摘要
目的:探讨输尿管软镜碎石术(FURL)和微通道经皮肾镜碎石术(MPCNL)对2~3 cm肾结石患者治疗效果及并发症的影响。方法:2017年1月-2018年12月收治120例肾结石患者,按照随机数字表法分为FURL组和m PCNL组,各60例。记录两组患者的手术时间、术后下床活动时间、术中出血量、平均住院时间、血红蛋白下降水平、并发症发生情况、清石率情况等。采用VAS评分和GCQ评分评估患者疼痛情况和舒适度。结果:FURL组术后住院时间、手术时间、术中出血量、术后下床活动时间、血红蛋白下降时间均显著小于m PCNL组,差异有统计学意义(P<0.05);两组患者术后1~3 d、术后1个月清石率比较,差异无统计学意义(P>0.05);术后4 h、术后48 h,FURL组的视觉模拟评分显著低于m PCNL组,舒适状况评分显著高于m PCNL组(P<0.05);按照Caiven-Dindo并发症分级标准确定并发症发生情况,FURL组并发症发生率为3.33%,m PCNL组并发症发生率为13.33%,FURL组并发症发生情况较m PCNL组轻(P<0.05)。结论:对于2~3 cm肾结石患者而言,m PCNL和FURL的清石率相似,FURL在住院时间、下床活动时间、手术时间、术后生活质量、降低并发症发生率方面具有明显优势,随着设备和材料的改进,FURL将有更大的应用前景,但还应根据患者的具体情况合理选择。
Objective:To investigate the effect of flexible ureteroscopic lithotripsy(FURL)and micro-channel percutaneous nephrolithotripsy(mPCNL)on the curative effects and complications of 2-3 cm renal calculi.Methods:From January 2017 to December 2018,120 patients with kidney stones were divided into FURL group and mPCNL group,60 cases in each group.FURL group was given FURL,and mPCNL group was given mPCNL.The opera⁃tion time,the time of getting out of bed after operation,the amount of bleeding during operation,the average length of hospital stay,the level of hemoglobin reduction,the occurrence of complications and the rate of stone removal were recorded.VAS score and GCQ score were used to evaluate patients'pain and comfort.Results:The postopera⁃tive hospital stay,operation time,time of getting out of bed and time of hemoglobin reduction were significantly shorter,and intraoperative blood loss was significantly in FURL group than those in mPCNL group(all P<0.05).There was no significant difference in the stone removal rate between the two groups(P>0.05).The VAS score was significantly lower,and the GCQ score was significantly higher in the FURL group than those in the mPCNL group(both P<0.05).According to the caiven Dindo criteria,the incidence of complications was 3.33%in FURL group,significantly lower than 13.33%in mPCNL group(P<0.05).Conclusion:For patients with 2-3 cm renal calculi,the stone removal rate of mPCNL and FURL is similar.FURL has obvious advantages in hospital stay,out of bed activity time,operation time,quality of life after operation and reducing the incidence of complications.With the improvement of equipment and materials,FURL will have greater application prospects,but it should also be rea⁃sonably selected according to the specific situations of patients.
作者
郭军
李知春
任泽杰
程洋生
李波
宋忠伟
GUO Jun;LI Zhichun;REN Zejie;CHENG Yangsheng;LI Bo;SONG Zhongwei(Department of Urology,Wenjiang District People's Hospital,Chengdu 611130,China)
出处
《微创泌尿外科杂志》
2020年第2期92-95,共4页
Journal of Minimally Invasive Urology
关键词
肾结石
结石清除率
并发症
kidney stones
stone clearance rate
complications
作者简介
通信作者:郭军,1203696720@qq.com
