经皮肾镜和逆行输尿管软镜处理≤2 cm肾结石的比较

目的比较经皮肾镜取石取石术（PCNL）和逆行输尿管软镜碎石取石术（RIRS）治疗≤2 cm肾结石的疗效。 方法回顾性分析2015年10月至2016年11月广西医科大学第一附属医院泌尿外科收治的96例≤2 cm肾结石患者的临床资料，按术式将其分为PCNL组42例和RIRS组54例。比较分析两组术前准备时间、手术时间、碎石时间、术后住院时间、住院费用、术后清石率、并发症发生率等。 结果42例PCNL患者中，36例患者结石一次碎石完成，3例患者分2次碎石完成，3例患者残留结石。54例RIRS患者中，48例患者结石一次碎石完成，6例患者残留结石。PCNL组和RIRS组术后1周结石清除率分别为78.57%（33/42）和57.41%（31/54），术后1个月结石清除率分别为92.86%（39/42）和88.89%（48/54）。平均手术时间PCNL组（70±15）min，RIRS组（54±13）min。平均碎石时间PCNL组（32±13）min，RIRS组（39±13）min。术前准备时间PCNL组4（2）d，RIRS组3（2）d。术后住院时间PCNL组5（4）d，RIRS组1（1）d。平均住院费用PCNL组（19 195±3 809）元，RIRS组（13 319±1 537）元。并发症发生率PCNL组23.81%（10/42），RIRS组3.70%（2/54）。 结论相对于PCNL，RIRS在处理≤2 cm的肾结石在术后住院时间、并发症发生率、平均住院费用上有优势，而两者术后结石清除率相当。

Comparision of percutaneous nephrolithotomy and retrograde intrarenal surgery for the treatment of kidney stones smaller than 2 cm

ObjectiveTo compare the efficacy between percutaneous nephrolithotomy (PCNL) and retrograde intrarenal surgery (RIRS) in treatment of kidney stones smaller than 2 cm. MethodsFrom October 2015 to November 2016, clinical data of 96 patients with kidney stones smaller than 2 cm were analyzed retrospectively. According to the operative method, the patients were divided into two groups: PCNL group (42 cases) and the RIRS group (54 cases). The preoperative preparation time, operative time, gravel time, postoperative hospital stay, hospitalization expenses, stone free rate and complication rate between two groups were recorded and compared. ResultsIn group PCNL, stones were cleared in 36 cases after one surgery procedure, while 3 cases needed second surgery procedure, there were still residual stones in 3 cases after the treatment. In group RIRS, stones were cleared in 48 cases after one surgery procedure, there were still residual stones in 6 cases after the treatment. The stone clearance rate of PCNL and RIRS after one week was 78.57%(33/42) and 57.41%(31/54) respectively, while one month later, the stone clearance rate was 92.86%(39/42) and 88.89%(48/54). The average operation time in PCNL group and RIRS group were (70±15) min and (54±13) min, respectively. For the PCNL group and the RIRS group, indexes of the average gravel time were (32±13) min and (39±13) min, the preoperative preparation time were 4(2) days and 3(2) days, the postoperative hospital stay were 5(4) days and 1(1) day, the average hospitalization expenses were (19 195±3 809) yuan and (13 319±1 537) yuan, the overall complication rates were 23.81% (10/42) and 3.70%(2/54), respectively. ConclusionsFor the treatment of kidney stones smaller than 2 cm, RIRS had the advantage in the postoperative hospital stay, the overall complication rate, and the hospitalization expenses, when compared with PCNL.