| 仰光,诸禹平,肖峻.输尿管软镜碎石术与经皮肾镜碎石术治疗肾下盏结石的疗效对比[J].安徽医药,2016,20(3):488-491. |
| 输尿管软镜碎石术与经皮肾镜碎石术治疗肾下盏结石的疗效对比 |
| Comparison between retrograde intrarenal surgery and percutaneous nephrolithotomy in the treatment of lower-pole stones |
| 投稿时间：2015-09-26 |
| DOI： |
| 中文关键词: 肾下盏结石 输尿管软镜碎石术 经皮肾镜碎石术 |
| 英文关键词: percutaneous nephrolithotomy retrograde intrarenal surgery lower-pole renal stone |
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| 中文摘要: |
| 目的 探讨对于直径≤2.5 cm肾下盏结石的最佳微创治疗方法。方法 回顾性分析2014年1月—2015年5月该科收治的单侧肾下盏结石81例临床资料和治疗方法。将患者随机分为两组,其中采用输尿管软镜碎石术(retrograde intrarenal surgery,RIRS)的患者为33例,采用经皮肾镜碎石术(percutaneous nephrolithotomy,PCNL)的患者为48例。比较两种手术方法治疗结石的手术时间、碎石成功率、手术前后血红蛋白下降值、术后住院天数、住院费用和并发症等,分析两种治疗方式的临床疗效。 结果 RIRS组患者的结石直径为(18.9±3.4)mm,PCNL组患者的结石直径为(19.1±3.2)mm,组间比较差异无统计学意义(P＞0.05)。RIRS组手术均顺利完成,术后发热2例,未出现严重的并发症；PCNL组手术均顺利完成,术后发热7例,术中术后明显出血2例,经选择性肾动脉栓塞治愈。一期清石率PCNL组为86.0%,RIRS组为82.3%,组间比较差异无统计学意义(P＞0.05)；PCNL组手术前后血红蛋白下降值为(16.9±8.9)g·L-1,RIRS组手术前后血红蛋白下降值为(4.7±1.6)g·L-1,手术时间分别为(94.0±17.1)、(117.9±25.1)min,住院天数分别为(9.6±2.4)d、(6.3±1.4)d,住院费用分别为(20 214±3 436.2)、(16 414±2 572.6)元,组间比较差异均有统计学意义(P＜0.05)。 结论 对于直径≤2.5 cm的肾脏下盏结石,RIRS与PCNL疗效相近,而RIRS具有创伤小、住院天数少、并发症率低等优点,值得在临床推广使用。 |
| 英文摘要: |
| Objective To compare the therapeutic effect of retrograde intrarenal surgery(RIRS) and percutaneous nephrolithotripsy(PCNL) in treating patients with renal calculi ≤2.5 cm.Methods Data of a total of 81 cases treated by either PCNL(48) or RIRS(33) from January 2014 to May 2015 were retrospectively analyzed.Operative time,stone free rate,postoperative hospital stay,hospitalization expenses and complications were compared between the 2 groups.Results The stones of the RIRS group and PCNL group were (18.9±3.4)mm and (19.1±3.2)mm,respectively. There was no significant difference between the two groups. In RIRS group,operations were performed successfully in all 33 calculi. No serious complications was recorded except postoperative fever in 2 cases. In PCNL group,all patients had been successfully operated.Postoperative fever occurred in 7 cases. Obvious intraoperative and postoperative haemorrhage appeared in 2 cases,and cured by selective renal artery embolization. The operation time of the RIRS group and PCNL group was (117.9±25.1)min and (94.0±17.1)min respectively,with no significant difference between the two groups(P>0.05). The stone free rates of the RIRS group and PCNL group were 86.0％and 82.3％respectively with no significant difference between the two groups(P>0.05). Hemoglobin drop-out values of the RIRS group and PCNL group were (4.7±1.6)g·L-1 and(16.9±8.9)g·L-1 with a significant difference between the two groups(P<0.05). Postoperative hospital stays of the RIRS group and PCNL group were (6.3±1.4) days and (9.6±2.4) days with a statistical difference between the two groups(P<0.05). Hospitalization expenses of the RIRS group and PCNL group were (16 414±2 572.6) RMB and (20 214±3 436.2) RMB with a statistical difference between the two groups(P<0.05) .Conclusions Although RIRS and PCNL have similar curative effect in treating lower-pole renal stones of less than 2.5 cm,RIRS has the advantages of less trauma and fewer complications,lower expenses and shorter hospital stay,which is worthy of clinical application. |
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