ESWL治疗1~2 cm肾下盏结石无效后行PCNL或RIRS治疗的临床效果比较  

Comparison of clinical effects of extracorporeal shock wave lithotripsy in the treatment of 1-2 cm lower calyx calculi with percutaneous nephrolithotripsy or flexible ureteroscopic lithotripsy

作　　者：李海见 李锋 张峰 高修建 程田坡 余阳 穰路弟 陈海飞 宋帅帅 Li Haijian;Li Feng;Zhang Feng;Gao Xiujian;Cheng Tianpo;Yu Yang;Rang Ludi;Chen Haifei;Song Shuaishuai(Department of Urology,the Fifth People's Hospital of Fuyang City,Fuyang 236000,China)

机构地区：[1]阜阳第五人民医院泌尿外科,阜阳236000

出　　处：《国际泌尿系统杂志》2022年第6期1019-1022,共4页International Journal of Urology and Nephrology

摘　　要：目的探讨体外冲击波碎石术(ESWL)治疗1~2 cm肾下盏结石无效后行经皮肾镜碎石术(PCNL)或输尿管软镜碎石术(RIRS)治疗的临床效果,评估并比较两种治疗方式的疗效及安全性。方法回顾性分析2019年1月至2021年1月在本院收治的ESWL治疗无效后行PCNL或RIRS的75例1~2 cm肾下盏结石患者的临床资料,根据治疗方式分为PCNL组(36例)和RIRS组(39例)。收集并比较两组患者的一般资料、结石清除率、手术时间、住院时间、术中出血量、住院费用、术后辅助ESWL次数、3个月结石清除率以及手术并发症。结果两组患者的结石清除率比较,差异无统计学意义(86.1%vs.84.6%,P>0.05)。RIRS组的手术时间、住院费用、术后辅助ESWL次数多于PCNL组,术中出血量、住院时间少于PCNL组,差异均有统计学意义(均P<0.05)。RIRS组的围手术期并发症发生率低于PCNL组,差异有统计学意义(P=0.029)。结论经ESWL治疗无效后行RIRS治疗的1~2 cm肾下盏结石的并发症发生率更低、住院时间更短,但RIRS碎石效率不如PCNL,总体花费较高,术后需行ESWL辅助治疗才能取得与PCNL相当的治疗效果。Objective To compare the clinical effects of percutaneous nephrolithotomy(PCNL)or retrograde intrarenal surgery(RIRS)after extracorporeal shock wave lithotripsy(ESWL)in the treatment of 1-2 cm subrenal calyx stones,and to evaluate and compare the two treatments efficacy and safety.Methods A retrospective analysis of 75 cases of PCNL or RIRS treated in our hospital from January 2019 to January 2021 who failed ESWL were retrospectively analyzed.The clinical data of patients with 1-2 cm subrenal calyx calculi were divided into PCNL group(36 cases)and RIRS group(39 cases)according to the treatment method.The general data,stone clearance rate,operation time,hospital stay,intraoperative blood loss,hospitalization cost,postoperative auxiliary ESWL times,3-month stone clearance rate and surgical complications were collected and compared between the two groups.Results There was no significant dfference in the stone clearance rate between the two groups(P>0.05).The operation time,hospitalization costs and postoperative adjuvant ESWL times in the RIRS group were more than those in the PCNL group,and the intraoperative blood loss and hospital stay were shorter than those in the PCNL group,with statistically significant differences(all P<O.05).The perioperative complication rate of RIRS group was lower than that of PCNL group,and the difference was statistically significant(P=0.029).Conclusions The 1-2 cm subrenal calyx calculi treated with RIRS after ESWL treatment failed have lower complication rate and shorter hospital stay,but RIRS lithotripsy efficiency is not as high as PCNL,the overall cost is higher,and postoperative ESWL adjuvant therapy is required In order to achieve the same therapeutic effect as PCNL.

关 键 词：肾结石 肾造口术 经皮 输尿管镜检查 体外冲击波疗法 碎石术 

分 类 号：R699.2[医药卫生—泌尿科学]