超声引导下经皮肾镜取石术与可视超微通道经皮肾镜取石术治疗儿童肾结石的效果比较

Efficacy of ultrasound-guided percutaneous nephrolithotomy vs.visual super-mini percutaneous nephrolithotomy in the treatment of kidney stones in children

目的对比超声引导下经皮肾镜碎石取石术(PCNL)与可视超微通道经皮肾镜取石术(SMP)对儿童肾结石的临床疗效。方法回顾性分析2018年5月—2020年8月宝鸡市人民医院收治的55例接受超声引导下PCNL治疗的肾结石患儿为PCNL组,纳入同期55例接受可视SMP治疗的肾结石患儿为SMP组。对比两组患者结石直径<20 mm和≥20 mm时的手术相关指标及住院时间、结石清除率、术后并发症发生率等。结果结石直径<20 mm患儿中,SMP组经皮肾通道建立时间、住院时间短于PCNL组,术中出血量少于PCNL组(P<0.05);结石直径≥20 mm患儿中,两组手术时间[(101.67±26.41)min vs.(94.05±23.86)min]、经皮肾通道建立时间[(12.95±3.29)min vs.(14.92±3.85)min]、术中出血量[(14.98±3.83)mL vs.(17.54±4.60)mL]及住院时间[(9.07±2.30)d vs.(10.55±2.69)d]比较,差异均无统计学意义(P>0.05)。结论超声引导下PCNL与可视SMP治疗儿童肾结石均安全、有效,但可视SMP更有利于治疗结石直径<20 mm的肾结石患儿,比超声引导下PCNL建立的经皮肾通道用时更短,术后恢复较快。

Objective To compare the clinical efficacy of ultrasound-guided percutaneous nephrolithotomy(PCNL)and visual super-mini percutaneous nephrolithotomy(SMP)in children with kidney stones.Methods A total of 55 children with kid⁃ney stones treated with ultrasound-guided PCNL and 55 children treated with visual SMP during May 2018 and Aug.2020 were enrolled.The operation related indexes of stone diameter<20 mm and≥20 mm,hospital stay,stone-clearance rate and postopera⁃tive complications were compared between the two groups.Results When the stone diameter was<20 mm,SMP group had shorter time to establish the channel,shorter hospital stay,and less intraoperative blood loss than the PCNL group(P<0.05).When the stone diameter≥20,there were no significant differences in operation time[(101.67±26.41)min vs.(94.05±23.86)min],time to establish the channel[(12.95±3.29)min vs.(14.92±3.85)min],intraoperative blood loss[(14.98±3.83)mL vs.(17.54±4.60)mL]and hospital stay[(9.07±2.30)d vs.(10.55±2.69)d]between the two groups(P>0.05).Conclusion Ultrasound-guided PCNL and visual SMP are both safe and effective in the treatment of kidney stones in children,but visual SMP is more conducive for stones<20 mm.It needs shorter time to establish the channel and yields faster recovery.