微通道经皮肾镜碎石与输尿管软镜碎石治疗孤立肾肾下盏2～3cm结石的比较  

Comparison of the treatment of minimally invasive percutaneous nephrolithotomy and flexible ureteroscope lithotripsy for solitary kidney subrenal calyx calculus 2-3 cm

作　　者：张宇 姜有涛[3] 李九智[3] 陈乐仲 吴越[2] ZHANG Yu1,2 ,JIANG Youtao3, LI Jiuzhi3 ,CHEN Lezhong1, WU Yue2(1.Department of Urology, Baoan Central Hospital of Shenzhen, Guangdong Province, Shenzhen 518102, China; 2.De- partment of Urology, the Sixth Affiliated Hospital of XinJiang Medical University, Xinjiang Uygur Autonomous Region, Urumqi 830000, China; 3. People＇s Hospital of XinJiang Uygur Autonomous Region, Urumqi, Xinjiang Uygur Au- tonomous Region, Urumqi 830001, Chin)

机构地区：[1]广东省深圳市宝安区中心医院泌尿外科,广东深圳518102 [2]新疆医科大学第六附属医院泌尿外科,新疆乌鲁木齐830001 [3]新疆维吾尔自治区人民医院泌尿外科中心,新疆乌鲁木齐830011

出　　处：《中国医药导报》2018年第6期58-62,共5页China Medical Herald

基　　金：广东省深圳市宝安区医疗卫生科研项目(2016CX049)

摘　　要：目的比较微通道经皮肾镜取石术(MPCNL)和输尿管软镜碎石术(FURL)治疗孤立肾肾下盏2~3 cm结石的效果。方法回顾性分析2013年4月~2016年2月深圳市宝安区中心医院治疗的孤立肾结石96例临床资料,根据治疗方法的不同分为MPCNL组(52例)和FURL组(44例),并分析比较两组的结石清除率、手术时间、术中出血量、住院时间、术后24h血红蛋白下降值和术后24h血清肌酐升高值、手术并发症、结石成分。结果 MPCNL组一期结石清除率高于FURL组(P<0.05),但两组总结石清除率比较,差异无统计学意义(P>0.05);MPCNL组手术时间短于FURL组(P<0.01),但术中出血量多于FURL组(P<0.01),住院时间长于FURL组(P<0.01);MPCNL组术后24h血红蛋白下降值高于FURL组(P<0.01),两组术后24h血清肌酐升高值比较,差异无统计学意义(P>0.05);MPCNL组与FURL组并发症发生率比较,差异有统计学意义(P<0.05);两组结石成分比较,差异无统计学意义(P>0.05)。结论治疗2~3 cm孤立肾肾下盏结石,MPCNL虽然一期结石清除率高于FURL,但FURL出血更少,住院时间更短,在一定程度上可以作为一种替代的治疗方式。Objective To compare the cffects of mininlally invasive percutaneous nephrolithotomy （MPCNL） and flexi- ble ureteroscope lithotripsy （FURL） for the treatment of solitary kidney subrenal calyx calculus 2-3 cm. Methods The clinical data of 96 cases of isolated kidney stone and treated in Baoan Central Hospital of Shenzhen from April 2013 to February 2017 were analyzed retrospectively. According to the different treatment methods, they were divided into MPCNL group （52 cases） and FURL group （44 cases）, and the stone clearance rate, operation time, intraoperative bleed- ing, length of hospital stay, 24 hours postoperatively hemoglobin drop value and 24 hours postoperatively serum creati- nine elevation value, surgical complications, and calculi composition were compared between the two groups, Results The phase 1 calculi clearance rate of MPCNL group was higher than that of FURL group （P 〈 0.05）, but the total stone clearance rate of both groups were compared, the difference was not statistically significant （P 〉 0.05）. The operation time of MPCNL group was shorter than that of FURL group （P 〈 0.01）, but the intraoperative bleeding of MPCNL group higher than that of FURL group （P 〈 0.01）, the length of hospital stay of MPCNL group was longer than that of FURL group （P 〈 0.01）. The 24 hours postopera- tively hemoglobin drop value of MPCNL group was higher than that of FURL group （P 〈 0.01）, the 24 hours postoperativedy serum creatinine elevation value of both groups were compared, the difference was not sta-tistically significant （P 〈 0.05）. The surgical complications of MPCNL group and FURL group were compared, the dif- ference was not statistically significant （P 〈 0.05）. The calculi composition of both groups were compared, the differ- ence was not statistically significant （P 〉 0.05）. Conclusion In the treatment of solitary kidney subrenal calyx calculus 2-3 cm, although the phase 1 calculi clearance rate of MPCNL is higher than FURL, FURL is le

关 键 词：孤立肾 肾结石 经皮肾镜碎石取石术 输尿管软镜碎石术 

分 类 号：R692.4[医药卫生—泌尿科学]