经皮肾镜碎石取石术与输尿管软镜碎石术治疗<3.5 cm肾结石的安全性及疗效的临床探讨  

Clinical Study on Safety and Curative Effect of Percutaneous Nephrolithotomy and Ureteroscopic Lithotripsy in Treatment of Renal Stones < 3.5 cm

作　　者：王晓甫[1] 刘昌伟[1] 褚校涵[1] 赵兴华[1] 李武学[1] 赵永立[1] 张胜威[1] 樊长晖[1] 贾龙江[1] 王友志[1] 许长男 

机构地区：[1]郑州大学第二附属医院泌尿外科,河南郑州450003

出　　处：《中外医疗》2017年第17期54-56,共3页China & Foreign Medical Treatment

摘　　要：目的研究经皮肾镜碎石取石术(PCNL)与输尿管软镜碎石术(F-URS)治疗肾结石的临床疗效及安全性。方法方便选取该院2016年8月—2017年2月收治的82例肾结石患者,根据随机数字表法均分为两组,观察组41例行F-URS治疗,对照组41例行PCNL治疗,对比两组手术时间、术中出血量、术后住院时间、清石率以及术后并发症发生情况。结果观察组清石率为95.12%,与对照组的92.68%相当(P>0.05);观察组手术时间、术中出血量和术后住院时间分别为(65.35±11.58)min、(10.86±2.65)m L和(3.23±1.06)d,与对照组的(82.36±12.46)min、(79.65±25.68)m L和(6.83±1.31)d,比较差异有统计学意义(P<0.05);观察组术后肾包膜下血肿、肾绞痛和菌血症发生率分别为4.88%、4.88%和2.44%,均较对照组显著减少(P<0.05)。结论 F-URS和PCNL均为肾结石的有效治疗方法 ;较PCNL而言,F-URS清石率相当,但更为微创,安全;可缩短手术时间,减少术中失血量和术后并发症发生率。Objective To research the safety and curative effect of percutaneous nephrolithotomy and ureteroscopic lithotripsy in treatment of renal stones. Methods 82 cases of renal stone patients admitted and treated in our hospital from August2016 to February 2017 were conveniently selected and randomly divided into two groups with 41 cases in each, the observation group and the control group were respectively treated with F-URS and PCNL, and the operation time, intraoperative bleeding amount, postoperative length of stay, stone clearance rate and occurrence of postoperative complications were compared between the two groups. Results The stone clearance rate in the observation group was similar to that in the control group,（95.12% vs 92.68%）（P〉0.05）, and the operation time, intraoperative bleeding amount and postoperative length of stay in the observation group and in the control group were respectively（65.35±11.58）min,（10.86±2.65）mL,（3.23±1.06）d and（82.36±12.46）min,（79.65±25.68）mL,（6.83±1.31）d, and the differences were obvious by comparison（P〈0.05）, and the incidence rate of postoperative subcapsular renal hematoma, renal colic and bacteremia in the observation group were respectively 4.88%,4.88% and 2.44%, which were obviously decreased compared with those in the control group（P〈0.05）. Conclusion F-URS and PCNL are the effective treatment methods of renal stones, and the stones clearance rate of F-URS is similar to that of PCNL, but it is safer and can also shorten the operation time, reduce the intraoperative bleeding amount and incidence rate of postoperative complications.

关 键 词：肾结石 经皮肾镜碎石取石术 输尿管软镜碎石术 微创治疗 

分 类 号：R5[医药卫生—内科学]