Objective:To discuss the curative effect and safety analysis of the microchannel percutaneous nephroscope lithotripsy(PCNL) treatment in elderly distal ureteral calculus(DUC) complicated with renal infection(RI).Methods:200 elderly patients with DUC complicated with renal infection RI were selected from September 2013 to September 2016 in our hospital,according to the random distribution,all patients were divided into the standard group and the micro group,100 cases in each group,the standard group of patients were given standard channel percutaneous nephroscope lithotripsy treatment,the micro group of patients were given microchannel percutaneous nephroscope lithotripsy treatment,which according to the infusion velocity(v) was divided into the high speed group (v＞250 mL/min) and the low speed group (v=250 mL/min or less),50 cases in each group,statistical analyzed all patients with intraoperative blood loss,ambulation time,bowel function recovery time,hospital stay,postoperative stone net effect and complications and surgical happening again.Results:The bleeding amount of high-speed and low-speed group,ambulation,bowel function recovery,length of hospital stay and the incidence of infectious complications were significantly lower than the standard group (P＜0.05),but reoperation rate was basically the same three groups of patients (P＞0.05);Low-speed patients urine bacteria culture positive rate and the incidence of infectious symptoms were significantly lower than the high speed and standard group,patients with calculi in net rate low group was obviously higher than that of high speed and standard group (P＜0.05).Conclusion:Microchannel PCNL treatment can effectively reduce the patients with senile DUC concurrent RI intraoperative trauma and postoperative complications,it is beneficial to patients with postoperative recovery,and low perfusion rate can improve the patients the stones from the net effect and reduce the rate of infectious complications.%目的:探讨微通道经皮肾镜碎石术(PCNL)治疗老年输尿管下段结石(DUC)并发肾感染(RI)的疗效和安全性分析.方法:选取2013年9月至2016年9月期间我院确诊治疗的老年DUC并发RI患者200例,依据随机数表法随机分为标准组和微小组,每组100例,标准组给予标准通道PCNL治疗;微小组患者给予微通道PCNL,其中依据灌注速度(v)分为高速组(v＞250 mL/min)和低速组(v≤250 mL/min),每组50例,统计分析所有患者治疗疗效、并发症及再手术发生情况.结果:高速组和低速组术中出血量、下床活动、肠功能恢复、住院时间和非感染性并发症发生率明显低于标准组(P＜0.05),但三组再手术率基本相同(P＞0.05);低速组尿细菌培养阳性率和感染性症状发生率明显低于高速组和标准组,前者结石取净率明显高于后两者(P＜0.05).结论:微通道PCNL治疗可有效减少老年DUC并发RI患者术中创伤和术后并发症发生,有利于患者术后恢复,且低灌注速度可提高患者的结石取净效果和减少感染性并发症的发生.
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