输尿管软镜碎石术和体外冲击波碎石术治疗小于20 mm肾结石的临床疗效及影响因素分析  

Clinical effect and influencing factors of the flexible ureteroscopic lithotripsy and extracorporeal shock wave lithotripsy for diameter < 20 mm renal calculi

作　　者：王磊[1] 马玲[2] 乔庆东[1] 李龚龙[1] 冀阳[2] 刘振锋[1] WANG Lei;MA Ling;QIAO Qing-dong;LI Gong-long;JI Yang;LIU Zhen-feng(Department of the First Urologic Surgery,the Central Hospital of Xinxiang City,Xinxiang 453000,Henan Province,China;Department of the Second Urologic Surgery,the Central Hospital of Xinxiang City,Xinxiang 453000,Henan Province,China)

机构地区：[1]新乡市中心医院泌尿外一科,河南新乡453000 [2]新乡市中心医院泌尿外二科,河南新乡453000

出　　处：《新乡医学院学报》2019年第12期1141-1144,共4页Journal of Xinxiang Medical University

摘　　要：目的评估输尿管软镜碎石术(FURS)和体外冲击波碎石术(ESWL)治疗直径<20 mm肾结石的效果,并分析影响治疗效果的因素。方法回顾性分析2014年10月至2019年7月新乡市中心医院收治的264例直径<20 mm肾结石患者的临床资料,按治疗方式分为FURS组(n=112)和ESWL组(n=152),2组患者再按照结石直径分为<10 mm组、10~15 mm组和15~20 mm组。FURS组患者给予FURS进行治疗,ESWL组患者给予ESWL进行治疗。比较2组患者治疗后结石清除率、重复治疗率及并发症发生率,采用logistic回归分析影响结石清除率的因素。结果FURS组患者治疗后结石清除率高于ESWL组,重复治疗率低于FURS组(P<0.05);2组患者并发症发生率比较差异无统计学意义(P>0.05)。亚组分析结果显示,结石直径<10 mm组中FURS组和ESWL组患者结石清除率、重复治疗率、并发症发生率比较差异均无统计学意义(P>0.05)。10~15 mm组中FURS组患者结石清除率高于ESWL组,重复治疗率低于FURS组(P<0.05)。FURS组和ESWL组患者并发症发生率比较差异无统计学意义(P>0.05)。15~20 mm组中FURS组患者结石清除率高于ESWL组,重复治疗率低于FURS组(P<0.05);FURS组和ESWL组患者并发症发生率比较差异无统计学意义(P>0.05)。Logistic回归分析结果显示,肾下盏结石是影响FURS术后结石清除率的因素(P<0.05),结石直径是影响ESWL术后结石清除率的因素(P<0.05)。结论FURS和ESWL均为治疗直径<20 mm肾结石的有效方法,对于直径<10 mm结石,2种术式者疗效相似;结石直径10~20 mm时,FURS治疗效果优于ESWL;结石直径及位置情况是影响结石清除率的因素。Objective To evaluate the therapeutic efficacy of the flexible ureterscopic lithotripsy(FURS)and extracorporeal shock wave lithotripsy(ESWL)in treatment of diameter<20 mm renal calculi and analyse the factors influencing the treatment effect.Methods The clinical data of 264 patients with diameter<20 mm renal calculi in the Xinxiang Central Hospital from October 2014 to July 2019 were collected and analyzed retrospectively.The patients were divided into FURS group(n=112)and ESWL group(n=152)according to the treatment method.According to the stone diameter,the patients in the FURS group and ESWL group were divided into<10 mm group,10-15 mm group and 15-20 mm group.The stone clearance rate,repeated treatment rate and complication rate were compared between the two groups,and the influencing factors of stone clearance rate were analyzed by logistic regression.Results Compared with ESWL group,the stone clearance rate of patients in FURS group was higher and the repeated treatment rate was lower after treatment(P<0.05);there was no significant difference in the incidence of complications between the two groups(P<0.05).The results of subgroup analysis showed that there was no significant difference in stone clearance rate,repeated treatment rate and complication rate between FURS group and ESWL group in diameter<10 mm patients(P>0.05).In 10-15 mm group and 15-20 mm group,the stone clearance rate of patients in FURS group was higher than that in ESWL group and the repeated treatment rate was lower than that in the ESWL group(P<0.05);there was no significant difference in complication rate between FURS group and ESWL group.Logistic regression analysis showed that lower calyceal calculi was the influencing factors of stone clearance rate after FURS(P<0.05),and the stone diameter was the influencing factor of stone clearance rate after ESWL(P<0.05).Conclusion Both FURS and ESWL are effective treatment method for the diameter<20 mm renal calculi.FURS and ESWL have similar therapeutic efficacy in treatment of diameter<10 mm r

关 键 词：体外冲击波碎石 输尿管软镜碎石术 肾结石 

分 类 号：R691.4[医药卫生—泌尿科学]