RIRS与PCNL治疗肾盂输尿管交界处结石伴高度肾积水的安全性比较  

Comparison of Retrograde Intrarenal Surgery and Standard Percutaneous Nephrolithotomy in Treatment of Ureteropelvic Junction Stones with High Hydronephrosis

作　　者：石峰 孙文功 刘增振 孟庆泽 SHI Feng;SUN Wen-gong;LIU Zeng-zhen(No.988th Hospital of the Joint Logistic Support Force of the People's Liberation Army,Zhengzhou Henan 450007)

机构地区：[1]中国人民解放军联勤保障部队第九八八医院,河南郑州450007

出　　处：《医学临床研究》2023年第1期68-70,共3页Journal of Clinical Research

摘　　要：[目的]探讨标准经皮肾镜取石术(PCNL)和逆行肾内输尿管软镜碎石术(RIRS)治疗肾盂输尿管交界处结石伴高度肾积水的安全性.[方法]回顾性分析2018年12月至2021年12月本院收治的100例肾盂输尿管交界处结石伴高度肾积水患者的临床资料,根据手术方法的不同将其分为观察组(行PCNL术治疗)与对照组(行RIRS术治疗),每组50例.比较两组手术操作时间、结石清除率、住院时间、术后血红蛋白流失量、麻醉镇痛使用率、术后尿毒症及并发症发生率、二次手术率.[结果]观察组手术时间短于对照组,住院时间长于对照组,差异有统计学意义(P<0.05);两组患者术后结石清除率比较,差异无统计学意义(P>0.05).观察组术后尿毒症发生率、二次手术率低于对照组,术后血红蛋白丢失高于对照组,差异有统计学意义(P<0.05);两组麻醉镇痛使用率、术后并发症Clavien系统分级比较,差异无统计学意义(P>0.05).[结论]RIRS、PCNL是治疗肾盂输尿管交界处结石伴高度肾积水的安全、有效的方法,PCNL在降低术后尿毒症发生率和二次手术率方面更具优势.【Objective】To compare the efficacy and safety of standard percutaneous nephrolithotomy(PCNL)and retrograde intrarenal surgery(RIRS)in the treatment of ureteropelvic junction stonrs/calculi with high hydronephrosis.【Methods】A total of 100 patients with renal pelvic and ureteral junction stones with high hydronephrosis who were treated in our hospital from December 2018 to December 2021 were selected in the study.Patients were divided into the observation group and the control group with 50 cases each,according to the random drawing method.The observation group received PCNL,while the control group received RIRS.The operation time,stone removal rate,hospital stay,postoperative hemoglobin loss rate,anesthesia and analgesia utilization rate,postoperative uremia incidence,complication rate and secondary operation rate were compared between the two groups.【Results】The operation time in the observation group was shorter than that in the control group,while the hospitalization time,the postoperative hemoglobin loss were higher than those in the control group(P<0.05).The incidence of uremia in the observation group(2.00%)and the rate of secondary operation were significantly lower than those in the control group(P<0.05).【Conclusion】RIRS and PCNL are safe and effective methods for the treatment of stones at the junction of the renal pelvis and ureter with high hydronephrosis.PCNL has more advantages in reducing the incidence of postoperative uremia and the rate of secondary operations.

关 键 词：输尿管疾病/并发症 肾结石/并发症 肾结石/外科学 肾造口术 经皮 治疗结果 

分 类 号：R693[医药卫生—泌尿科学]