摘要
目的:比较输尿管软镜钬激光与经皮肾镜超声气压弹道联合治疗肾结石的疗效和安全性。方法:回顾分析2012年3月~2014年3月手术治疗89例肾结石患者临床资料,其中37例采用组合式输尿管软镜钬激光碎石术治疗(URL组),52例采用经皮肾镜超声联合气压弹道碎石术治疗(PCNL组),比较两组的结石取净率和手术并发症。结果:URL组血红蛋白损失量为0~6g/L,平均(2.0±2.0)g/L;结石取净率为81.1%(30/37);术后4例出现轻度贫血、3例出现发热,并发症发生率为18.9%(7/37)。PCNL组血红蛋白损失量为4~36g/L,平均(13.6±7.4)g/L;结石取净率为86.5%(45/52);术后21例出现轻度贫血、3例出现中度贫血,术后4例出现发热,并发症发生率为53.8%(28/52)。结论:PCNL和URL都属于治疗肾结石的微创手术方法,疗效相同。但URL与PCNL相比,具有损伤更小、出血更少、并发症更少等优点,特别在治疗肾结石合并脊柱侧弯等复杂性肾结石时具有独特的优势。
Objective:To compare the efficacy and safety of flexible ureteroscopy vs.percutaneous nephrolithotomy for renal calculi.Methods:From March 2012 to March 2014,89 patients with renal calcul underwent operation,among them 37 patients were given modular flexible ureteroscopy combined with holmiun laser lithotripsy(URL group),and 52 patients were given percutaneous nephrolithotripsy ultrasound combined with pneumatic lithotripsy(PCNL group).Calculi-free rate and postoperative complication incidence between two groups were compared.Results:In the URL group,hemoglobin was decreased by 0-6g/L [mean(2.0±2.0)g/L].The calculi-free rate was81.1%(30/37).Four patients suffered from mild anemia after the operation,and 3patients suffered from fever.The complication rate was 18.9%(7/37).In the PCNL group,hemoglobin was decreased 4-36g/L [mean(13.6±7.4)g/L].The calculi-free rate was 86.5%(45/52).Twenty-one patients suffered from mild anemia after the operation,3patients suffered from moderate anemia,and 4patients suffered from fever.The complication rate was53.8%(28/52).Conclusions:PCNL and URL are both minimally invasive surgical procedures for renal calculi,and their efficacy is similar.But as compared with PCNL,URL has the advantages of smaller damage,less bleeding,lower complication rate,and has unique advantages for complex renal calculi such as renal calculi complicated with scoliosis.
出处
《微创泌尿外科杂志》
2015年第6期348-351,共4页
Journal of Minimally Invasive Urology
