标题：输尿管软镜与经皮肾镜治疗直径2 cm以下肾结石的对照研究

      作者：王勤军 1，刘同族 1，方少洪 2，廖国强 2，王志远 2，冯兆喜 2，廖胜 2    (1.武汉大学中南医院泌尿外科，湖北 武汉 430071；2.深圳市龙岗区第二人民医院泌尿外科，广东 深圳 518114)

      卷次： 2018年29卷7期

      【摘要】 目的 探讨输尿管软镜与经皮肾镜钬激光碎石术治疗肾结石的有效性及安全性。方法 选择深圳市龙岗区第二人民医院泌尿外科于 2016年 1~12月期间收治的 126例肾结石患者为研究对象，根据随机数表法分为观察组和对照组，每组 63例，对照组患者行经皮肾镜钬激光碎石术，观察组行输尿管软镜下钬激光碎石术，比较两组患者临床疗效及并发症发生情况。结果 观察组患者的手术时间为(68.3±25.6) min，长于对照组的(40.7±17.2) min，但是观察组患者术中出血量(10.2±3.1) mL、术后血清CRP水平(14.1±3.2) mg/L明显低于对照组[(68.4±32.4) mL、(21.3±5.8) mg/L]，术后住院时间[(5.6±2.3) d]短于对照组[(8.7±3.1) d]，差异均有统计学意义(P<0.05)；观察组和对照组患者的清石率分别为93.65%和90.48%，差异无统计学意义(P>0.05)；观察组患者的并发症发生率为3.17%，明显低于对照组的14.29%，差异有统计学意义(P<0.05)。结论 输尿管软镜与经皮肾镜碎石具有相同的碎石效果，但是前者对机体创伤小，具有术中出血量少、术后并发症发生率低、术后恢复快的优势。
      【关键词】 输尿管软镜；经皮肾镜；钬激光；肾结石；疗效
      【中图分类号】 R692.4 【文献标识码】 A 【文章编号】 1003—6350（2018）07—1003—03

Comparative study of flexible ureteroscopy and percutaneous nephrolithotomy in the treatment of renal calculiless than 2 cm in diameter.
WANG Qin-jun 1, LIU Tong-zu 1, FANG Shao-hong 2, LIAO Guo-qiang 2, WANG Zhi-yuan 2,FENG Zhao-xi 2, LIAO Sheng 2. 1. Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan 430071, Hubei,CHINA; 2. Department of Urology, the Second People's Hospital of Longgang District, Shenzhen 518114, Guangdong, CHINA
【Abstract】 Objective To evaluate the efficacy and safety of flexible ureteroscopy and percutaneous nephroli-thotomy holmium laser lithotripsy for the treatment of renal calculi. Methods A total of 126 patients with renal calculi,who treated in Department of Urology of the Second People's Hospital of Longgang District during January 2016 to De-cember 2016, were selected and divided into the observation group and the control group according to the random num-ber table method, with 63 patients in each group. The control group underwent percutaneous nephrolithotomy holmiumlaser lithotripsy, and the observation group underwent flexible ureteroscopy holmium laser lithotripsy. The clinical cu-rative effect index and the incidence of complications of the two groups were compared. Results The operation timein the observation group was (68.3 ± 25.6) min, which was significantly longer than (40.7 ± 17.2) min in the controlgroup (P<0.05). While the intraoperative bleeding and postoperative serum CRP levels of the observation group wererespectively (10.2±3.1) mL and (14.1±3.2) mg/L, which were significantly lower than corresponding (68.4±32.4) mL and(21.3±5.8) mg/L of the control group (P<0.05); the postoperative hospitalization time of the observation group was (5.6±2.3) d, which also significantly shorter than (8.7 ± 3.1) d of the control group (P<0.05). The stone clearance rate was93.65% in the observation group versus 90.48% in the control group (P>0.05). The complication rate in the observationgroup was 3.17%, which was significantly lower than 14.29% in the control group (P<0.05). Conclusion Flexible ure-teroscopy and percutaneous nephrolithotomy have the same lithotripsy effect, but flexible ureteroscopy has the advantag-es of less invasive, less bleeding, less postoperative complications, and faster postoperative recovery.
      【Key words】 Flexible ureteroscopy; Percutaneous nephrolithotomy; Holmium laser; Renal calculi; Curative effect·临床经验·doi:10.3969/j.issn.1003-6350.2018.07.036