输尿管软镜碎石术与经皮肾镜碎石术治疗直径≤2 cm肾结石的临床疗效对比

Comparison of Clinical Efficacy between Ureteroscopic Lithotripsy and Percutaneous Nephrolithotomy for Renal Calculi with Diameter≤2 cm

目的比较输尿管软镜碎石术(FURS)与经皮肾镜碎石术(PCNL)治疗直径≤2cm肾结石患者的临床疗效,为≤2cm肾结石患者选择合适的治疗方法提供依据。方法选取2017年7月~2018年7月来我院就诊的160例直径≤2cm的肾结石患者为研究对象,按手术方式分为FURS组和PCNL组,每组80例。对比两组的手术时间、术中出血量、手术成功率、住院时间、住院费用、碎石成功率以及并发症发生率。结果FURS组平均手术时间少于PCNL组[(45.05±12.89)minvs(65.95±14.63)min],术中出血量、住院时间及费用均低于PCNL组,差异具有统计学意义(P<0.05)。FURS组和PCNL组的手术成功率分别为95.00%和92.50%,结石清除率分别为90.79%和87.84%,差异均无统计学意义(P>0.05)。FURS组术后并发症发生率低于PCNL组(5.26%vs17.57%),差异具有统计学意义(P<0.05)。结论治疗直径≤2cm的肾结石,FURS和PCNL两种手术方式均具有较高的结石清除率,但PCNL的术后并发症发生率更高,相比PCNL,FURS具有术中出血量少、住院时间短以及住院费用低等优势,因此FURS是治疗直径≤2cm肾结石更好的手术选择。

Objective To compare the clinical efficacy of ureteroscopic lithotripsy (FURS) and percutaneous nephrolithotomy (PCNL) in patients with ≤2 cm diameter renal calculi, and to provide appropriate treatment for patients with ≤2 cm kidney stones. Methods A total of 160 patients with renal calculi with a diameter of ≤2 cm who came to our hospital from July 2017 to July 2018 were enrolled. The patients were divided into FURS group and PCNL group according to the surgical procedure, 80 cases in each group. The operation time, intraoperative blood loss, surgical success rate, hospitalization time, hospitalization cost, gravel success rate and complications were compared between the two groups. Results The average operation time in the FURS group was less than that in the PCNL group [(45.05±12.89) min vs (65.95±14.63) min]. The intraoperative blood loss, hospitalization time and cost were lower than those in the PCNL group,the difference was statistically significant (P<0.05).The success rates of surgery in the FURS group and the PCNL group were 95.00% and 92.50%, respectively. The stone removal rates were 90.79% and 87.84%, respectively,the differences were not statistically significant (P>0.05). The incidence of postoperative complications in the FURS group was lower than that in the PCNL group (5.26% vs 17.57%),the difference was statistically significant (P<0.05). Conclusions For the treatment of renal calculi with a diameter of ≤2 cm, both FURS and PCNL have higher stone clearance rates, but the incidence of postoperative complications of PCNL is higher. Compared with PCNL, FURS has less intraoperative blood loss. With short hospital stays and low hospitalization costs, FURS is a better surgical option for treating kidney stones ≤2 cm in diameter.