输尿管软镜与经皮肾镜碎石术治疗肾结石的效果比较  

Comparison of the effect of soft ureter and percutaneous nephrolithotomy in the treatment of renal calculi

作　　者：王健[1] 刘建华[1] 侯国良[1] 罗飞 WANG Jian;LIU Jian-hua;HOU Guo-liang;LUO Fei(The First Department of Urology,Foshan First People′s Hospital,Guangdong Province,Foshan 528000,China)

机构地区：[1]广东省佛山市第一人民医院泌尿外一科,广东佛山528000

出　　处：《中国当代医药》2019年第34期59-61,共3页China Modern Medicine

摘　　要：目的比较输尿管软镜与经皮肾镜碎石术(PCNL)治疗肾结石的临床效果。方法选取2016年1月~2019年1月在我院泌尿外科手术治疗的60例肾结石患者,按不同术式分为对照组和观察组,每组各30例。对照组采用输尿管软镜碎石术,观察组采用PCNL。比较两组的结石清除率、各项手术指标、并发症发生率。结果观察组术后3 d结石清除率高于对照组(P<0.05),但两组术后3个月的结石清除率比较,差异无统计学意义(P>0.05);观察组碎石时间短于对照组,但术中出血量多于对照组,术后24 h内出血率高于对照组,住院时间长于对照组,差异均有统计学意义(P<0.05);两组肾包膜下血肿、发热、严重血尿、肾绞痛、菌血症等并发症总发生率比较,差异无统计学意义(P>0.05)。结论肾结石应用输尿管软镜与PCNL治疗均可获得较好的结石清除效果,两种术式各具优缺点,临床可根据患者的实际情况选择适宜术式。Objective To investigate the effects of soft ureter and percutaneous nephrolithotomy(PCNL)in the treatment of renal calculi.Methods From January 2016 to January 2019,60 patients with renal calculi treated by urology in our hospital were selected and divided into control group and observation group according to different surgical methods,30 cases in each group.The control group was treated with flexible ureteroscope lithotripsy,while the observation group was treated with PCNL.The stone clearance rate,surgical indicators,complication rate were compared between the two groups.Results The stone clearance rate 3 d after operation in the observation group was higher than that in the control group(P<0.05),but there was no significant difference in stone clearance rate between the two groups at 3 months after operation(P>0.05).The time of lithotripsy in the observation group was shorter than that in the control group,the intraoperative blood output was more than that of the control group,the intraoperative bleeding rate was higher than that in the control group within 24 h after operation,and the hospitalization time was longer than that in the control group,the differences were statistically significant(P<0.05).There was no significant difference in the incidence of complications such as subcapsule hematomas,fever,severe hematuria,renal colic and bacteremia between the two groups(P>0.05).Conclusion Both flexible ureteroscope and PCNL can achieve better stone clearance effect for renal calculi.The two methods have their advantages and disadvantages,and can be selected according to the actual situation of patients.

关 键 词：肾结石 输尿管软镜碎石术 经皮肾镜碎石术 临床预后 

分 类 号：R692.4[医药卫生—泌尿科学]