超声引导下超微经皮肾镜取石术与微创经皮肾镜取石术在治疗≤2.5 cm上尿路结石的疗效比较  

Comparison on efficacy of ultrasound guided super-mini percutaneous nephrolithotomy and minimally invasive percutaneous nephrolithotomy in the treatment of upper urinary tract calculi≤2.5 cm

作　　者：费涛 林海星 杨明喜 熊超玉 宋赏 罗洪星 Fei Tao;Lin Haixing;Yang Mingxi;Xiong Chaoyu;Song Shang;Luo Hongxing(Department of Urology,Tongren Municipal People's Hospital,Tongren,Guizhou 554300,China)

机构地区：[1]铜仁市人民医院泌尿外科,贵州铜仁554300

出　　处：《齐齐哈尔医学院学报》2025年第1期55-58,共4页Journal of Qiqihar Medical University

摘　　要：目的探讨超声引导下超微经皮肾镜碎石术(SMP)应用于≤2.5 cm上尿路结石患者中的安全性和有效性。方法回顾性分析2020年7月—2021年12月本院收治的77例上尿路结石≤2.5 cm且接受超声引导下经皮肾镜取石术(PCNL)治疗的患者的临床资料,其中36例接受SMP治疗,41例接受微创经皮肾镜碎石术(MPCNL),比较两组患者的分析患者手术时间、结石清除率、手术前后血红蛋白下降程度、术后无管率、术后住院时间、术后并发症发生率等。结果两组的手术时间[(84.81±26.26)min vs.(88.81±31)min]、一次性清石率(97.2%vs.92.7%)比较无差异(P>0.05),但在手术前后血红蛋白下降量[(5.89±9.00)g/L vs.(9.56±11.50)g/L]、部分无管化率(83.33%vs.21.95%)、术后住院时间[(2.64±1.05)d vs.(4.19±2.19)d]等指标上SMP组均低于MPCNL组(P<0.05)。且SMP组在术后肾周渗出、肾周血肿以及术后发热等并发症发生率上(2.78%vs.17.07%)低于MPCNL组(P<0.05)。结论SMP与MPCNL均可用于治疗≤2.5 cm的上尿路结石,SMP具有手术时间短、并发症发生率低、住院时间短、出血少等优点,值得临床推广。Objective To investigate the safety and efficacy of ultrasound guided super-mini percutaneous nephrolithotomy(SMP)in patients with upper urinary tract calculi≤2.5 cm.Methods The clinical data of 77 patients with upper urinary tract stones≤2.5 cm treated by ultrasound-guided percutaneous nephrolithotomy(PCNL)in our hospital from July 2020 to December 2021 were analyzed retrospectively,including 36 patients who underwent SMP and 41 patients who underwent minimally invasive percutaneous nephrolithotomy(MPCNL).The operation time,one-time stone clearance rate,hemoglobin decrease,tubeless rate,postoperative hospital stay,and incidence of postoperative complications were compared between the two groups.Results There were no significant differences in operation time[(84.81±26.26)min vs.(88.81±31)min]and one-time stone clearance rate(97.2%vs.92.7%)between the two groups(P>0.05).However,the decrease in hemoglobin[(5.89±9.00)g/l vs.(9.56±11.50)g/l],partial tubeless rate(83.33%vs.21.95%),and postoperative hospital stay[(2.64±1.05)d vs.(4.19±2.19)d]in the SMP group were lower than those in the MPCNL group(P<0.05).Moreover,the incidence of complications such as postoperative perirenal exudation,perirenal hematoma,and postoperative fever in the SMP group(2.78%vs.17.07%)was lower than that in the MPCNL group(P<0.05).Conclusions Both SMP and MPCNL can be used in the treatment of upper urinary tract stones≤2.5 cm.SMP has the advantages of short operation time,less postoperative hospital stay,less bleeding,and low incidence of complications,which is worthy of clinical promotion.

关 键 词：超声引导 超微经皮肾取石术 微创经皮肾镜取石术 上尿路结石 无管化 

分 类 号：R699[医药卫生—泌尿科学]