输尿管镜下钬激光碎石与经皮肾镜取石术治疗肾结石的疗效比较

目的比较输尿管镜下钬激光碎石与经皮肾镜取石术治疗。肾结石的疗效。方法回顾性分析2008年2月至2011年4月间109例肾结石患者的临床资料及治疗方法。其中采用输尿管硬镜和软镜钬激光碎石术64例，采用经皮肾镜钬激光碎石取石术45例。比较分析两种方法治疗结石的手术时间、碎石成功率、血红蛋白下降情况、术后住院时间、住院费用和并发症。结果输尿管镜组43例术中换用输尿管软镜击碎冲入肾盏的结石，术后发热3例。经皮肾镜组术后发热2例，1例出现术中、术后明显出血。两组手术时间、一期结石清除率比较，差异均无统计学意义（P〉0．05）；血红蛋白下降值、住院时间、住院费用比较差异有统计学意义（P〈0．05）。结论输尿管镜下碎石与经皮肾镜疗效相近，且输尿管镜下碎石具有创伤小、住院时间少、治疗费用低及并发症发生率低的优势。

Comparison of therapeutic effects of renal calculi with ureteroscopic holminum laser lithotripsy versus percutaneous nephrostolithotripsy

Objective To compare the therapeutic effects of ureteroscopic holminum laser litho- tripsy（UHL） and percutaneous nephrostolithotripsy（PCNL） in treating patients with renal calculus. Meth- ods From February 2008 to April 2011, the clinical data and therapeutic methods of 109 patients with re- nal calculi were retrospectively reviewed,including 64 cases of rigid and flexible ureteroscopy with holmi- um laser lithotripsy（ UHL group） and 45 cases of percutaneous nephroscope with holmium laser lithotripsy （ PCNL group）. Operation time, success rate, hemoglobin decrease, postoperative hospital stay, hospitaliza- tion expenses and complication ratio were compared between the groups. Results In the UHL group,43 cases were intraoperatively switched to the flexible ureteroscopy for crashing calyceal calculi and postopera- tive fever were found in 3 cases. In the PNCL group, there were 2 cases of postoperative fever and 1 case of intraoperative and postoperative bleeding. There were no differences in operation time and primary stone free rate between the groups（ P 〉 0. 05 ）. The hemoglobin decrease, hospitalization stay and hospitalization expenses had significant differences （P 〈 0.05 ）. Conclusion The UHL has similar therapeutic effect as PCNL. It has the advantages of less trauma, short hospital stay,less hospitalization expenses and low com- plication rate.