摘要
目的比较输尿管软镜激光碎石及体外冲击波碎石治疗肾下盏结石的疗效。方法肾下盏结石患者146例均接受体外冲击波碎石(SWL)或输尿管软镜钬激光碎石(FURSL)治疗,并随访3个月。结石清石率标准为结石残片≤3mm,复查设备为B超影像或x线检查。数据用EXCEL记录并用SPSS19.0进行分析。结果所有肾下盏结石患者均接受治疗(78例swL及68例FURSL)。SWL组结石平均10.2mm明显低于FURSL组16.4mm。FURSL组平均手术时间65min,平均术后住院天数2.8d。FURSL组结石清石率92.6%明显高于SWL组24.4%(io〈0.001),FURSL组术后出现4例并发症(3例NClavienII及1例ClavienI),2例尿源性脓毒血症,1例尿路感染,1例术后置管不适。SWL组3例患者(ClavienI)因肾绞痛患者再次住院,两组均未出现其他并发症。结论FURSL治疗肾下盏结石较SWL更具优势,包括高清石率及能处理更大的结石。或能成为未来治疗肾下盏结石的金标准。
Objective To compare the efficacy of flexible ureteroscope and laser lithotripsy ( FURSL ) and shock wave lithotripsy ( SWL ) treatment for renal lower calyx stones. Methods Data of 146 cases with renal lower calyx calculi who were undergone shock wave lithotripsy ( SWL ) or flexible ureteroscope holmium laser lithotripsy ( FURSL ) treatment from April to October in 2015 at the First Affiliated Hospital of Wannan Medical College were collected, follow-up period was three months and checked by ultrasound or X-ray examination. The stone free rate ( SFR ) was defined as〈3mm fragments on follow-up imaging or stone free endoscopically. Data was recorded in an excel spreadsheet with SPSS version 19.0 used for statistical analysis. Results All 146 cases of lower calyx calculi patients were treated ( 78 SWL and 68 FURSL ) . Mean stone size of SWL group wasl0.2 mm ( 8-16 mm ) ,which was significantly lower than FURSL group whose was 16.4 mm ( 9-33 mm ) .mean operation time OF FURSL was 65 minutes ( 30-160min ) average postoperative hospital stay was 2.8 days ( 1-7 days ) . FURSL stone free rate ( n=63; 92.6% ) was significantly higher than ( P〈0.001 ) SWL group ( n=19; 24.4% ) ; There were four cases with postoperative complications ( 3 Clavien II and 1 Clavien I ) in the FURSL group, 2 cases urosepsis, 1 case urinary tract infection, 1 patient stent discomfort. SWL group 3 patients ( Clavien I ) due to renal colic patients admitted to hospital. Conclusions Compare to SWL, FURSL may become the gold standard for lower calyx stones in the future with its advantages, including high stone free rate and can handle larger stones.
出处
《浙江临床医学》
2016年第9期1594-1595,共2页
Zhejiang Clinical Medical Journal
关键词
肾结石
激光
输尿管软镜
下盏
碎石术
Renal stones Laser Flexible ureteroroscopys lower calyx lithotripsy