输尿管软镜碎石术与经皮肾镜碎石术治疗肾结石的疗效观察

The Efficacy of Ureteral Flexible Lithotripsy Versus Percutaneous Nephrolithotripsy in the Treatment of Renal Stones

目的:探究输尿管软镜碎石术(RIRS)与经皮肾镜碎石术(PCNL)治疗肾结石的临床疗效。方法:选取2021年6月—2022年6月汕头市潮阳区大峰医院接受治疗的63例肾结石患者作为研究对象,将采用PCNL治疗的31例患者作为PCNL组,采用RIRS治疗的32例患者作为RIRS组。比较两组患者的结石清除率,围术期指标(手术时间、术中出血量、住院时间),血清指标[去甲肾上腺素(NE)、促肾上腺皮质激素(ACTH)、皮质醇(Cor)]以及不良反应发生率。结果:RIRS组手术时间长于PCNL组,但术中出血量低于PCNL组,住院时间短于PCNL组,差异有统计学意义(P<0.05)。两组结石清除率比较,差异无统计学意义(P>0.05)。两组术后NE、ACTH、Cor水平均明显高于术前,但RIRS组的NE、ACTH、Cor水平低于PCNL组,差异有统计学意义(P<0.05)。结论:RIRS与PCNL治疗肾结石的疗效相当,但是RIRS对机体造成的损伤更小,患者恢复时间更短,且应激反应水平较低。

Objective:To investigate the clinical efficacy of ureteral flexible lithotripsy(RIRS)and percutaneous nephrolithotripsy(PCNL)for the treatment of renal stones.Methods:63 patients with kidney stones treated in Dafeng Hospital,Chaoyang District,Shantou City,China,from June 2021 to June 2022 were selected as the study subjects,and 31 patients treated with PCNL were treated as the PCNL group and 32 patients treated with RIRS were treated as the RIRS group.The followings factors between the two groups were compared:the stone clearance rate,perioperative indexes(operation duration,intraoperative bleeding,und Length of hospital stay),serum norepinephrine(NE),serum adrenocorticotropic hormone(ACTH),and serum cortisol(Cor),and the incidence of adverse reactions.Results:The RIRS group had longer operation duration than the PCNL group,but the intraoperative bleeding was lower than that of the PCNL group,and the hospital stay was shorter than that of the PCNL group,and the difference was statistically significant(P<0.05).Comparison of stone removal rate between the two groups does not result in a statistically significant difference(P>0.05).Postoperative NE,ACTH,and Cor levels were significantly higher than preoperative levels in both groups,but they were lower in the RIRS group than in the PCNL group,and the difference was statistically significant(P<0.05).Conclusion:The efficacy of both RIRS and PCNL in the treatment of kidney stones was remarkable,but RIRS contribute to less damage to the organism,shorter recovery time for the patients,and lower level of stress reaction.