Li Zhi-Gang, Zhao Yan, Fan Tao, Hao Lin, Han Cong-Hui, Zang Guang-Hui
Department of Urology, Xuzhou Central Hospital, Xuzhou, Jiangsu 221009, P.R. China.
Exp Ther Med. 2016 Dec;12(6):3653-3657. doi: 10.3892/etm.2016.3835. Epub 2016 Oct 25.
In the present study, the clinical effects of flexible ureteroscopy lithotripsy (FURL) and percutaneous nephrolithotomy (PCNL) for the treatment of kidney stones of ≤2 cm was studied. Seventy-two patients with kidney stones were randomly divided into the FURL group (n=39) under ureteroscope lithotripsy with holmium laser and PCNL group (n=33) under PCNL with holmium laser and compared their clinical effects. At 3 months after the operation, the stone removal rate of the FURL group was significantly higher than that of the PCNL group. The subgroup analysis revealed that the difference in the lower kidney calyx was more obvious (P<0.05) while the difference in the complex kidney stones was not statistically significant (P>0.05). The incidence of complications of the FURL group was significantly lower than that of the PCNL group (P<0.05). The operation time and recurrence rate of the FURL group were significantly less than that of the PCNL group (P<0.05). Differences regarding the creatinine and urea nitrogen levels before operation, and 3 and 7 days after the operation between the two groups were not statistically significant (P>0.05). Additionally, 3 and 7 days after operation, the cystatin C levels of the FURL group were significantly higher than those of the PCNL group, and the KIM-1 levels were significantly lower than the PCNL group (P<0.05). In conclusion, compared with PCNL with holmium laser, FURL with holmium laser was more safe and effective in treating kidney stones ≤2 cm. Therefore, the method is worthy of wide application in clinic.
在本研究中，探讨了输尿管软镜碎石术（FURL）和经皮肾镜取石术（PCNL）治疗直径≤2 cm肾结石的临床效果。将72例肾结石患者随机分为输尿管镜下钬激光碎石的FURL组（n = 39）和经皮肾镜钬激光碎石的PCNL组（n = 33），比较两组的临床效果。术后3个月，FURL组的结石清除率显著高于PCNL组。亚组分析显示，下肾盏结石清除率差异更明显（P < 0.05），而复杂性肾结石差异无统计学意义（P > 0.05）。FURL组并发症发生率显著低于PCNL组（P < 0.05）。FURL组的手术时间和复发率显著低于PCNL组（P < 0.05）。两组术前、术后3天和7天的肌酐和尿素氮水平差异无统计学意义（P > 0.05）。此外，术后3天和7天，FURL组的胱抑素C水平显著高于PCNL组，而KIM-１水平显著低于PCNL组（P < 0.05）。综上所述，与钬激光PCNL相比，钬激光FURL治疗直径≤2 cm肾结石更安全有效。因此，该方法值得在临床上广泛应用。
