【摘要】：目的:比較經(jīng)皮腎鏡取石術(shù)(PCNL)和逆行輸尿管軟鏡碎石術(shù)(RIRS)處理2cm范圍腎結(jié)石的療效。方法:回顧性分析2015年10月至2016年11月廣西醫(yī)科大學(xué)第一附屬醫(yī)院泌尿外科收治的96例2cm范圍腎結(jié)石患者的臨床資料,按術(shù)式將其分為PCNL組42例和RIRS組54例。比較分析兩組手術(shù)時(shí)間、碎石時(shí)間、術(shù)后住院時(shí)間、住院費(fèi)用、術(shù)后清石率、并發(fā)癥發(fā)生率。結(jié)果:42例PCNL患者中,36例患者結(jié)石一次碎石完成,3例患者分2次碎石完成,3例患者殘留結(jié)石。54例RIRS患者中,48例患者結(jié)石一次碎石完成,6例患者殘留結(jié)石。PCNL組和RIRS組術(shù)后1周結(jié)石清除率分別為78.57%(33/42)和57.41%(31/54),術(shù)后1個(gè)月結(jié)石清除率分別為92.86%(39/42)和88.89%(48/54)。平均手術(shù)時(shí)間PCNL組(69.55±15.16)min,RIRS組(54.48±12.89)min。平均碎石時(shí)間PCNL組(32.36±13.04)min,RIRS組(39.48±12.67)min。術(shù)后住院時(shí)間PCNL組5(4)d,RIRS組1(1)d。平均住院費(fèi)用PCNL組(19194.50±3809.24)元,RIRS組(13318.97±1537.15)元。并發(fā)癥發(fā)生率PCNL組23.81%(10/42),RIRS組3.70%(2/54)。結(jié)論:對于處理2cm范圍內(nèi)的腎結(jié)石,PCNL和RIRS均是安全而有效的措施,但RIRS的手術(shù)時(shí)間、術(shù)后住院天數(shù)、并發(fā)癥發(fā)生率及住院費(fèi)用均明顯少于PCNL,而其碎石時(shí)間卻長于PCNL,術(shù)后清石率則與PCNL基本相當(dāng)。
[Abstract]:Objective: to compare the effect of percutaneous nephrolithotomy (PCNL) and retrograde ureteral soft lithotripsy (RIRS) in the treatment of renal calculi in 2cm range. Methods: the clinical data of 96 patients with 2cm renal calculi treated in Urology Department of the first affiliated Hospital of Guangxi Medical University from October 2015 to November 2016 were retrospectively analyzed. The patients were divided into two groups: PCNL group (n = 42) and RIRS group (n = 54). The operative time, lithotripsy time, postoperative hospitalization time, hospitalization cost, postoperative lithotomy rate and complication rate were compared between the two groups. Results among 42 PCNL patients, 36 patients were treated with lithotripsy in one time. 3 patients were divided into 2 lithotripsy cases and 3 patients were treated with residual stones. 48 out of 54 patients with RIRS were treated with lithotripsy at one time. 6 patients with residual stones. PCNL group and RIRS group. The stone clearance rates were 78.57% (33 / 42) and 57.41% (31 / 54) at 1 week postoperatively, and 92.86% (39 / 42) and 88.89% (48 / 54) at 1 month postoperatively. Mean operative time in PCNL group (69.55 鹵15.16) min,RIRS group (54.48 鹵12.89) min. Mean lithotripsy time in PCNL group (32.36 鹵13.04) min,RIRS group (39.48 鹵12.67) min. Postoperative hospitalization time was 1 (1) d in PCNL group (5 (4) d) and RIRS group (1 (1) d). The average hospitalization cost was (19194.50 鹵3809.24) yuan in PCNL group and (13318.97 鹵1537.15) yuan in Rirs group. The incidence of complications was 23.81% (10 / 42) in PCNL group and 3.70% (2 / 54) in RIRS group. Conclusion: both PCNL and RIRS are safe and effective measures for the treatment of renal calculi within the scope of 2cm, but the operation time of RIRS and the days of hospitalization after RIRS are safe and effective. The incidence of complications and hospitalization cost were significantly less than that of PCNL, but the lithotripsy time was much longer than that of PCNL,. The rate of stone removal was similar to that of PCNL.
【學(xué)位授予單位】：廣西醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R699.4

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