發(fā)布時(shí)間：2019-06-19 04:19

【摘要】：目的：比較逆行輸尿管軟鏡下鈥激光碎石(flexible ureteroscopy, FURS)和經(jīng)皮腎鏡鈥激光碎石(percutaneous nephrolithotomy, PCNL)治療鹿角形腎結(jié)石的有效性和安全性。 方法：2011年9月至2014年3月邵逸夫醫(yī)院收治的鹿角形結(jié)石患者60例納入研究,隨機(jī)分為FURS組、PCNL組各30例。比較兩組患者手術(shù)時(shí)間、術(shù)中出血量、輸血百分比、術(shù)后血紅蛋白下降量、術(shù)后CRP上升量、術(shù)后住院天數(shù)、總住院費(fèi)用、清石率和并發(fā)癥等。 結(jié)果：兩組患者年齡、性別、腎積水情況、結(jié)石最長(zhǎng)徑、S.T.O.N.E. Nephrolithometry系統(tǒng)評(píng)分等比較差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。FURS組和PCNL組手術(shù)時(shí)間分別為(102.9±40.2)min和(136.9±46.6)mmin；術(shù)中出血量分別為(20.5±20.0)ml和(102.4±249.8)ml；術(shù)后住院日分別為(2.6±1.2)d和(5.3±1.8)d；總住院費(fèi)用分別為(24.5±6.8)千元和(28.6±5.4)千元；血紅蛋白分別下降(0.89±0.69)g/L和(1.48±0.98)g/L；差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。FURS組和PCNL組CRP分別上升(2.59±1.16)mg/L和(5.55±6.81)mg/L,差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。FURS組和PCNL組術(shù)中輸血百分比分別為0%和3.33%(1/30)。并發(fā)癥(Clavien分級(jí)Ⅱ級(jí))發(fā)生率分別為6.67%(2/30)和10%(3/30),差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。其中軟鏡1例術(shù)后感染發(fā)熱,1例后腹膜炎癥；經(jīng)皮腎鏡1例術(shù)后出血需輸血,1例胸腔積液發(fā)熱,1例腎周血腫；總清石率(殘石≤4mm)分別為86.7%(26/30)和90%(27/30),差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05),其中FURS組8例術(shù)后行ESWL輔助碎石治療,PCNL組1例術(shù)后行ESWL輔助治療。 結(jié)論：逆行輸尿管軟鏡下鈥激光碎石和經(jīng)皮腎鏡鈥激光碎石治療鹿角形腎結(jié)石都是可行的、安全的手術(shù)方式,但FURS具有手術(shù)時(shí)間短、術(shù)中出血少、術(shù)后恢復(fù)快、住院費(fèi)用少等優(yōu)勢(shì)。
[Abstract]:Objective: to compare the efficacy and safety of retrograde endoscopic holmium laser lithotripsy (flexible ureteroscopy, FURS) and percutaneous holmium laser lithotripsy (percutaneous nephrolithotomy, PCNL) in the treatment of staghorn renal calculi. Methods: from September 2011 to March 2014, 60 patients with staghorn stones were randomly divided into FURS group (n = 30) and PCNL group (n = 30). The operation time, intraoperative blood loss, blood transfusion percentage, postoperative hemoglobin decrease, postoperative CRP rise, postoperative hospitalization days, total hospitalization expenses, stone clearance rate and complications were compared between the two groups. Results: there were no significant differences in age, sex, hydronephrosis, longest diameter of stones and Nephrolithometry system score between the two groups (P 0.05). The operation time of). FURS group and PCNL group were (102.9 鹵40.2) min and (136.9 鹵46.6) mmin;, respectively. The intraoperative bleeding volume was (20.5 鹵20.0) ml and (102.4 鹵249.8) ml;, respectively. The postoperative hospitalization days were (2.6 鹵1.2) days and (5.3 鹵1.8) days, the total hospitalization expenses were (24.5 鹵6.8) km and (28.6 鹵5.4) km, the hemoglobin decreased by (0.89 鹵0.69) g / L and (1.48 鹵0.98) g / L, respectively. There was no significant difference in CRP between). FURS group and PCNL group (P 0.05) CRP increased by (2.59 鹵1.16) mg/L and (5.55 鹵6.81) mg/L, respectively (P < 0.05). The percentage of intraoperative blood transfusion in). FURS group and PCNL group was 0% and 3.33% (1 鈮，

本文編號(hào)：2502084