Comparative Study On The Treatment Of Kidney Stones By Partial Tubeless-PCNL And The Standard PCNL

Objective:To compare the efficacy and safety of partial Tubeless-PCNL and the Standard PCNL in the treatment of kidney stones and the effect on the quality of life of postoperative patients.Methods:A retrospective analysis was performed on 46 patients with unilateral renal calculi(> 2.0cm)treated by percutaneous nephrolithotomy from June 2018 to August 2018 in a treatment group of the department of urology,china-japan friendship hospital,jilin university.Patients who had been identified as isolated kidney,horseshoe kidney and renal dysplasia were not included in this analysis.All the patients were divided into groups by random number grouping method before surgery,among which 21 patients were in the non-catheterization group,and ureteral catheters and catheters were indwelling after surgery.In the standard group,25 patients received indwelling renal fistula,ureter catheter and catheter.Stone clearance rate in the four weeks after surgery,postoperative hemoglobin value,postoperative blood transfusion,postoperative fever,Visual Analogue Scale(VAS),postoperative analgesic drug use,postoperative peritoneal exudation,and length of hospital stay were recorded,and then compared and analyzed.Results:In the partial tubeless group,postoperative stone free rate was90.47%(19/21),postoperative hemoglobin change value(13.71±6.04)g/L,postoperative blood transfusion rate was 4.76%(1/21),postoperative fever rate was 23.81%(5/21),postoperative 24 h VAS score was(4.23±1.60),postoperative analgesic use rate was 14.28%(3/21),and the average hospital stay was(6.14±1.52)days.In the standard group,postoperative stone free rate was 88.00%(22/25),postoperative hemoglobin change value(14.28±6.86)g/L,postoperative blood transfusion rate was 8%(2/25),postoperative fever rate was 24.00%(6/25),postoperative 24 h VAS score was(5.72±1.62),postoperative analgesic drug utilization rate was 44%(11/25),and the average hospitalization time was(7.80±1.93)days.There were statistically significant differences in VAS score,stone free rate and the length of time in hospital.Conclusion:The advantages of the Tubeless-PCNL group over the standard PCNL group were as follows:(1)The incidence of postoperative pain symptoms was significantlyreduced,and the proportion of using painkillers was also significantly reduced,which significantly improved the postoperative quality of life.(2)Postoperative hospitalization time was significantly shortened.