经输尿管软镜取石术与经皮肾镜取石术治疗肾结石的疗效及安全性分析(1)
摘要：目的 探讨经输尿管软镜取石术与经皮肾镜取石术治疗肾结石的疗效及安全性。方法 将122例肾结石患者随机分为输尿管软镜组和经皮肾镜组，比较两组术后4 w清石率、手术持续时间、术中出血量及术后并发症发生率。结果 两组结石最大径≤2 cm患者，术后4 w清石率比较差异无统计学意义(P>0.05)，术中出血量及手术时间比较差异有统计学意义(P<0.05)；两组结石最大径﹥2 cm患者，术后4 w清石率、术中出血量及手术时间比较差异有统计学意义(P<0.05)；两组并发症的发生率差异有统计学意义(P<0.05)。结论 对于最大径≤2 cm的肾结石，选用经输尿管软镜取石术出血量少，手术时间短，具有安全、微创的优势；对于最大径>2 cm的肾结石，采用经皮肾镜取石术具有清石率高，其具有着取石彻底、手术时间短的优点，但是经皮肾镜取石术术后并发症风险较大，需要严格监控患者的手术禁忌证。
关键词：输尿管软镜取石术；经皮肾镜取石术；疗效；安全性；肾结石
Efficacy and Safety of Ureteroscopic Soft Lithotripsy and Percutaneous Nephrolithotomy in the Treatment of Kidney Stones
, 百拇医药
LIU Guo-qi
(Department of Urology，Tianjin Permanent Hospital，Tianjin 300450，China)
Abstract：Objective To investigate the efficacy and safety of the flexible ureteroscope lithotripsy and percutaneous nephrolithotomy in treatment of renal calculi.Methods 122 cases of kidney stones were randomly divided into ureteroscope group and percutaneous nephrolithotomy group，the two groups were compared after 4 w stone clearance rate，duration of operation，amount of bleeding and the incidence of postoperative complications during the operation.Results The two groups of the largest stone diameter≤2 cm patients，4 w postoperative stone clearance rate was no significant difference(P >0.05)，a significant amount of intraoperative bleeding and operation time difference(P<0.05)；the two group is the maximum diameter of calculi>2 cm patients，4 w after operation，stone clearance rate，intraoperative bleeding volume and operation time were statistically significant difference(P<0.05)；the two group the incidence of complications was statistically significant(P< 0.05).Conclusion For renal calculi maximum diameter≤2 cm，the flexible ureteroscope lithotomy，less bleeding，short operation time，safe，minimally invasive advantages；for the maximum diameter of>2 cm in renal calculi by percutaneous nephrolithotomy with high stone clearance rate，which has a stone completely， the advantages of shorter operation time，but percutaneous nephrolithotomy postoperative complications risk，need surgical contraindication strict monitoring of patients.
, 百拇医药
Key words：Ureteroscopy；Percutaneous nephrolithotomy；Efficacy；Safety；Renal calculi
肾结石是泌尿系统常见疾病之一，患者可表现为剧烈疼痛、血尿等症状，如不及时治疗可造成肾功能的严重损伤[1]。随着手术方式的不断进步，以往的开放取石手术逐渐被经输尿管软镜取石术、经皮肾镜取石术等新型微創手术方式所取代[2，3]。本研究分析经输尿管软镜取石术和经皮肾镜取石术的疗效及安全性，以期为患者找到合适的治疗方法，现将结果报告如下。
1资料与方法
1.1 一般资料 以2014 年12月～2015年11月我科收治的122例肾结石患者为研究对象，所有患者均经腹部平片(KUB)、超声、肾脏CT明确诊断为肾结石，排除肾功能严重损害、凝血功能异常及严重高血压糖尿病患者。将122例患者随机分为经皮肾镜组和输尿管软镜组，其中经皮肾镜组61例，男32例，女29例，平均年龄(45.26±8.53)岁，结石最大径平均为(15.98±4.15)mm，结石最大径≤2 cm者35例，﹥2 cm者26例；输尿管软镜组61例，男35例，女26例，平均年龄(44.95±8.42)岁，结石最大径平均为(16.11±4.08)mm，结石最大径≤2 cm者33例，﹥2 cm者28例。两组患者在性别、年龄、结石最大径等方面比较，差异无统计学意义(P>0. 05) ，具有可比性。, 百拇医药(刘国歧)
关键词：输尿管软镜取石术；经皮肾镜取石术；疗效；安全性；肾结石
Efficacy and Safety of Ureteroscopic Soft Lithotripsy and Percutaneous Nephrolithotomy in the Treatment of Kidney Stones
, 百拇医药
LIU Guo-qi
(Department of Urology，Tianjin Permanent Hospital，Tianjin 300450，China)
Abstract：Objective To investigate the efficacy and safety of the flexible ureteroscope lithotripsy and percutaneous nephrolithotomy in treatment of renal calculi.Methods 122 cases of kidney stones were randomly divided into ureteroscope group and percutaneous nephrolithotomy group，the two groups were compared after 4 w stone clearance rate，duration of operation，amount of bleeding and the incidence of postoperative complications during the operation.Results The two groups of the largest stone diameter≤2 cm patients，4 w postoperative stone clearance rate was no significant difference(P >0.05)，a significant amount of intraoperative bleeding and operation time difference(P<0.05)；the two group is the maximum diameter of calculi>2 cm patients，4 w after operation，stone clearance rate，intraoperative bleeding volume and operation time were statistically significant difference(P<0.05)；the two group the incidence of complications was statistically significant(P< 0.05).Conclusion For renal calculi maximum diameter≤2 cm，the flexible ureteroscope lithotomy，less bleeding，short operation time，safe，minimally invasive advantages；for the maximum diameter of>2 cm in renal calculi by percutaneous nephrolithotomy with high stone clearance rate，which has a stone completely， the advantages of shorter operation time，but percutaneous nephrolithotomy postoperative complications risk，need surgical contraindication strict monitoring of patients.
, 百拇医药
Key words：Ureteroscopy；Percutaneous nephrolithotomy；Efficacy；Safety；Renal calculi
肾结石是泌尿系统常见疾病之一，患者可表现为剧烈疼痛、血尿等症状，如不及时治疗可造成肾功能的严重损伤[1]。随着手术方式的不断进步，以往的开放取石手术逐渐被经输尿管软镜取石术、经皮肾镜取石术等新型微創手术方式所取代[2，3]。本研究分析经输尿管软镜取石术和经皮肾镜取石术的疗效及安全性，以期为患者找到合适的治疗方法，现将结果报告如下。
1资料与方法
1.1 一般资料 以2014 年12月～2015年11月我科收治的122例肾结石患者为研究对象，所有患者均经腹部平片(KUB)、超声、肾脏CT明确诊断为肾结石，排除肾功能严重损害、凝血功能异常及严重高血压糖尿病患者。将122例患者随机分为经皮肾镜组和输尿管软镜组，其中经皮肾镜组61例，男32例，女29例，平均年龄(45.26±8.53)岁，结石最大径平均为(15.98±4.15)mm，结石最大径≤2 cm者35例，﹥2 cm者26例；输尿管软镜组61例，男35例，女26例，平均年龄(44.95±8.42)岁，结石最大径平均为(16.11±4.08)mm，结石最大径≤2 cm者33例，﹥2 cm者28例。两组患者在性别、年龄、结石最大径等方面比较，差异无统计学意义(P>0. 05) ，具有可比性。, 百拇医药(刘国歧)
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