微创经皮肾镜与逆行输尿管软镜治疗1~2 cm肾结石疗效对比

 目的 比较微创经皮肾镜(minipercutaneous,Mini-PCNL)与逆行输尿管软镜(retrograde intrarenal surgery,RIRS)治疗直径1~2 cm的肾结石的临床疗效。方法 收集2015-03至2017-04医院泌尿外科收治的72例患者的临床资料,按手术方法分为 Mini-PCNL组和RIRS组,每组36例,对两组的手术结石清除率、重复治疗率、并发症、手术时间、术后镇痛、血红蛋白下降、治疗费用和住院天数进行对比。结果 Mini-PCNL组结石清除率(94.44%)明显高于RIRS组(75.00%),差异有统计学意义(P<0.05)。Mini-PCNL组重复治疗率、手术时间、治疗费用与RIRS组比较,差异均有统计学意义(P<0.05)。但术后24 h镇痛药用量和血红蛋白下降高于RIRS组,差异均有统计学意义(P<0.05)。Mini-PCNL组住院天数和并发症高于RIRS组,但差异无统计学意义。结论 Mini-PCNL治疗1~2 cm的肾结石的临床疗效好、手术时间短、费用少,值得临床推广。

Comparative study of mini- percutaneous nephrolithotomy and retrograde intrarenal surgery for medium-size (1- 2cm) renal calculi

Objective To compare the clinical effect of mini-percutaneous nephrolithotomy (Mini-PCNL) and retrograde intrarenal surgery (RIRS)in the treatment of renal calculi with a diameter of 1to 2 cm. Methods The clinical data on 72 patients admitted to the Department of Urology at our hospital between March 2015 and April 2017 was collected and equally divided into the Mini-PCNL group and RIRS group according to the surgical approach. The stone clearance rate, repeated treatment rate, complications, duration of surgery, postoperative analgesia, hemoglobin decrease,costs and hospital stay were compared between the two groups. Results The stone clearance rate of the Mini-PCNL group(94.44%) was significantly higher than that of the RIRS group (75.00%)(P<0.05). The Mini- PCNL group compared favorably with the RIRS group in terms of the repeated treatment rate ,duration of surgery, postoperative analgesia, hemoglobin decrease and treatment cost (P<0.05).The dosage of analgesics and levels of hemoglobin 24h postoperatively decreased more significantly in the Mini- PCNL group than in the RIRS group, and the difference was statistically significant (P<0.05).The hospital stay and rate of complications in the Mini-PCNL group were longer or higher than those of the RIRS group, but the difference was not statistically significant. Conclusions Mini-PCNL has a good clinical effect and requires short duration of surgery and low treatment costs when used to treat renal calculi with a diameter of 1 to 2 cm, which should be made more accessible.