MPCNL和FURS治疗输尿管上段结石的效果比较

目的 探讨微创经皮肾镜取石(MPCNL)、输尿管软镜(FURS)治疗输尿管上段结石的临床效果.方法 回顾性分析本院泌尿外科收治的94例输尿管上段结石患者进行回顾性分析,其中采用MPCNL治疗49例、FURS治疗45例,对比两组患者的手术期指标、结石清除及手术并发症情况.结果 FURS组患者的手术时间长于MPCNL组患者(P＜0.05),FURS组患者的住院时间短于MPCNL组患者(P＜0.05);两组间碎石成功率、清石率、Hb降低值、ESWL辅助率差异均无统计学意义(P＞0.05).FURS组、MPCNL组患者手术后IL-6、IL-8、TNF-α、CRP水平均较本组术前显著的降低(P＜0.05).FURS组的手术并发症率(4.44％)显著的低于MPCNL组的(18.37％,P＜0.05).结论 MPCNL、FURS治疗输尿管上段结石效果相当,但是FURS具有恢复较快、并发症少的优点.

Comparison of MPCNL and FURS in the treatment of upper ureteral calculi

Objectives To investigate the clinical effect of minimally invasive percutaneous nephrolithotomy (MPCNL)and flexible ureteroscopy(FURS) in the treatment of upper ureteral calculi.Methods A retrospective analysis of 94 patients with upper ureteral calculi in our hospital were performed.Of the 94 cases,49 cases underwent MPCNL and 45 cases underwent FURS.Stone removal,surgical complications and other criteria were compared between the two groups.Results Operation time in the FURS group was longer than MPCNL group,and duration of hospitalization in the FURS group was shorter than MPCNL group (P ＜ 0.05).There was no significant difference in successful rate of lithotripsy,stone clearance rate,reduced value of Hb and ESWL aid rate between the two groups (P ＞ 0.05).IL-6,IL-8,TNF-u,CRP levels after treatment significantly reduced than before treatment(P ＜ 0.05).Rate of complications(4.44％) in FURS group was significantly lower than MPCNL group(18.37％,P ＜ 0.05).Conclusions MPCNL and FURS for upper ureteral calculi is effective,but FURS has the advantages of quick recovery and few complication.