经输尿管软镜取石术与经皮肾镜取石术治疗肾结石有效性和安全性的系统评价

Effectiveness and safety of flexible ureteroscope and percutaneous nephrolithotomy in the treat-ment of kidney stones

目的：探讨经皮肾镜取石术与经输尿管软镜取石术治疗肾结石的有效性和安全性。方法随机选取2013年7月至2014年6月肾结石患者140例，其中50例行输尿管软镜治疗，90例采用经皮肾镜取石术进行治疗，对两组患者的手术情况及其不良反应发生情况进行观察分析。结果输尿管软镜组患者的手术时间明显长于经皮肾镜组，其术中出血量明显少于后者，差异有统计学意义（P﹤0.05）；对于直径﹥20 mm结石，经输尿管软镜取石术的结石清除率明显低于经皮肾镜，差异有统计学意义（ P﹤0.05）。结论经输尿管软镜取石术和经皮肾镜取石术均是有效的肾结石治疗手段，安全性较佳，在较小结石治疗方面二者结石清除效果并无明显差异，但对于较大直径结石患者，采用经皮肾镜取石术可取得更加优越的治疗效果。

Objective To investigate the safety and effectiveness of percutaneous nephrolithoto-my and flexible ureteroscope in the treatment of kidney stones. Methods From July 2013 to June 2014, 140 patients with kidney stones were randomly selected,among which 50 cases were treated by flexible ureteroscopy,90 cases were treated by percutaneous nephrolithotomy,the operation status and occurrence of adverse reactions of the two groups were observed and analyzed. Results The operation time of pa-tients treated by flexible ureteroscopy was significantly longer than that of patients treated by percutaneous nephrolithotomy,and the blood loss was significantly less than the latter,the differences were significant＆amp;nbsp;（P﹤0. 05）;for the diameter ﹥20 mm stones,the stone clearance rate of flexible ureteroscopy was sig-nificantly lower than that of percutaneous nephrolithotomy,the difference was significant（ P ﹤0. 05 ）. Conclusions Flexible ureteroscopy and percutaneous nephrolithotomy surgery are effective methods for the treatment of kidney stones,the security is better,there is no significant difference of the two methods in the treatment of small stones,but for larger diameter stones,percutaneous nephrolithotomy can obtain more favorable treatment effect.