输尿管软镜与微通道经皮肾镜处理1~2 cm无积水肾结石的对比研究  

Effects of Flexible Ureteroscopic Lithotripsy and Microchannel Percutaneous Nephrolithotomy for 1~2cm Kidney Stones without Hydronephrosis

作　　者：郭绍洪 程庆[2] 蔡笃森 GUO Shao-hong;CHENG Qing;CAI Du-sen(Department of Urology, the Second People's Hospital of Hainan, Wuzhishan572299 , Hainan,China;Department of Urology, Haikou People's Hospital, Haikou 570102, Hainan, China)

机构地区：[1]海南省第二人民医院泌尿外科,海南五指山572299 [2]海口市人民医院泌尿外科,海南海口570102

出　　处：《中国现代手术学杂志》2021年第2期138-141,共4页Chinese Journal of Modern Operative Surgery

基　　金：海南省重点研发计划(ZDYF2016137)。

摘　　要：目的探讨输尿管软镜碎石术(flexible ureteroscopic lithotripsy,FURL)与微通道经皮肾镜碎石术(microchannel percutaneous nephrolithotomy,mPCNL)治疗1~2 cm无积水肾结石的有效性及安全性。方法回顾性分析93例直径1~2 cm无积水肾结石患者临床资料,分为FURL组和mPCNL组。FURL组共48例,给予FURL治疗;mPCNL组共45例,给予mPCNL治疗。对比两组手术时间、住院时间、术中出血量、结石清除率(一期、二期)、血红蛋白(hemoglobin,Hb)下降值及并发症(发热、肾绞痛、肾包膜下血肿、石街、严重血尿)发生率。结果两组手术时间、二期结石清除率比较无统计学差异(P>0.05);相较于mPCNL组,FURL组住院时间、术中出血量、Hb下降值均明显减少(P<0.05),同时一期结石清除率显著提高(P<0.05)。两组发热、石街及严重血尿发生率比较无统计学差异(P>0.05);相较于mPCNL组,FURL组肾绞痛及肾包膜下血肿发生率均明显降低(P<0.05)。结论对于直径1~2 cm无积水肾结石,FURL能显著缩短住院时间,减少术中出血,降低术后并发症发生率,并能获得更高的一期结石清除率,其效果优于mPCNL。Objective To evaluate the efficacy and safety of flexible ureteroscopic lithotripsy(FURL)and microchannel percutaneous nephrolithotomy(mPCNL)for 1~2cm kidney stones without hydronephrosis.Methods From January 2019 to December 2019,there were 93 patients with 1~2cm kidney stones without hydronephrosis underwent FURL(n=48)or mPCNL(n=45)in our hospital.Their clinical data were retrospectively studied.Operation time,hospital stay,intraoperative blood loss,the stone clearance rate(in the first stage and the second stage),the hemoglobin(Hb)drop-out value and the complication rate(fever,renal colic,subcapsular renal hematoma,ureteral stones street and severe hematuria)were compared between the two groups.Results There was no statistical difference(P>0.05)of operation time and the stone clearance rate in the second stage between two groups.The hospital stay,intraoperative blood loss and Hb drop-out value of FURL group was significantly less than mPCNL group(P<0.05),and the stone clearance rate in the first stage of FURL group was significantly higher than mPCNL group(P<0.05).There was no statistical difference of the incidence of fever,ureteral stones street and severe hematuria between two groups(P>0.05).The incidence of renal colic and subcapsular renal hematoma of FURL group was significant less than mPCNL group(P<0.05).Conclusion For 1~2cm kidney stone patients without hydronephrosis,FURL has better clinical effects than mPCNL for its less hospital stay,less intraoperative blood loss,lower complication rate,and higher first-stage stone clearance rate.

关 键 词：微通道经皮肾镜碎石术 输尿管软镜碎石术 肾积水 肾结石 

分 类 号：R699[医药卫生—泌尿科学]