输尿管软镜和超微经皮肾镜碎石术治疗中等大小肾结石的疗效对比

Comparison of the effect of soft ureteroscopy and ultramicro percutaneous nephrolithotripsy in the treatment of middle-sized renal stones

目的比较超微经皮肾镜(SMP)和输尿管软镜碎石术(FURL)治疗中等大小肾结石(1.5 cm^2.5 cm)的临床疗效和安全性。方法回顾性分析我院2016年6月—2018年12月收治的76例直径1.5 cm^2.5 cm肾结石患者的临床资料,依据手术方法分组,其中SMP组35例,FURL组41例,比较2组患者的手术时间、住院时间、结石清除率及并发症发生率。结果 SMP组手平均术时间短于FURL组(P<0.01),手术前后血红蛋白下降值高于FUR L组(P<0.01)。SMP组单次治疗的结石清除率显著高于FUR L组(P<0.05)。2组术后住院时间、并发症发生率差异无统计学意义(P>0.05)。结论 SMP对中等大小(1.5 cm^2.5 cm)肾结石的疗效优于FURL,且有手术时间短和结石清除率高的特点,值得推广。

Objective To compare the efficacy and safety between super-mini percutaneous nephrolithotomy (SMP)and flexible ureteroscopic lithotripsy(FURL)in the treatment of mediumrenal stones(1.5~2.5 cm).Methods The clinical data of 76 patients who received SMP or FURL with renal stones of 1.5~2.5 cm in diameter were retrospectively analyzed from June 2016 to December 2018 in our hospital. The operation time,hospital stay after operation,drop of hemoglobin,stone-free rate(onemonth after procedure),and complication of operation were evaluated between two groups. Results All patients were successfully treated. The SMPgroup had significantly shorter operation time([ 47.1±8.7)min vs.(63.5±7.2)min,P<0.05],more drop of hemoglobin ([ 12.7±4.9)g/L vs.(4.7±0.8)min,P<0.01]than FURL group. The stone-free rate in the SMPgroup was significantly higher than the FURL group [94.3%(33/35)vs.75.6%(31/41),P<0. 05]. There were no significant difference between the SMP and FURL group in the hospital stay after operation ([ 3.5±1.3)d vs.(2.7±0.5)d,P>0.05] and complication rate of operation [8.6%(3/35)vs.12.2%(5/41),P>0. 05].Conclusion SMP is more effective for themanagement of renal stone of 2~4 cmin diameter than FURL,and has the characteristics of higher stone-free rate and shorter operation time,and so on,it can be considered to promote the use.