摘要
目的比较微通道经皮肾镜碎石取石术(mPCNL)和输尿管软镜碎石术(RIRS)两种方式下利用高频率钬激光治疗2~3 cm肾结石的临床疗效。方法回顾性分析嘉兴市第一医院泌尿外科2020年10月—2022年10月收治的105例单发2~3 cm肾结石患者的临床资料,其中52例采用RIRS利用40~80 Hz钬激光碎石(RIRS组),53例采用mPCNL利用40~80 Hz钬激光碎石(mPCNL组)。比较两组的结石一期清除率、手术时间、24 h内血红蛋白(Hb)下降量、术后24 h内炎症指标、术后并发症发生率、住院时间、住院费用。结果两组患者术前基本资料、一期清除率、术后24 h内炎症指标及术后并发症发生率,差异无统计学意义(P>0.05)。RIRS组较mPCNL组术后24 h内Hb下降量更少[(6.35±2.00)g/L vs.(12.25±5.72)g/L,P=0.001],住院时间较短[(5.13±0.82)d vs.(7.92±1.59)d,P<0.001],住院费用更少[(15221.52±796.46)元vs.(19514.51±909.98)元,P<0.001],而手术时间更长[(58.17±7.67)min vs.(49.60±4.52)min,P<0.001]。结论在钬激光频率为40~80 Hz情况下行mPCNL和RIRS治疗2~3 cm肾结石均安全有效,且一期清石率相近,而RIRS虽较mPCNL的手术时间长,但具有手术创伤更小、术后恢复更快、住院时间更短的优点,在2~3 cm肾结石的治疗中可能更具优势和前景。
Objective To compare the clinical efficacy of high frequency holmium laser in the treatment of 2-3 cm renal calculi by minimally invasive percutaneous nephrolithotomy(mPCNL)and retrograde intrarenal surgery(RIRS).MethodsThe clinical data of 105 patients with a solitary 2-3 cm renal calculus treated during Oct.2020 and Oct.2022 were retrospectively analyzed.The patients were divided into two groups,including 52 cases in the RIRS group and 53 cases in the mPCNL group.The one-stage stone clearance rate,operation time,hemoglobin decline within 24 hours,inflammatory indicators within 24 hours after operation,postoperative complications,hospital stay and hospitalization costs were compared between the two groups.Results There were no significant differences in the preoperative general data,one-stage stone clearance rate,inflammatory indicators within 24 hours and incidence of postoperative complications between the two groups(P>0.05).The RIRS group had less decrease of hemoglobin than the mPCNL group[(6.35±2.00)g/L vs.(12.25±5.72)g/L,P=0.001],shorter hospital stay[(5.13±0.82)d vs.(7.92±1.59)d,P<0.001],lower hospitalization costs[(15221.52±796.46)yuan vs.(19514.51±909.98)yuan,P<0.001],but longer operation time[(58.17±7.67)min vs.(49.60±4.52)min,P<0.001].Conclusion Both mPCNL and RIRS are safe and effective in the treatment of 2-3 cm renal calculi with 40-80 Hz holmium laser,and the one-stage stone clearance rate is similar.Although RIRS needed longer operation time than mPCNL,it has the advantages of less surgical trauma,faster postoperative recovery and shorter hospital stay,and is more prospective in the treatment of 2-3 cm renal calculi.
作者
丁强
谢文华
何屹
DING Qiang;XIE Wenhua;HE Yi(Graduate School of Bengbu Medical College,Bengbu 233000;Department of Urology,The First Hospital of Jiaxing City,Jiaxing 314000,China)
出处
《现代泌尿外科杂志》
2024年第1期65-68,共4页
Journal of Modern Urology
关键词
输尿管软镜碎石术
微通道经皮肾镜碎石取石术
肾结石
高频率钬激光
经皮肾镜取石术
retrograde intrarenal surgery
minimally invasive percutaneous nephrolithotomy
renal calculi
high frequency holmium laser
percutaneous nephrolithotomy
