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柔性输尿管镜碎石术与微创经皮肾镜取石术治疗直径≤2 cm的肾及输尿管上段结石的疗效:一项回顾性研究

The efficacy of flexible ureteroscopy lithotripsy and miniaturized percutaneous nephrolithotomy for the treatment of renal and proximal ureteral calculi of ≤2 cm: A retrospective study.

作者信息

Jiao Binbin, Lai Shicong, Xu Xin, Zhang Meng, Diao Tongxiang, Zhang Guan

机构信息

Peking University China-Japan Friendship School of Clinical Medicine.

Department of Urology, China-Japan Friendship Hospital, Chaoyang District.

出版信息

Medicine (Baltimore). 2019 Mar;98(11):e14535. doi: 10.1097/MD.0000000000014535.

Abstract

To assess the clinical effect of miniaturized percutaneous nephrolithotomy (MPCNL) and flexible ureteroscopy lithotripsy (FURL) for the treatment of renal and proximal ureteral calculi of ≤2 cm.A retrospective analysis was carried out on clinical data of 106 patients with kidney or upper urethral calculi. Among these patients, 58 underwent the MPCNL, and 48 received FURL. Stone-free rates, operating time, blood loss, hemoglobin drop, length of hospital stay, complications, and renal damage indexes were compared.The stone removal rates of the FURL and MPCNL groups were 81.25% versus 87.93% (p > .05). Although operating time was significantly shorter in the MPCNL group, hospital stays were significantly shorter in the FURL group. In addition, pooled analysis showed that mean estimated blood loss was significantly higher in the PCNL group but the hemoglobin decline of the FURL group and PCNL group had no significant difference. The PCNL group had no significant difference in complications compared to the FURL group. Differences on the creatinine levels and urea nitrogen levels before the operation and after the operation were not statistically significant.FURL is an effective method for treating renal stone. FURL not only had a similar stone-free rate as compared to MPCNL but also was associated with less blood loss and more favorable recovery time. However, FURL had a longer operative time.

摘要

评估微创经皮肾镜取石术(MPCNL)和输尿管软镜碎石术(FURL)治疗直径≤2 cm的肾及输尿管上段结石的临床效果。对106例肾或上段输尿管结石患者的临床资料进行回顾性分析。其中,58例行MPCNL,48例行FURL。比较结石清除率、手术时间、出血量、血红蛋白下降情况、住院时间、并发症及肾损伤指标。FURL组和MPCNL组的结石清除率分别为81.25%和87.93%(p>0.05)。虽然MPCNL组手术时间明显较短,但FURL组住院时间明显较短。此外,汇总分析显示,PCNL组平均估计出血量明显较高,但FURL组和PCNL组血红蛋白下降情况无显著差异。PCNL组与FURL组并发症无显著差异。术前和术后肌酐水平及尿素氮水平差异无统计学意义。FURL是治疗肾结石的有效方法。FURL不仅结石清除率与MPCNL相似,而且出血量少,恢复时间更有利。然而,FURL手术时间较长。

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