经皮肾镜碎石术与经尿道输尿管软镜碎石术治疗≤2 cm肾下盏结石疗效比较  

Comparison of the Curative Effect of Percutaneous Nephrolithotripsy and Transurethral Flexible Ureteroscopic Lithotripsy in the Treatment of Infe⁃rior Calices of≤2 cm

作　　者：谭宝飞 庞宽[1] 庞桂建[1] 张振强 刘兴泽 TAN Baofei;PANG Kuan;PANG Guijian;ZHANG Zhenqiang;LIU Xingze(Department of Urology,the First People's Hospital of Yulin,Yulin,Guangxi,537000 China)

机构地区：[1]广西玉林市第一人民医院泌尿外科,广西玉林537000

出　　处：《中外医疗》2023年第2期64-67,72,共5页China & Foreign Medical Treatment

摘　　要：目的比较经皮肾镜碎石术(percutaneous nephroscopic lithotripsy,PCNL)与经尿道输尿管软镜碎石术(flexible ureteroscopic lithotripsy,FURL)治疗≤2 cm肾下盏结石的疗效。方法回顾性分析2019年1月—2021年12月于广西玉林市第一人民医院治疗肾下盏结石患者88例的临床资料,根据手术方法不同分为PCNL组与FURL组,各44例。比较两组患者围术期指标、临床疗效、炎症指标及并发症发生情况。结果PCNL组较FURL组手术时间更短、血红蛋白下降量更多、住院时间更长,差异有统计学意义(P<0.05),两组患者白细胞升高值、结石清除率对比,差异无统计学意义(P>0.05);PCNL组治疗有效率为90.91%,高于FURL组的88.64%,差异无统计学意义(P>0.05);与手术前对比,手术后两组患者炎症因子水平均更高,PCNL组患者炎症因子水平比FURL组更高,差异有统计学意义(P<0.05);PCNL组并发症发生率为18.18%,高于FURL组的4.55%,差异有统计学意义(χ^(2)=4.062,P=0.044)。结论PCNL与FURL两种方法疗效相当,FURL手术时间更长,但其手术应激较轻,患者术后恢复更快,住院时间更短,且术后并发症更少,肾下盏结石≤2 cm的患者在治疗时可优先选择FURL治疗。Objective To Compare the curative effect of percutaneous nephroscopic lithotripsy(PCNL)and flexible ureteroscopic lithotripsy(FURL)in the treatment of≤2 cm lower renal stones.Methods A retrospective analysis was performed for clinical data of 88 patients with subrenal calculi treated in the First People's Hospital of Yulin City,Guangxi Province from January 2019 to December 2021.The patients were divided into PCNL group and FURL group according to different surgical methods.with 44 cases each The perioperative indexes,clinical efficacy,inflammatory indexes and complications of the two groups were compared.Results Compared with the FURL group,the PCNL group had shorter operation time,more hemoglobin decrease,and longer hospital stay,and the difference was statistically sig⁃nificant(P<0.05),and there was no statistically significant difference in the elevated value of white blood cells and stone clearance between the two groups(P>0.05).The effective rate of treatment in the PCNL group was 90.91%,which was higher than that in the FURL group(88.64%),and the difference was not statistically significant(P>0.05).Compared with before surgery,the levels of inflammatory factors in both groups after surgery were higher,and the lev⁃els of inflammatory factors in the PCNL group were higher than those in the FURL group,and the difference was statis⁃tically significant(P<0.05).The complication rate was 18.18%in the PCNL group,higher than 4.55%in the FURL group,and the difference was statistically significant(χ^(2)=4.062,P=0.044).Conclusion PCNL and FURL have compa⁃rable efficacy,FURL surgery time is longer,but the surgical stress is less,patients recover faster after surgery,the hos⁃pital stay is shorter,and postoperative complications are less,and patients with subrenal calculi≤2 cm can be given priority in FURL treatment.

关 键 词：经皮肾镜碎石术 经尿道输尿管软镜碎石术 肾下盏结石 

分 类 号：R683[医药卫生—骨科学]