40～80Hz钬激光微通道经皮肾镜与输尿管软镜手术治疗肾结石患者的疗效比较
Compareison of the efficacy of mPCNL and RIRS using 40-80 Hz holmium laser in the treatment of renal calculi
丁强 1谢文华 2何屹1
作者信息
- 1. 蚌埠医学院研究生院,安徽蚌埠 233000;嘉兴市第一医院泌尿外科,浙江嘉兴 314000
- 2. 嘉兴市第一医院泌尿外科,浙江嘉兴 314000
- 折叠
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 2～3cm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、24h内血红蛋白(Hb)下降量、术后 24h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 24h 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 24h 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.
Abstract
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).Methods The 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.
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Key words
retrograde intrarenal surgery/minimally invasive percutaneous nephrolithotomy/renal calculi/high frequency holmium laser/percutaneous nephrolithotomy引用本文复制引用
出版年
2024
NETL
NSTL
万方数据