输尿管软镜碎石术联合可弯曲负压输尿管导引鞘与经皮肾镜取石术治疗2～3cm肾结石的疗效比较
Comparison of flexible ureteroscopy combined with flexible suction ureteral access sheath and percutaneous nephrolithotomy for treatment of 2-3 cm renal stones
冷松 1李方志 1王晓宁2
作者信息
- 1. 赣南医科大学第一临床医学院
- 2. 赣南医科大学第一附属医院泌尿外科,江西 赣州 341000
- 折叠
摘要
目的:比较输尿管软镜碎石术(Flexible ureteroscopy lithotripsy,FURL)联合可弯曲负压输尿管导引鞘与经皮肾镜取石术(Percutaneous nephrolithotomy,PCNL)治疗2～3 cm肾结石的效果.方法:分析2022年1月至2023年2月收治的151例2～3 cm肾结石患者的临床资料.根据手术方式分为FURL组(86例)与PCNL组(65例).比较2组患者术前资料、总手术时间、清石时间、术后住院时间、血红蛋白下降值、结石清除率及术后并发症.结果:2组患者术前一般资料比较差异无统计学意义(P＞0.05).FURL组与PCNL组术后1天结石清除率分别为81.40%、86.15%,术后1月结石清除率分别为87.21%、89.23%,差异均无统计学意义(P＞0.05).与PCNL组相比,FURL组清石时间较长[(66.78±25.87)min vs(47.23±16.70)min],术后住院时间更短(3 d vs 5 d),差异均有统计学意义(P＜0.05),但2组总手术时间差异无统计学意义(P＞0.05).与PCNL组相比,FURL组血红蛋白下降更少[(5.16±7.48)g·L-1 vs(10.32±7.48)g·L-1],术后并发症发生率更低,差异均有统计学意义(P＜0.05).结论:FURL联合可弯曲输尿管导引鞘是一种安全有效的手术方式,可作为治疗2～3 cm肾结石的选择方案.
Abstract
Objective:To compare the efficacy of flexible ureteroscopy lithotripsy(FURL)combined with flexible suction ureteral access sheath and percutaneous nephrolithotomy(PCNL)for the treatment of 2-3 cm renal stones.Methods:The clinical data of 151 cases with 2-3 cm renal stones treated during Jan 2022 to Feb 2023 were analyzed,including the FURL group(86 cases)and PCNL group(65 cases)according to the surgical approaches.The preoperative data,overall operative time,stone free time,postoperative hospitalization time,hemoglobin drop value,stone free rates and postoperative complications were compared between the two groups.Results:The differences of preoperative data between the two groups were not statistically significant(P＞0.05).Stone free rates of two groups at 1 day and 1 month after surgery were not statistically significant(81.40%vs 86.15%,P＞0.05)and(87.21%vs 89.23%,P＞0.05).Compared with PCNL,stone free time was longer in the FURL group[(66.78±25.87)min vs(47.23±16.70)min,P＜0.05],but overall operative time was similar between the two groups(P＞0.05).In the FURL group,postoperative hospitalization was shorter(3 d vs 5 d,P＜0.05),hemoglobin drop was less[(5.16±7.48)g·L-1 vs(10.32±7.48)g·L-1,P＜0.05],and the rate of postoperative complications was lower,with statisrical significance(5.81%vs 16.92%,P＜0.05).Conclusion:The FURL combined with a bendable ureteral introducer sheath is a safe and effective surgical approach.It can be used as a preferred option for the treatment of 2-3 cm kidney stones.
关键词
输尿管鞘/输尿管软镜/经皮肾镜取石术/肾结石Key words
Ureteral access sheath/Flexible ureteroscopy/Percutaneous nephrolithotomy/Renal stones引用本文复制引用
出版年
2024
国家科技期刊平台
NSTL
万方数据