经输尿管软镜碎石术与经皮肾镜碎石术治疗肾结石的效果比较

Comparison of the effects of flexible ureteroscopic lithotripsy and percutaneous nephrolithotripsy in the treatment of renal calculi

目的比较经输尿管软镜碎石术与经皮肾镜碎石术治疗肾结石的效果。方法根据手术方法将本院80例肾结石患者分为A组(n=40,经皮肾镜碎石术)和B组(n=40,经输尿管软镜碎石术)。比较两组的结石一次性清除情况、手术相关指标、临床疗效及术后并发症发生情况。结果A组结石直径>2.0 cm患者的结石一次性清除率显著高于B组,差异具有统计学意义(P<0.05);A组结石直径≤2.0 cm、>2.0 cm患者的术中出血量均显著多于B组,手术时间均显著短于B组,差异具有统计学意义(P<0.05)。B组的治疗总有效率为95.00%,高于A组的75.00%,差异具有统计学意义(P<0.05)。B组的术后并发症总发生率为12.50%,低于A组的27.50%,差异具有统计学意义(P<0.05)。结论经输尿管软镜碎石术适合用于治疗直径≤2.0 cm肾结石,经皮肾镜碎石术适合用于治疗直径>2.0 cm肾结石,临床应根据患者的具体情况合理选择。

Objective To compare the effects of flexible ureteroscopic lithotripsy and percutaneous nephrolithotripsy in the treatment of renal calculi.Methods According to the operation method,80 patients with renal calculi in our hospital were divided into group A(n=40,percutaneous nephrolithotomy)and group B(n=40,flexible ureteroscopic lithotripsy).One-time stone clearance,operation related indicators,clinical efficacy and postoperative complications were compared between the two groups.Results The one-time stone clearance rate of patients with stone diameter>2.0 cm in the group A was significantly higher than that in the group B,and the difference was statistically significant(P<0.05);the intraoperative blood loss of patients with stone diameter≤2.0 cm and>2.0 cm in the group A were significantly higher than those in the group B,the operation time were significantly shorter than those in the group B,and the differences were statistically significant(P<0.05).The total effective rate of treatment in the group B was 95.00%,which was higher than 75.00%of the group A,and the difference was statistically significant(P<0.05).The total incidence of postoperative complications in the group B was 12.50%,which was lower than 27.50%in the group A,and the difference was statistically significant(P<0.05).Conclusion Flexible ureteroscopic lithotripsy is suitable for the treatment of renal calculi with diameter≤2.0 cm,while percutaneous nephrolithotomy is suitable for the treatment of renal calculi with diameter>2.0 cm.The operation mode should be reasonably chosen according to the specific situation of the patients in clinic.