超微通道经皮肾镜与输尿管软镜治疗1~2 cm单发性肾结石的对比研究  

A comparative study of super-mini percutaneous nephrolithotomy and retrograde intrarenal surgery in treatment of 1-2 cm single renal calculi

作　　者：朱瑞龙[1] 蔡超 吴荣海[1] 徐炜[1] 邓硕[1] 陈伟文[1] 麦新 ZHU Rui-long;CAI Chao;WU Rong-hai(Department of Urology, Jiangmen Central Hospital, Guangdong 529000, China)

机构地区：[1]江门市中心医院泌尿外科,广东529000

出　　处：《中国临床新医学》2020年第11期1145-1149,共5页CHINESE JOURNAL OF NEW CLINICAL MEDICINE

摘　　要：目的对比超微通道经皮肾镜与输尿管软镜治疗1~2 cm单发性肾结石的疗效及安全性。方法选取江门市中心医院2018-01~2019-12收治的110例1~2 cm单发性肾结石患者资料进行回顾性分析。将患者按手术方式分为观察组(超微通道经皮肾镜组,n=54)和对照组(输尿管软镜组,n=56)。比较两组的手术时间、术中出血量、术后住院时间、术后2 d和术后1个月结石清除率、术后24 h体温、白细胞计数、降钙素原等炎性指标以及全身炎症反应的发生率。结果观察组手术时间、术后降钙素原异常率低于对照组(P<0.05),观察组术后血红蛋白下降值、术后2 d结石清除率、术后1个月结石清除率高于对照组(P<0.05),两组术后住院时间、发热、血白细胞异常率、全身炎症反应发生率比较差异均无统计学意义(P>0.05)。结论超微通道经皮肾镜碎石术和输尿管软镜碎石术均是治疗1~2 cm单发性肾结石安全、有效的方法。超微通道经皮肾镜碎石术结石清除率更高、感染风险较低,输尿管软镜碎石术出血量更少,机体创伤更小。Objective To compare the efficacy and safety of super-mini percutaneous nephrolithotomy and retrograde intrarenal surgery in treatment of 1-2 cm single renal calculi.Methods One hundred and ten patients with 1-2 cm single renal calculi were selected from Jiangmen Central Hospital during January 2018 and December 2019,and their data were retrospectively analyzed.The patients were divided into the observation group(super-mini percutaneous nephrolithotomy group,n=54)and the control group(retrograde intrarenal surgery group,n=56)according to different surgical methods.The operative time,intraoperative blood loss,postoperative hospital stay,stone-free rates 2 days and one month after operation,body temperature 24 hours after operation,white blood cell count(WBC),procalcitonin(PCT)and other inflammatory indexes as well as the incidence of systemic inflammatory response were compared between the two groups.Results The operative time and the postoperative abnormal rate of PCT in the observation group were significantly lower than those in the control group(P<0.05),while the decrease of postoperative hemoglobin,and the stone-free rates 2 days and one month after operation in the observation group were significantly higher than those in the control group(P<0.05).There were no differences in the postoperative hospital stay,fever,abnormal rate of white blood cells and the incidence of systemic inflammatory response between the two groups(P>0.05).Conclusion Both super-mini percutaneous nephrolithotomy and retrograde intrarenal surgery are safe and effective methods for treatment of 1-2 cm single renal calculi.Super-mini percutaneous nephrolithotomy has a higher stone-free rate and a lower risk of infection,while retrograde intrarenal surgery has less intraoperative blood loss and trauma.

关 键 词：肾结石 超微通道经皮肾镜碎石术 输尿管软镜碎石术 结石清除率 

分 类 号：R692.4[医药卫生—泌尿科学]