输尿管软镜与微通道经皮肾镜碎石术治疗肾结石的疗效比较

Comparative study of clinical effect between flexible ureteroscopic lithotripsy and mini-percutaneous nephrolithotomy for treatment of renal calyceal stones

目的：比较输尿管软镜碎石术与微通道经皮肾镜碎石术治疗肾结石的安全性及临床效果。方法：回顾性分析我院2008年3月～2015年3月收治的行输尿管软镜与经皮肾镜碎石术70例患者临床资料,其中35例行输尿管软镜碎石术,35例行经皮肾镜碎石术。比较分析两组手术时间、清石率、并发症发生率。采用t检验组间比较,P〈0.05有统计学意义。结果：输尿管软镜组和经皮肾镜组结石大小分别为（1.7±0.3）cm和（1.6±0.4）cm（P〉0.05）,手术时间分别为（58.5±7.6）min和（39.8±7.8）min,术后住院时间分别为（4.5±1.5）d和（7.5±1.6）d（P〈0.01）,并发症发生率分别为6.7%和8.6%（P〉0.05）,术后1个月总清石率分别为91.4%（32/35）和94.2%（33/35）（P〉0.05）。结论：与经皮肾镜碎石术相比输尿管软镜碎石术处理肾结石具有创伤小,术后住院时间短,并发症发生率低。因此对于直径≤2cm肾结石输尿管软镜碎石术是经皮肾镜碎石术很好的替代方案。

Objective：To compare safety and clinical effects between flexible ureteroscopic lithotripsy（FUL）and percutaneous nephrolithotomy（PCNL）in the treatment of renal stones.Method：We retrospectively analysed the records of 70 patients in our hospital from March 2008 to March 2015.Thirty-five patients underwent FUL and 35 patients underwent PCNL.We comparatively analysed operative time,stone clearance rate and complication rate between two groups.Data were compared usingt-test,and probability（P）value of less than 0.05 was taken to indicate statistical significance.Result：Stone size of FUL and PCNL were（1.7±0.3）and（1.6 ± 0.4）cm respectively（P 〉0.05）.Their operative time were（58.5±7.6）and（39.8±7.8）min respectively.Their postoperative hospital stay were（4.5±1.5）and（7.5±1.6）days respectively（P〈 0.01）.The complication rate were 6.7% and 8.6% respectively（P 〉0.05）.One month postoperatively the total stone clearance rates were 91.4%（32/35）and 94.2%（33/35）respectively（P 〉0.05）.Conclusion：Compared with PCNL,FUL has a minimal trauma,shorter hospital stay,low complication rate,so it is an alternative treatment for the diameter less than 2cm renal stones.