微通道经皮肾镜与组合式输尿管软镜碎石术治疗肾结石比较性研究

目的 比较微通道经皮肾镜与组合式输尿管软镜碎石术两种方式治疗肾结石的疗效和并发症.方法 100例体外冲击波碎石无效的肾结石患者,分为两组,51例患者行微通道经皮肾镜碎石术,49例患者行组合式输尿管软镜碎石术,比较两组患者的手术时间、术中出血量、术后并发症、术后住院时间、术后清除率.结果 51例微通道经皮肾镜组手术时间(53.5±19.6)min,术中出血(75.0±18.5) mL,术后住院时间为(8.0±1.5)d;术后总并发症发生率80.4％:47例结石清除,总清石率为92.16％.49例输尿管软镜组手术时间为(49.0±25.6)min,术中出血(15.2±2.9) mL,术后住院时间为(4.5±0.6)d;术后总并发症发生率为30.6％;32例结石清除,总清石率为65.31％.两者比较手术时间无明显差别;术中出血量、术后住院时间、术后并发症发生率、总清石率微通道经皮肾镜组大于组合式输尿管软镜组;但分组分层发现在多部位、多发结石方面清石率组合式输尿管软镜组优于微通道经皮肾镜组.结论 微通道经皮肾镜在治疗结石负荷＜2 cm、下盏结石、单个结石优于组合式输尿管软镜,但在多部位、多发结石方面清石率组合式输尿管软镜优于微通道经皮肾镜.

Comparative study of microchannel percutaneous nephrolithotomy and flexible ureteroscope lithotripsy for renal calculi

Objectives To compare efficacy and complications of micro-channel percutaneous nephrolithotomy and flexible ureteroscope lithotripsy in the treatment of patients with renal calculi.Methods One hundred patients with renal calauli who underwent invalid extracorporeal shock wave lithotripsy were,divided into two groups of 51 patients underwent micro-channel percutaneous nephrolithotomy lithotripsy and 49 patients underwent combined flexible ureteroscope lithotripsy.The operation time,blood loss,intraoperative and postoperative complications,postoperative hospital stay and postoperative stone clearance rate were compared between the two groups.Results Operation time of the micro channel by percutaneous renal lens group was (53.5 ± 19.6) min,blood loss was (75.0 ± 18.5) mL,postoperative hospital stay was (8.0 ± 1.5) d.The total complication rate was 80.4％,the total stone clearance rate was 92.16％ (47/51).The operation time,blood loss and postoperative hospital stay in ureteral soft mirror group was (49 ± 25.6) min,(15.2 ± 2.9) mL,(4.5 ± 0.6) d,respectively,There were postoperative pain in 6 cases,antibiotic therapy in 10 cases of infection,1 case of blood transfusion,perirenal hematoma in 1 case,complication rate was 30.6％,the total stone clearance rate was 65.31％ (32/49).Conclusions There was no significant difference in operation time.Intraoperative bleeding volume,postoperative hospitalization time,postoperative complication rate,total stone clearance rate of micro channel by percutaneous renal mirror group were higher than that of modular flexible ureteroscope group.The packet layer found that stone clearance rate of combined ureter soft lens group was better than that of microchannel percutaneous nephrolithotomy group in multiple locations and complicated stone.