经输尿管软镜取石术与经皮肾镜取石术治疗肾结石的临床对比

Clinical Comparison of Ureteroscopic Lithotripsy and Percutaneous Nephrolithotomy for the Treatment of Kidney Stones

目的探究经输尿管软镜取石术与经皮肾镜取石术治疗肾结石的临床对比。方法分析2016年1月-2017年12月接收治疗的550例肾结石患者,按照患者在入院后不同手术治疗方法分为两组,观察组患者500例,对照组患者50例。采用经皮肾镜取石术的是对照组,采用经输尿管软镜取石术的是观察组。在结束治疗之后,对比两组患者的术中出血量、术后4周清石率、术后并发症及手术时间。结果通过对两组患者行不同手术治疗方法,观察组患者的手术治疗时间相较于对照组明显较长,术中出血量较低,差异具有统计学的意义(P<0.05)。但结石直径≤2 cm,两组患者对比清石率差异无统计学意义(P>0.05);针对于结石直径>2 cm患者,相较于对照组,观察组术中出血量较低,清石率较低,手术时间较长,术后并发症发生率较低,因此差异具有统计学的意义(P<0.05)。结论对于直径>2 cm的肾结石,经皮肾镜取石术是最佳的选择,具有手术时间短、取石彻底的优势特色,但是其术后有较大的并发症发生率,需对患者的叔叔禁忌症进行严格的监控;而针对于结石直径≤2 cm的肾结石患者,选用经输尿管软镜取石术,具有微创及安全的优势。

Objective To investigate the clinical comparison between ureteroscopic lithotripsy and percutaneous nephrolithotomy for the treatment of kidney stones. Methods Select the time period from January 2016 to December2017 period,received treatment in our hospital of 550 cases of kidney stones patients,according to the patients after admission in different surgical methods were divided into two groups,the observation group of 500 patients in the control group 50 cases. The use of percutaneous nephrolithotomy is the control group,the use of ureteroscopic lithotomy is the observation group. After the treatment was completed,the amount of intraoperative blood loss,the rate of clear stones after 4 weeks,the postoperative complications and the operation time were compared between the two groups. Results Compared with the control group,the observation group had longer operation time and lower intraoperative blood loss,so the difference was statistically significant（P〈0. 05）,but the stone diameter ≤2 cm,the difference was not found between the two groups（P〉0. 05）. Compared with the control group,the patients in observation group had lower blood loss,lower rate of clear stone,longer operation time and more postoperative complication Low,so the difference was statistically significant（P〈0. 05）. Conclusions Percutaneous nephrolithotomy is the best choice for renal calculi〉 2 cm in diameter. It has the advantages of short operation time and thorough stone removal. However,the incidence of postoperative complications is relatively high,Uncle contraindications for strict monitoring; and for patients with stone diameter≤2 cm kidney stones,the selection of ureteroscopic lithotripsy,with the advantages of minimally invasive and safe.