经皮肾镜气压弹道碎石与输尿管软镜钬激光碎石治疗长径2 cm左右肾结石的效果比较

Comparison of percutaneous nephroscopic pneumatic lithotripsy and flexible ureteroscopic holmium laser lithotripsy in the treatment of renal calculus with major diameter about 2 cm

目的分析经皮肾镜气压弹道碎石与输尿管软镜钬激光碎石治疗长径2 cm左右肾结石的效果。方法抽取2020年1月至2021年12月南阳市第一人民医院收治的肾结石患者100例,按照手术方式分为A组和B组,每组50例。A组患者采取经皮肾镜气压弹道碎石术治疗,B组患者采取输尿管软镜钬激光碎石术治疗。比较两组患者的碎石情况、术中出血量、手术时间、术后尿液转清时间及并发症发生情况。结果A组结石取净率(96.0%,48/50)高于B组(78.0%,39/50),差异有统计学意义(P<0.05)。A组手术时间[(23.24±2.31)min]短于B组[(47.98±2.29)min],术中出血量[(24.49±2.43)ml]大于B组[(4.58±0.33)ml],P<0.05;两组术后尿液转清时间比较差异未见统计学意义(P>0.05)。A组感染发生率和发热发生率均低于B组(P<0.05)。结论在长径2 cm左右肾结石的临床治疗中,经皮肾镜气压弹道和输尿管软镜钬激光碎石术各具优缺点,在临床实践中应根据患者实际情况选择相应的碎石术。

Objective To analyze the effect of percutaneous nephroscopic pneumatic lithotripsy and flexible ureteroscopic holmium laser lithotripsy in the treatment of renal calculus with major diameter about 2 cm.Methods A total of 100 patients with renal calculus treated in Nanyang First People’s Hospital from January 2020 to December 2021 were enrolled in the study,and they were divided into group A and group B according to surgical method,with 50 cases in each group.Patients in the group A were treated by percutaneous nephroscopic pneumatic lithotripsy,and patients in the group B were treated by flexible ureteroscopic holmium laser lithotripsy.The lithotripsy status,intraoperative blood loss,operation time,postoperative urine clearance time,and complications of the two groups were compared.Results The net extraction rate of stones in the group A(96.0%,48/50)was higher than that in the group B(78.0%,39/50),and the difference was statistically significant(P<0.05).The operation time of the group A was(23.24±2.31)min,shorter than the(47.98±2.29)min of the group B,and the intraoperative blood loss of the group A was(24.49±2.43)ml,higher than the(4.58±0.33)ml of the group B(P<0.05).There was no significant difference in the postoperative urine clearance time between the two groups(P>0.05).The incidence of infection and fever in the group A were lower than those in the group B(P<0.05).Conclusions In the clinical treatment of renal calculus with major diameter about 2 cm,percutaneous nephroscopic pneumatic lithotripsy and flexible ureteroscope holmium laser lithotripsy have their own advantages and disadvantages.Therefore,lithotripsy method should be selected according to individual condition in clinical to get better therapeutic effects.