mPCNL、FURSL治疗ESWL术失败的输尿管上段结石的效果比较

Comparison of the effect between mPCNL and FURSL in the treatment of upper ureteral calculi after failed ESWL

目的:探究微创经皮肾镜取石术(mPCNL)、输尿管软镜钬激光碎石术(FURSL)治疗体外冲击波碎石(ESWL)术失败的输尿管上段结石的效果。方法:选取淇县人民医院于2021-02~2022-02收治的56例ESWL治疗失败的输尿管上段结石患者作为研究对象,采用随机数字表法分为两组,各28例,其中A组采用mPCNL治疗,B组采用FURSL治疗,比较两组患者围术期指标及疗效、炎症因子、肾功能、并发症。结果:A组手术时间少于B组,B组住院时间少于A组(P<0.05);A组结石清除率高于B组(P<0.05);两组术后炎症因子:降钙素原(PCT)、C-反应蛋白(CRP)、白细胞计数(WBC)、白介素-6(IL-6)水平均上升,B组低于A组(P<0.05);两组血中性粒细胞明胶酶相关脂质运载蛋白(NGAL)、尿素氮(BUN)、肌酐(Cr)水平均上升且A组NGAL水平高于B组(P<0.05);两组并发症发生率比较无统计学意义(P>0.05)。结论:mPCNL、FURSL治疗输尿管上段结石,前者手术时间短、结石清除率高,后者住院时间短,术后炎症因子水平低,两者一次成功率与安全性相当。

Objective:To investigate the effect of mPCNL and FURSL in the treatment of upper ureteral calculi after failed ESWL.Methods:A total of 56 patients with upper ureteral calculi who failed ESWL in Qixian People’s Hospital from February 2021 to February 2022 were selected,and divided into two groups by random number table method with 28 cases in each group.Patients treated with mPCNL and FURSL were included in group A and group B,respectively.Perioperative indicators,curative effect,inflammatory factors,renal function,and complications were compared between the groups.Results:The operation time and hospital stay of group A were shorter than those of group B(P<0.05).The stone clearance rate in group A was higher than that in group B(P<0.05).After operation,the levels of PCT,CRP,WBC,and IL-6 in group B were lower than those in group A(P<0.05).The levels of blood NGAL,BUN,and Cr increased in the two groups.The level of NGAL in group A was higher than that in group B(P<0.05).The incidence of complications showed no significant difference between the groups(P>0.05).Conclusion:Compared with FURSL in the treatment of upper ureteral calculi,the duration of mPCNL is shorter and the stone clearance rate is higher.However,patients treated with FURSL have shorter hospital stay,and low inflammatory factor levels after operation.The one-time success rates and safety of the two surgical methods are equivalent.