经输尿管软镜与经皮肾镜碎石术治疗肾结石对照研究

目的：探讨经输尿管软镜与经皮肾镜碎石术治疗肾结石的临床疗效。方法将115例肾结石患者根据其意愿分为甲乙两组，甲组42例，予以输尿管软镜术治疗，乙组73例，予以经皮肾镜碎石术治疗，比较两组手术时间、术中出血量、清石率。结果甲组术中出血量显著少于乙组（P＜0．01），但手术时间显著长于乙组（P＜0．01）。甲组对直径≤20 mm及直径＞20 mm肾结石的清石率分别为96．2％、87．5％，乙组分别为82．1％、91．2％，甲组对直径≤20 m m肾结石的清石率高于乙组，对直径＞20 mm肾结石的清石率低于乙组，但差异无显著性（χ2＝2．87、0．16， P＞0．05）。结论肾结石直径≤20 m m者应选用输尿管软镜碎石术，肾结石直径＞20 m m以及鹿角形结石应采用经皮肾镜碎石术，对于存在解剖结构异常、凝血功能异常、肾功能不全及穿刺困难者仍应该选用输尿管软镜碎石术。

A control study of flexible ureteroscopy lithotripsy vs .percu-taneous nephrolithotomy for kidney stone

Objective To explore the efficacy of flexible ureteroscopy lithotripsy (FUL) vs .percutaneous nephrolithotomy (PCNL) for kidney stone .Methods A total of 115 kidney stone patients were assigned to group A and B according to their wills ,group A (n=42) received FUL and B (n=73) did PCNL ,inter‐group operation times ,intraoperative amounts of bleeding and stone clearance rates were compared .Re‐sults Intraoperative amounts of bleeding were fewer (P<0 .01) and operation times longer (P<0 .01) in group A than B .Clearance rates of stones with diameter ≤ 20 mm and > 20 mm were respectively 96 .2%and 87 .5% in group A and 82 .1% and 91 .2% in B ,which showed no notable group differences (χ2 =2 .87 ,0 .16 ;P>0 .05) .Conclusion Patients with kidney stone ≤ 20mm should be treated with FUL and ones >20mm and stag‐horn calculi with PCNL .Patients with anatomical deformity ,coagulation disor‐ders ,renal insufficiency and puncture difficulty should still be treated with FUL .