摘要
目的：：比较经输尿管硬通道下软硬镜联合钬激光碎石术与微创经皮肾镜取石术治疗肾盂结石的临床疗效及安全性.方法：回顾分析于2012年3月~2013年12月期间进行经输尿管硬通道下软硬镜联合钬激光碎石术或者微创经皮肾镜取石术治疗的132例肾盂结石患者资料,其中73例采用经输尿管硬通道下软硬镜联合钬激光碎石术,59例采用微创经皮肾镜取石术,比较两组手术时间、血红蛋白下降量、术后住院天数、结石残留率和并发症等指标.结果：两组患者在年龄、性别、病程、左右侧部位、积水程度、结石大小方面均无统计学差异.经输尿管硬通道下软硬镜联合钬激光碎石术组：66例完成手术,手术平均时间为(40.3±8.3)min,血红蛋白平均下降量为(1.3±5.7)g/L,术后平均住院(2.2±0.7)天,结石残留率为9.1％(6例残留结石),2例术后有发热,1例出现肾绞痛,无输尿管离断、撕脱、肾盂撕裂等严重并发症,术后3个月随访未发现输尿管反流.微创经皮肾镜取石术组：59例均完成手术,手术平均时间为(74.6±12.2)min,血红蛋白平均下降量为(20.4±10.4)g/L,术后平均住院(5.1±0.7)天,结石残留率为5.1％(3例残留结石),2例出现大出血,未见其他并发症.两组在手术时间、血红蛋白下降量、术后住院天数方面差异有统计学意义(均P＜0.01)；两组在结石残留率(P＝0.387)、并发症发生率(P＝0.742)方面,均差异无统计学意义.结论：经输尿管硬通道下软硬镜联合钬激光碎石术治疗肾盂结石的手术时间短,创伤小,康复快,并发症严重程度低,比微创经皮肾镜取石术具有更大的优势.
Objective:To compare the clinical efficacy and safety of rigid combined flexible ureteroscope homium laser lithotripsy with rigid ureteral access sheath and mini-percutaneous nephrolithotomy for pelvic calculi.Methods:Between March 2012 and December 2013,of the total 132 cases,seventy-three cases underwent rigid combined flexible ureteroscope homium laser lithotripsy with rigid ureteral access sheath(group A),and 59 cases underwent minipercutaneous nephrolithotomy(group B).The operating time,hemoglobin decreased value,postoperation hospital stay time,stone residue rate and complication were compared between the two groups.Results:There was no significant difference between the two groups in terms of age,gender,course of disease,position,degree of hydronephrosis and stone size(P>0.05).66 cases of the total 73 cases in group A were completed successfully in the first procedure.The mean operating time was(40.3±8.3)min.The decreased mean hemoglobin value was(1.3±5.7)g/L.The mean post-operative hospital stay was(2.2±0.7)days.The stone residue rate was 9.1%.2cases had fever after operation.One case was suffered with renal colic.No case was suffered with ureteral transaction,avulsion,the renal pelvis tearing or other serious complications.No case was suffered with ureteral reflux after three months following-up.All of the 59 cases in group B were completed successfully.The mean operating time was(74.6±12.2)min.The decreased mean hemoglobin value was(20.4±10.4)g/L.The mean post-operative hospital stay was(5.1±0.7)days.The stone residue rate was 5.1%.Except 2cases were suffered with massive hemorrhage,no case was suffered with another serious complications.The operating time,the decreased hemoglobin value and the post-operative hospital stay time had significant difference between the two groups(P<0.05).The stone residue rate and complication rate were not significantly different between the two groups(P>0.05).Conclusions:Of the two surgical technique,the rigid combined flexible ureteroscope homium laser lithotripsy
出处
《微创泌尿外科杂志》
2014年第5期302-305,共4页
Journal of Minimally Invasive Urology
关键词
肾结石
输尿管镜鞘
输尿管镜
经皮肾镜取石术
renal calculi
ureteral access sheath
ureteroscope
percutaneous nephrolithotomy
