Clinical Application Of Partially Tubeless Percutaneous Nephrolithotripsy Combined With Enhanced Recovery After Surgery In Upper Urinary Tract Calculi

ObjectiveThe purpose of this study was to explore the safety,feasibility and clinical value of the treatment of selected upper urinary tract calculi with the combination of partially tubeless percutaneous nephrolithotripsy(PTPCNL)and enhanced recovery after surgery(ERAS)concept.MethodsThis study retrospective analysis the patients with upper urinary calculi who were hospitalized in the First Ward of Urology Department of the First Affiliated Hospital of Nanhua University from January 2018 to December 2019.According to the inc lusion and exclusion criteria,124 patients were enrolled in this study.The observation group(PTPCNL+ERAS)include 42 patients,male: 23,female: 19,age: 53.2±12.5 years,stone diameter: 20.8±5.8mm;control group 1(PCNL+ERAS)include 42 patients,male: 22,female: 20,age: 49.8±12.3 years,stone diameter: 23.5±6.3mm;control group 2(PTPCNL+traditional rehabilitation)include 40 patients,male: 21,female: 19,age: 48.9±10.4 years,stone diameter: 22.1± 5.1mm;statistical comparison the differences between the observation group and the 2 control groups,include general information,incidence of postoperative nausea and vomiting,incidence of postoperative abdominal pain and distention,and postoperative visual pain score,postoperative creatinine change,postoperative hemoglobin reduction,postoperative stone removal rate,postoperative fever rate,postoperative anal exhaust time,postoperative time of Activities and postoperative hospitalization time.Statistical data were analyzed by statistical method,the P<0.05 was considered with statistically significant.ResultsThere was no statistical difference(P>0.05)between the observation group and the control groups in the sex,age,stone size,stone location,lithotripsy time,postoperative hemoglobin reduction degree,postoperative creatinine value change,postoperative stone removal rate,postoperative fever rate,postoperative nausea and vomiting rate(observation group and control group 1),postoperative anal exhaust time(observation group and control group 1),postoperative abdominal pain and distention rate,and postoperative related complications rate;but there was statistical difference(P < 0.05)between the observation group and the control groups in the incidence of nausea and vomiting(observation group and control group 2),postoperative anal exhaust time(observation group and control group 2),the VAS score of 4 hours after operation,the VAS score of first day after operation,the time of indwelling catheter,the time of getting out of bed and the average hospital stay.Conclusions1? It is safe and effective to take partially tubeless percutaneous nephrolithotripsy for the selected patients with upper urinary tract calculi.2? For the selected patients with upper urinary tract calculi undergoing percutaneous nephrolithotripsy,the combination of the idea of partially tubeless and ERAS can reduce the postoperative pain,promote the recovery of patients and shorten the postoperative hospital stay.