超微经皮肾镜与电子输尿管软镜治疗肾中、上盏2.0～2.5 cm结石疗效的比较  

Comparison between super-mini percutaneous nephrolithotomy and digital flexible ureteroscopy for the management of 2.0-2.5 cm stones in upper and middle calices of kidney

作　　者：梁福律 涂建平[1] 林剑峰[1] 郭昭建[1] 范先明[1] 张遵俊[1] 胡力仁 叶志彬 LIANG Fulv;TU Jianping;LIN Jianfeng;GUO Zhaojian;FAN Xianming;ZHANG Zunjun;HU Liren;YE Zhibin(Department of Urology,Thrid Hosp让al of Xiamen,Fujian TCM University,Xiamen,Fujian,361100,China)

机构地区：[1]福建中医药大学附属厦门第三医院泌尿外科

出　　处：《临床泌尿外科杂志》2019年第12期965-968,共4页Journal of Clinical Urology

摘　　要：目的:比较超微经皮肾镜取石术(SMP)与电子输尿管软镜碎石术(FURL)治疗肾中、上盏2.0~2.5 cm结石的疗效。方法:回顾性分析2017年3月~2018年12月收治的90例肾中、上盏2.0~2.5 cm结石患者的临床资料,其中SMP组44例,FURL组46例,比较两组年龄、结石大小、手术时间、术后血红蛋白下降值、住院天数、住院费用、术前肾积水及感染情况、术后并发症及清石率。结果:SMP组和FURL组年龄分别为(45.84±7.69)岁和(46.76±7.55)岁,结石大小分别为(2.23±0.12)cm和(2.19±0.11)cm,术后1个月清石率分别为95.45%(42/44)和89.13%(41/46),两组比较差异均无统计学意义(P>0.05)。SMP和FURL组手术时间分别为(58.83±12.83)min和(107.43±14.65)min,术后血红蛋白下降值分别为(10.07±3.62)g/L和(4.39±2.71)g/L,术后住院天数分别为(3.39±1.37)d和(2.70±0.99)d,住院费用分别为(19041.50±1855.76)元和(22086.70±1942.67)元,术后1 d清石率分别为90.91%(40/44)和73.91%(34/46),两组比较差异均有统计学意义(P<0.05)。SMP组术后血尿3例,FURL组术后出现发热3例,明显血尿1例,均经保守治疗治愈。结论:对于肾中、上盏2.0~2.5 cm结石,SMP与FURL均为理想的手术方式。SMP具有即时清石率高、手术时间短、住院费用低等优势,而FURL具有创伤小、住院时间短等优势。Objective:To compare the therapeutic effect between super-mini percutaneous nephrolithotomy(SMP)and digital flexible ureteroscopy(FURL)in treating patients with 2.0-2.5 cm stones in upper and middle calices of kidney.Method:We retrospectively analysed the general clinical data of 90 cases who had renal calculi in upper and middle calices ranging from 2.0-2.5 cm treated by either SMP(44)or FURL(46)between March 2017 and December 2018.The age,stone size,operation time,hemoglobin decline,postoperative hospital stay,hospitalization expense,preoperative hydronephrosis and infection,stone-free rate and complications were compared between the 2 groups.Result:The mean age,stone size and the stone-free rate after 1 month of the SMP group and FURL group were(45.84±7.69)years and(46.76±7.55)years,(2.23±0.12)cm and(2.19±0.11)cm,95.45%(42/44)and 89.13%(41/46).There was no significant difference between two groups(P>0.05).The operation time,hemoglobin decline,postoperative hospital stay,hospitalization expense and the stone-free rate after 1 day of the SMP group and FURL group were(58.83±12.83)min and(107.43±14.65)min,(10.07±3.62)g/L and(4.39±2.71)g/L,(3.39±1.37)d and(2.70±0.99)d,(19041.50±1855.76)yuan and(22086.70±1942.67)yuan,90.91%(40/44)and 73.91%(34/46),which there was statistical difference between two groups(P<0.05).In SMP group,obvious postoperative haemorrhage appeared in 3 cases.In FURL group,postoperative fever occurred in 3 cases,and obvious postoperative haemorrhage appeared in 1 case.All these complications were cured by conservative treatment.Conclusion:For 2.0-2.5 cm renal calculi in upper and middle calices,both SMP and FURL are effective.SMP has the advantages of higher immediate stone-free rate,shorter operation time and less expense,while FURL is better in less operation trauma and shorter hospital stay.

关 键 词：超微经皮肾镜 输尿管软镜 肾中、上盏 结石 

分 类 号：R692.4[医药卫生—泌尿科学]