经尿道输尿管软镜碎石与微创经皮肾镜取石治疗肾盏结石的对比研究  

Comparative Study of Transurethral Flexible Ureteroscope Lithotripsy and Minimally Invasive Percutaneous Nephrolithotomy in Treatment of Renal Calyceal Calculi

作　　者：李健[1] 王健[1] 李应忠[1] 佟发春[1] 翟成喜[1] 业磊[1] 

机构地区：[1]玉溪市人民医院泌尿外科,云南玉溪653100

出　　处：《昆明医科大学学报》2015年第3期134-136,共3页Journal of Kunming Medical University

摘　　要：目的探讨经尿道输尿管软镜与微创经皮肾镜取石治疗肾盏结石的效果.方法收集玉溪市人民医院2012年3月至2014年3月收治的单发肾盏结石患者116例的临床诊疗资料,其中采用经尿道输尿管软镜碎石治疗的54例患者为输尿管软镜组,采用经皮肾镜取石治疗的患者62例为经皮肾镜组,观察2组患者手术时间、并发症及碎石成功率等.结果对于直径≥2 cm的上、中、下肾盏结石,微创经皮肾镜组手术时间、碎石成功率均明显优于输尿管软镜组,差异有统计学意义(P<0.05).对于直径<2 cm的上、中肾盏结石,2组碎石成功率无明显差异(P>0.05),但输尿管软镜组手术时间短于微创经皮肾镜组(P<0.05);对于直径<2 cm的下肾盏结石,微创经皮肾镜组手术时间及碎石成功率明显优于输尿管软镜组(P<0.05).结论肾盏结石直径≥2 cm时,无论结石位置均应首选微创经皮肾镜取石治疗;肾盏结石直径<2 cm时,结石位于上、中肾盏时推荐首选经尿道输尿管软镜碎石,结石位于下肾盏时,应首选微创经皮肾镜取石治疗.Objective To investigate the effect of transurethral flexible ureteroscope and minimally invasive percutaneous nephrolithotomy in treatment of renal calyceal stones.Methods The clinical data of 116 cases of solitary renal calyceal calculi were collected, 54 cases accepted transurethral flexible ureteroscope lithotripsy treatment as ureter soft lens group, 62 cases accepted Percutaneous nephrolithotomy treatment as percutaneous nephrolithotomy group. Then we compared the operation time,complications and the success rate between the two groups.Results When the renal calyceal calculi＇ diameter was greater than 2cm, minimally invasive percutaneous nephrolithotomy lithotripsy group was significantly better than the flexible ureteroscopy group in operation time and success rate, the difference was statistically significant（P〈0.05）. When the calculi＇ diameter was smaller than 2cm in the upper and middle renal calyceal, the lithotripsy successful rate had no significant difference between two groups（P〉0.05）, but the operation time of flexible ureteroscope was shorter（P〈0.05）.When the calculi＇ diameter was smaller than 2cm in the lower renal calyceal, minimally invasive percutaneous nephrolithotomy group was obviously better than the flexible ureteroscopy group in operation time and lithotripsy success rate（P〈0.05）.Conclusions Minimally invasive percutaneous nephrolithotomy should be chosen when the renal calyceal calculi＇s diameter is greater than or equal to 2cm,regardless the location where it was;when the diameter is smaller than 2 cm,transurethral flexible ureteroscope lithotripsy should be chosen when calculi＇ is in the upper and middle renal calyceal,while when calculi is in the lower renal calices, minimally invasive percutaneous nephrolithotomy should be the first choice.

关 键 词：肾盏结石 经尿道输尿管软镜碎石 微创经皮肾镜取石 

分 类 号：R693.4[医药卫生—泌尿科学]