输尿管软镜碎石术与微通道经皮肾镜碎石术治疗3cm以内肾结石的效果及安全性

Efficacy and Safety of Flexible Ureteroscopic Lithotripsy and Microchannel Percutaneous Nephrolithotomy for Renal Calculi within 3cm

目的:探讨输尿管软镜碎石术(FURS)与微通道经皮肾镜碎石术(MPCNL)治疗3cm以内肾结石的效果及安全性。方法:选取2018年12月~2019年12月本院收治的肾结石患者60例,依据随机数字表法分为FURS组和MPCNL组,各30例。对比两组手术效果,包括手术时间、术中出血量、结石清除率,记录肾功能及炎症因子指标,包括血尿素氮(BUN)、血肌酐(Scr)、C反应蛋白(CRP)水平变化以及术后并发症发生率。结果:FURS组与MPCNL组结石清除率无显著差异(P>0.05);FURS组手术时间明显短于MPCNL组,术中出血量较MPCNL组减少,有统计学意义(P<0.05);两组术后BUN、Scr、CRP水平比较无明显差异(P>0.05);FURS组术后并发症发生率为6.67%,MPCNL组并发症发生率为26.67%,差异显著,有统计学意义(P<0.05)。结论:FURS和MPCNL治疗3cm以内肾结石效果均较好,FURS在手术时间、术中出血量及降低术后并发症发生率方面更具有优势。

Objective:To investigate the effect and safety of flexible ureteroscopy lithotripsy(FURS)and microchannel percutaneous nephrolithotomy(MPCNL)in the treatment of kidney stones within 3cm.Methods:60 patients with renal calculi in our hospital from December 2018 to December 2019 were selected and randomly divided into FURS group and MPCNL group,30 cases in each group.The operative effects of two groups were compared,including operative time,intraoperative blood loss,stone clearance rate,renal function and inflammatory factors,including blood urea nitrogen(BUN),serum creatinine(Scr),C reactive protein(CRP)levels,and postoperative complications.Results:There was no significant difference in the stone clearance rate between FURS group and MPCNL group(P>0.05);the operation time of FURS group was significantly shorter than that of MPCNL group,and the intraoperative blood loss was less than that of MPCNL group,with statistical significance(P<0.05);there was no significant difference in the levels of bun,SCR and CRP between the two groups(P>0.05);the incidence of postoperative complications in FURS group was 6.67%,and that in MPCNL group was 26.67%,the difference is significant and statistically significant(P<0.05).Conclusion:FURS and MPCNL are effective in treating renal calculi within 3cm.FURS has more advantages in operation time,bleeding volume and incidence of postoperative complications.