经输尿管软镜取石术与经皮肾镜取石术治疗肾结石的有效性和安全性的比较
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摘要
目的通过用两种取石术治疗肾结石,比较两组有效性和安全性,探究两种取石术的临床效果特点。方法选择2016年1月—2018年6月的到该院进行碎石治疗的肾结石患者中随机抽取40例患者,随机分为U组20例采用输尿管软镜取石术,P组20例采用经皮肾镜取石术。结果 U组手术出血量为(8.36±2.83)mL比P组少,差异有统计学意义(t=9.156,P<0.05),手术时间为(86.27±18.73)min长于P组,差异有统计学意义(t=7.945,P<0.05);U组结石清除率(75%)低于P组(85%),差异有统计学意义(χ~2=8.441,P<0.05),并发症发生率(5%)低于P组(20%),差异有统计学意义(χ~2=7.473,P<0.05)。结论输尿管软镜治疗肾结石具有手术时间长,出血量少,并发症低和结石清除率低的特点,提示医师在治疗肾结石时要依据患者具体情况而决定手术方案。
Objective To compare the effectiveness and safety of transureteroscopic lithotripsy and percutaneous nephrolithotripsy in treatment of nephrolith and study the clinical effect features of the two types. Methods 40 cases of patients with nephrolith in our hospital from January 2016 to June 2018 were selected and randomly divided into two groups with 20 cases in each, the U group were treated with soft ureteroscope lithotripsy, while the P group were treated with percutaneous nephrolithotripsy. Results The operative bleeding amount in the U group was(8.36 ±2.83)mL,lower than that in the P group,the different was statistically significant(t=9.156,P<0.05), and the operation time was(86.27±18.73)min, longer than that in the P group,the different was statistically significant(t=7.945, P<0.05), the stone clearance rate in the U group was lower than that in the P group 75% vs 85%,the different was statistically significant(χ~2=8.441,P<0.05), and the incidence rate of complications was lower than that in the P group 5%vs 20%,the different was statistically significant(χ~2=7.473, P<0.05). Conclusion The operation time of transureteroscopic lithotripsy in treatment of nephrolith is longer with low bleeding amount, low complications and low stone clearance rate, which reminds that the physicians should determine the operation plan according to the specific conditions in treatment of nephrolith.
Objective To compare the effectiveness and safety of transureteroscopic lithotripsy and percutaneous nephrolithotripsy in treatment of nephrolith and study the clinical effect features of the two types. Methods 40 cases of patients with nephrolith in our hospital from January 2016 to June 2018 were selected and randomly divided into two groups with 20 cases in each, the U group were treated with soft ureteroscope lithotripsy, while the P group were treated with percutaneous nephrolithotripsy. Results The operative bleeding amount in the U group was(8.36 ±2.83)mL,lower than that in the P group,the different was statistically significant(t=9.156,P<0.05), and the operation time was(86.27±18.73)min, longer than that in the P group,the different was statistically significant(t=7.945, P<0.05), the stone clearance rate in the U group was lower than that in the P group 75% vs 85%,the different was statistically significant(χ~2=8.441,P<0.05), and the incidence rate of complications was lower than that in the P group 5%vs 20%,the different was statistically significant(χ~2=7.473, P<0.05). Conclusion The operation time of transureteroscopic lithotripsy in treatment of nephrolith is longer with low bleeding amount, low complications and low stone clearance rate, which reminds that the physicians should determine the operation plan according to the specific conditions in treatment of nephrolith.
引文
[1]牛超,廖邦华,罗德毅.经输尿管软镜取石术与经皮肾镜取石术治疗肾结石的有效性和安全性的系统评价[J].中国循证医学杂志,2013,13(7):868-874.
[2]徐鑫,蒋召强,刁统祥,等.经皮肾镜取石术与输尿管软镜碎石术治疗肾结石的Meta分析[J].临床泌尿外科杂志,2017,32(5):365-369.
[3]陈雷振,许海峰,冯涛,等.输尿管软镜在治疗经皮肾镜取石术后残余肾结石中的应用价值[J].中国医师进修杂志,2015,38(3):160-163.
[4]陈洪波,江克华,胡晓晖,等.微通道经皮肾镜取石术联合输尿管软镜治疗马蹄肾肾结石疗效分析[J].微创泌尿外科杂志,2015,4(5):274-276.
[5]GU SP,HUANG YT,YOU ZY,et al.Clinical effective ness of the PolyScope.endoscopesystem combined with holmium laser lithotripsy in the treatment of upper urinary calculi with adiameter of less than 2 cm[J].ExpTher Med,2013,6(2):591-595.
[6]范地兵,马晋,邓仕军.超声引导下微通道经皮肾镜或输尿管镜取石术在肾结石患者中的应用[J].海南医学,2017(8):1247-1249.
[7]张少青,董效飞,孙晓磊,等.输尿管软镜与经皮肾镜治疗肾盏憩室结石临床疗效对比[J].现代泌尿外科杂志[J],2017,22(3):189-191.
[8]李高飞.输尿管软镜与超微经皮肾镜治疗直径≤2 cm肾结石的疗效比较[J].长春:2017,吉林大学,2017.
[9]张杰.输尿管软镜碎石术与经皮肾镜碎石术治疗复杂性肾结石的疗效分析[D].乌鲁木齐:2018,新疆医科大学,2018.
[2]徐鑫,蒋召强,刁统祥,等.经皮肾镜取石术与输尿管软镜碎石术治疗肾结石的Meta分析[J].临床泌尿外科杂志,2017,32(5):365-369.
[3]陈雷振,许海峰,冯涛,等.输尿管软镜在治疗经皮肾镜取石术后残余肾结石中的应用价值[J].中国医师进修杂志,2015,38(3):160-163.
[4]陈洪波,江克华,胡晓晖,等.微通道经皮肾镜取石术联合输尿管软镜治疗马蹄肾肾结石疗效分析[J].微创泌尿外科杂志,2015,4(5):274-276.
[5]GU SP,HUANG YT,YOU ZY,et al.Clinical effective ness of the PolyScope.endoscopesystem combined with holmium laser lithotripsy in the treatment of upper urinary calculi with adiameter of less than 2 cm[J].ExpTher Med,2013,6(2):591-595.
[6]范地兵,马晋,邓仕军.超声引导下微通道经皮肾镜或输尿管镜取石术在肾结石患者中的应用[J].海南医学,2017(8):1247-1249.
[7]张少青,董效飞,孙晓磊,等.输尿管软镜与经皮肾镜治疗肾盏憩室结石临床疗效对比[J].现代泌尿外科杂志[J],2017,22(3):189-191.
[8]李高飞.输尿管软镜与超微经皮肾镜治疗直径≤2 cm肾结石的疗效比较[J].长春:2017,吉林大学,2017.
[9]张杰.输尿管软镜碎石术与经皮肾镜碎石术治疗复杂性肾结石的疗效分析[D].乌鲁木齐:2018,新疆医科大学,2018.