经皮肾镜取石术与输尿管软镜碎石术治疗肾下盏结石的疗效对比

目的:探讨经皮肾镜取石术与输尿管软镜碎石术治疗肾下盏结石的临床效果。方法:选择2014年8月至2016年1月收治的92例肾下盏结石患者,以随机数字表法分为两组,A组(n=46)行经皮肾镜取石术,B组(n=46)行输尿管软镜碎石术,观察两组患者手术情况及术后恢复情况。结果:A组手术时间较B组短,住院费用较B组低,B组住院时间、血红蛋白下降值低于A组,差异均有统计学意义(P0.05);A组并发症发生率为19.57%,B组为4.35%,两组相比差异有统计学意义(P0.05);A组一期结石清除率为95.65%,B组为89.13%,两组差异无统计学意义(P0.05);两组患者术后3个月症状消失、结石残留及结石复发率差异均无统计学意义(P0.05)。结论:肾下盏结石行输尿管软镜碎石术与经皮肾镜取石术手术效果相近,但输尿管软镜碎石术创伤较小,安全性更高,具有推广价值。

Comparison of the therapeutic effect of percutaneous nephrolithotomy and flexible ureteroscopic lithotripsy in the treatment of lower calyx calculi

Objective:To investigate the clinical effect of percutaneous nephrolithotomy and flexible ureteroscopic lithotripsy in the treatment of lower calyx calculi.Methods:Ninety-two cases with lower calyx calculi from Aug.2014 to Jan.2016 were included in the study and randomly divided into Group A and Group B with 46 cases in each group by random number table.Group A were treated by percutaneous nephrolithotomy while Group B by flexible ureteroscopic lithotripsy.The features of surgery and postoperative recovery were observed.Results:The operation time of Group A was shorter than that of Group B,the hospitalization costs of Group A were less than those of Group B.While the hospital stay of Group B was shorter than that of Group A,the decreasing in hemoglobin of Group B was less than that in Group A,the differences were statistically significant (P<0.05).The complication rate of Group A was 19.57%,which was more than 4.35% of Group B,the difference was statistically significant (P<0.05).The stone-free rate after a single procedure in Group A was 95.65%,Group B was 89.13%,which were not significantly different (P>0.05).The symptoms disappeared rate,stone recurrence rate and stone residual rate after 3 months in 2 groups were not significantly different (P>0.05).Conclusions:The clinical effect of percutaneous nephrolithotomy and flexible ureteroscopic lithotripsy in the treatment of lower calyx calculi are similar,but percutaneous nephrolithotomy is more mini-invasive and safer,should be popularized.