回顾性研究可视化超微经皮肾镜碎石术与软性输尿管镜碎石术治疗 1.5-2.5cm 肾结石且无肾积水患者的疗效。

Retrospective study of visualized ultra-mini percutaneous nephrolithotripsy vs. flexible ureterorenoscopy for nephrolithiasis patients with 1.5-2.5 cm kidney stones and without hydronephrosis.

机构信息

Department of Urology, the Affiliated Southeast Hospital of Xiamen University, Zhangzhou, Fujian, China.

出版信息

Eur Rev Med Pharmacol Sci. 2022 May;26(9):3185-3191. doi: 10.26355/eurrev_202205_28736.

DOI:10.26355/eurrev_202205_28736

PMID:35587069

Abstract

OBJECTIVE

To investigate the safety and efficacy of visualized ultra-mini percutaneous nephrolithotripsy (VUMP) and flexible ureterorenoscopy (FURS) in the treatment of nephrolithiasis patients with 1.5-2.5 cm kidney stones and without hydronephrosis.

PATIENTS AND METHODS

The clinical data of 143 nephrolithiasis patients without hydronephrosis (from April 2017 to March 2021) were collected and analyzed, including 65 cases in the VUMP group and 78 cases in the FURS group. The general clinical data, operation time, hospitalization time, recent stone-free rate (RSFR), long-term stone free rate (four weeks after operation, LSFR), Visual Analogue Scale (VAS), Bruggermann comfort score (BCS), and surgical complications of the two groups were collected and analyzed.

RESULTS

In the VUMP group, the operation time (49.14 ± 9.28 vs. 60.23 ± 9.45, p < 0.001), postoperative white blood cell count (11.05 ± 2.43 vs. 13.57 ± 2.71, p < 0.05) and BCS score (1.72 ± 0.80 vs. 2.81 ± 0.85, p < 0.001) were significantly lower than those of the FURS group, but the postoperative hemoglobin (8.25 ± 5.04 vs. 4.05 ± 3.07, p < 0.05), hospital stay (5.72 ± 1.75 vs. 3.12 ± 1.09, p < 0.001) and VAS score (3.18 ± 1.36 vs. 2.08 ± 1.28, p < 0.001) were significantly higher than those of the FURS group. Besides, the VUMP group was significantly higher than the FURS group in RSFR (90.32% vs. 72.22%, p < 0.05) and LSFR (95.38% vs. 85.89%, p < 0.05). The systemic inflammatory response syndrome rate (3.07% vs. 14.10%, p = 0.037) and total complications (9.23% vs. 20.51%, p = 0.032) were significantly lower in the VUMP group than in the FURS group.

CONCLUSIONS

Both VUMP and FURS are safe and effective in the treatment of nephrolithiasis patients with 1.5-2.5 cm kidney stones and without hydronephrosis, and the former is preferable for higher SFR, shorter operation time and lower complication rate.

摘要

目的

探讨可视化超微经皮肾镜碎石术（VUMP）联合输尿管软镜碎石术（FURS）治疗无肾积水 1.5～2.5cm 肾结石患者的安全性和有效性。

方法

回顾性分析 2017 年 4 月至 2021 年 3 月收治的 143 例无肾积水肾结石患者的临床资料，根据治疗方法不同分为 VUMP 组（65 例）和 FURS 组（78 例）。比较两组患者的一般临床资料、手术时间、住院时间、近期结石清除率（RSFR）、远期结石清除率（术后 4 周，LSFR）、视觉模拟评分（VAS）、Bruggermann 舒适度评分（BCS）、手术并发症等。

结果

VUMP 组患者手术时间为（49.14±9.28）min，明显短于 FURS 组的（60.23±9.45）min（P＜0.001）；术后白细胞计数为（11.05±2.43）×10^9/L，明显低于 FURS 组的（13.57±2.71）×10^9/L（P＜0.05）；BCS 评分为（1.72±0.80）分，明显低于 FURS 组的（2.81±0.85）分（P＜0.001）；血红蛋白为（8.25±5.04）g/L，明显低于 FURS 组的（4.05±3.07）g/L（P＜0.05）；住院时间为（5.72±1.75）d，明显长于 FURS 组的（3.12±1.09）d（P＜0.001）；VAS 评分为（3.18±1.36）分，明显高于 FURS 组的（2.08±1.28）分（P＜0.001）。VUMP 组 RSFR 为 90.32%，明显高于 FURS 组的 72.22%（P＜0.05）；LSFR 为 95.38%，明显高于 FURS 组的 85.89%（P＜0.05）。VUMP 组全身炎症反应综合征发生率为 3.07%，明显低于 FURS 组的 14.10%（P=0.037）；总并发症发生率为 9.23%，明显低于 FURS 组的 20.51%（P=0.032）。