孙氏末端可弯硬性输尿管肾镜与微创经皮肾镜碎石术治疗老年2~3cm肾脏下盏结石的疗效比较

【目的】比较孙氏末端可弯硬性输尿管肾镜与微创经皮肾镜碎石术治疗老年2~3cm肾脏下盏结石的临床疗效。【方法】选择2016年7月至2018年6月本院收治的老年单发性直径2~3cm肾脏下盏结石患者80例,根据手术方法的不同将其分为微创经皮肾镜碎石术(mPCNL)组与孙氏镜组,每组40例。检测两组患者血清C反应蛋白(CPR)、白细胞介素6(IL-6)、肿瘤坏死因子α(TNF-α)水平,比较两组术后并发症、术后住院时长、术中出血量、手术时长、一个月后结石清除率及手术成功率。【结果】两组患者手术均成功完成,术后一个月结石清除率比较,差异无统计学意义(92.5%vs 95.0%,χ^2=0.213,P>0.05);孙氏镜组手术时间长于mPCNL组,住院时间、术中出血量低于mPCNL组,差异均有统计学意义(P<0.05)。两组患者术后24h、72h血清CRP、TNF-α、IL-6水平均高于术后即刻,72h低于术后24 h,且mPCNL组患者术后24h、72h血清CRP、TNF-α、IL-6水平均高于孙氏镜组,差异均有统计学意义(P<0.05)。孙氏镜组术后并发症发生率为5%(2/40)低于mPCNL组的25.0%(10/40),差异有统计学意义(P<0.05)。【结论】孙氏镜治疗老年2~3cm肾脏下盏结石的临床效果较好,与mPCNL临床效果相近,同时具有术后恢复快、并发症少、创面小、出血少等优点。

Comparison of Sun's Tip-flexible Ureterorenoscopy and Minimally Invasive Percutaneous Nephrolithotomy in the Treatment for 2-3cm Lower-pole Stones in the Elderly

【Objeetive】To compare the therapeutic effect of Sim’s tip-flexible ureterorenoscopy and minimally invasive percutaneous nephrolithotomy for the treatment of 2-3cm renal inferior calyx stone in the elderly.【Methods】From June 2016 to July 2018,80 interns were randomly divided into Suns tip-flexible ureterorenoscopy group(40 cases)and minimally invasive percutaneous nephrolithotomy group(40 cases).They were treated by retrograde intrarenal surgery and minimally invasive percutaneous nephrolithotomy.The one-time success rate and stone clearance rate,operative time,intraoperative blood loss,postoperative hospitalization days,postoperative complications and trauma indicators were comp ared.【Results】There was no significant difference between the two groups(92.5%vs 95.0%,χ^2=0.213,P>0.05).The operation time of the Suns tip-flexible ureterorenoscopy group was longer than that of the mPCNL group,and the hospitalization time and intraoperative blood volume were lower than that of the mPCNL group(P<0.05).The serum CRP.TNF-αand IL-6 levels in the two groups were higher than those in the immediate and 72 hours postoperatively,and the serum CRP,TNF-α and IL-6 levels in the mPCNL group were higher than those in the Suns tip-flexible ureterorenoscopy group(P<0.05).The incidence of postoperative complications in the Suns tip-flexible ureterorenoscopy group was 5%(2/40)lower than that in the mPCNL group 25.0%(10/40),the difference was statistically significant(P<0.05).【Conclusion】Sun's tip-flexible ureterorenoscopy is better in the treatment of 2~3cm lower calyceal calculi in the elderly,which is similar to that of mPCNL.At the same time,it has the advantages of quick recovery,less complications,small wound and less bleeding.