chinese medicine and Western medicine may be more effective in the treatment of urinary calculi.In view of this,a retrospective analysis was made of 43 cases of <1.5cm renal calculi treated by visual puncture lithotripsy in our department from October 2016 to June 2018.The purpose of this study was to analyze and evaluate the clinical efficacy and safety of visual puncture lithotripsy in the treatment of<1.5cm renal calculi and the clinical efficacy of combined use of urolithotripsy,and to analyze the treatment of <1.5cm renal calculi by visual puncture lithotripsy combined with urolithotripsy.Clinical application value.Objective: To investigate the efficacy and application of 4.8F visual needle puncture lithotripsy combined with Nieshitong in the treatment of renal calculi less than 1.5cm in diameter.Methods: 43 cases of renal calculi less than 1.5 cm in diameter were treated by holmium laser lithotripsy with 4.8F visual needle puncture lithotripsy.The observation group(22 cases)took Urolithione orally after the operation,and the control group(21 cases)did not take any oral lithotripsy and other related drugs,and the control group only kept drinking water2500ml/d after the operation.The stone-free rate and stone-free time within 3 months after operation were compared between the two groups.Result:1.Establishment time of operation channel was 4.5±0.8 min and operation time was 35±11 min.2.The abdominal plain film was reexamined 2-3 days after operation,and the position of double "J" tubes was normal.3.The operation went smoothly without serious complications such as massive hemorrhage and peripheral organ injury.4.Data comparison: The stone-free rate in the first month after operation was 95.5%(21/22 cases)in the observation group and71.4%(15/21 cases)in the control group.The difference was statistically significant(P < 0.05).Stones in the observation group were cleared at the second month of review.In the control group,the stone-free rate was 90.5%(19/21 cases)in the second month and 100%(21/21 cases)in the third month.There was no significant difference between the two groups.The stone clearance time of the observation group was(1.05 ±0.21)months,and that of the control group was(1.38 ±0.67)months.The difference was statistically significant(P < 0.05).Conclusion: 4.8F visual needle puncture lithotripsy with holmium laser can effectively comminute kidney stones with diameter less than 1.5 cm.It is simple to operate,time-consuming and less bleeding.Nieshitong has the functions of clearing heat and dampness,removing obstruction by ventilating Qi and removing stones.After taking it,it can promote the removal of residual stones,reduce the risk of stone street formation,and further ensure that 4.8F visual needle puncture lithotripsy can be used as an integral mirror.Therapeutic effect of kidney stones,the combination of the two has a certain clinical application value,worthy of promotion and application. |
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