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经皮肾镜或逆行肾内手术治疗直径 1-2cm 的肾结石:一项前瞻性对比研究。

Treating renal calculi 1-2 cm in diameter with minipercutaneous or retrograde intrarenal surgery: a prospective comparative study.

机构信息

Muljibhai Patel Urological Hospital-Urology, Nadiad, Gujarat, India.

出版信息

BJU Int. 2012 Oct;110(8 Pt B):E346-9. doi: 10.1111/j.1464-410X.2012.11089.x. Epub 2012 Apr 4.

Abstract

OBJECTIVE

To plan a prospective comparative case-control designed study aiming to compare minipercutaneous (miniperc) and retrograde intrarenal surgery (RIRS) for a renal calculus of size 1-2 cm.

PATIENTS AND METHODS

A total of 64 cases (32 in each arm) underwent miniperc and RIRS during the study period from March 2009 to April 2011. The primary and secondary outcome objective was stone-free rate and retreatment rate, complications, operation duration, patient visual pain scores, analgesic requirement, haemoglobin drop and hospital stay, respectively.

RESULTS

Miniperc and RIRS had stone clearance rates of 100% and 96.88%, respectively. In the RIRS group, one patient required retreatment at 1 month. Hospital stay (0.24) and intra-operative (0.99) and postoperative complications (0.60) were similar in both groups. Operation duration (P = 0.003) was lower in the miniperc group. Haemoglobin drop (P < 0.001), patient pain and visual analogue scale score (each P < 0.001) at 6, 24 and 48 h, as well as analgesic requirement (P < 0.003), were all lower in the RIRS group.

CONCLUSIONS

The stone clearances in both modalities are high and complications are low. RIRS requires a larger operation duration, although it is associated with favourable pain scores and a lower haemoglobin drop.

摘要

目的

计划一项前瞻性病例对照设计研究,旨在比较 1-2cm 肾结石的微创经皮肾镜取石术(miniperc)和逆行性肾内手术(RIRS)。

患者与方法

2009 年 3 月至 2011 年 4 月期间,共有 64 例患者(每组 32 例)接受了 miniperc 和 RIRS 治疗。主要和次要结局指标分别为结石清除率和再治疗率、并发症、手术时间、患者视觉疼痛评分、镇痛需求、血红蛋白下降和住院时间。

结果

miniperc 和 RIRS 的结石清除率分别为 100%和 96.88%。在 RIRS 组中,1 例患者在 1 个月时需要再次治疗。两组的住院时间(0.24)、术中(0.99)和术后并发症(0.60)相似。miniperc 组的手术时间(P=0.003)较低。RIRS 组血红蛋白下降(P<0.001)、术后 6、24 和 48 小时患者疼痛和视觉模拟评分(均 P<0.001)以及镇痛需求(P<0.003)均较低。

结论

两种方法的结石清除率均较高,并发症发生率较低。RIRS 需要更长的手术时间,但疼痛评分较低,血红蛋白下降更少。

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