超微经皮肾镜与输尿管软镜治疗肾结石的疗效比较

Super-mini percutaneous nephroscopy vs. flexible ureteroscopy for kidney stones

目的比较超微经皮肾镜碎石取石术(SMP)与输尿管软镜碎石取石术(FURL)处理2cm左右(1.5~2.5cm)肾结石的疗效。方法以2015年5月至2016年10月本中心采用SMP或FURL治疗的2cm左右肾结石患者100例作为研究对象,进行回顾性分析研究。SMP组(n=50):男36例,女14例;年龄(50.6±12.9)岁;结石大小(2.01±0.30)(1.5~2.5)cm。FURL组(n=50):男37例,女13例;年龄(52.7±13.7)岁;结石大小(1.93±0.31)(1.5~2.5)cm。结果两组患者术前术后血白细胞(WBC)升高水平、术后发热率、术后结石清除率、术后住院天数和痛觉视觉模拟量表(PVAS)评分均无统计学差异(P>0.05)。SMP组血红蛋白降低水平显著高于FURL组[(10.2±5.68)g/L vs.(7.33±6.34)g/L,P=0.010],而平均手术时间显著少于FURL组[(50.7±13.4)min vs.(56.3±15.7)min,P=0.029]。结论 SMP治疗2cm左右肾结石安全有效、出血及并发症发生率低,术后舒适度高,住院时间短,能作为传统FURL的互补手术方式。

Objective To compare super-mini percutaneous nephrolithotomy （SMP） and flexible ureteroscopy lithotripsy （FURL） in the treatment of kidney stones about 2 cm. Methods The clinical data of 100 patients with nephrolithiasis treated with SMP or FURL during May 2015 and Oct. 2016 were retrospectively analyzed. The SMP group （n = 50） included 36 male and 14 female cases, aged （50.6±12.9） years, mean stone size （2.01 ± 0.30） （ 1.5 -- 2.5） cm. The FURL group （ n = 50） en- rolled 37 male and 13 female cases, aged （52.7±13.7）years, mean stone size （1.93±0.31） （1.5--2.5）cm. Results There were no differences in the WBC level, heating rate, stone-free rate, mean hospital stay and PVAS scores between the two groups （P〉0.05）. The drop of hemoglobin level was more obvious in SMP group than in FURL group [（10.2±5.68）g/L vs. （7.33 ± 6.34）g/L, P = 0.010]. The mean operation time was significantly shorter in SMP group than in FURL group [ （50.7 ±13.4） min vs. （56.3 ± 15.7）min, P = 0. 0291. Oonclusion SMP is technically feasible and safe, with lower incidence of bleeding and complications, higher comfort level and shorter hospital stay. It can be used as a complementary operation method for FURL.