摘要
目的比较经皮肾镜与输尿管软镜治疗2～4cm肾结石的l临床效果。方法收集2009年9月至2011年1月34例输尿管软镜和36例经皮肾镜手术治疗直径范围为2—4cm肾结石，比较两者结石清除率、手术时间、住院时间及并发症。结果输尿管软镜和经皮肾镜手术一期结石清除率分别为73．5％和88．9％（P〈0．05）。经二期治疗后输尿管软镜清除率提高到88．2％。3个月后随访，清除率分别达94．1％或94．4％（P〉0．05）。输尿管软镜平均手术时间为58．2±13．4（30～85）min，经皮肾镜为38．7±11．6（14～60）min（P〈0．001）。经皮肾镜组总体并发症发生率较高，与输尿管镜组比较差异没有统计学意义。住院时间输尿管软镜组30．0±37．4h，经皮。肾镜组61．4±34．oh，P〈0．001，比较差异有统计学意义。结论多期输尿管软镜治疗2～4era的肾结石可以达到令人满意的结果，可以替代经皮肾镜治疗较大肾结石。
Objectives TO compare the outcomes of percutaneous nephrolithotomy （PCNL） and flexible ureteroscope in the treatment of 2 - 4 cm kidney stones. Methods And methods between September 2009 and January 2011, 34 patients who had renal stones ranging from 2 to 4 cm in diameter were treated with flexible uretero- scope and 36 patients who had renal stones ranging from 2 to 4 cm in diameter were treated with percutaneous nephro- lithotomy. We compare the stone - free rate, operation time, hospital stay and complication after operation. Results Stone - free rates after one session were 73.5% and 88.9% for flexible ureteroscope and PCNL respectively（ P 〈 0.05）. Stone - free rate in the flexible ureteroscope group improved to 88.2% after the second procedure. With the following up after three months, clearance rates were up to 94.1% or 94.4% respectively（ P 〉 0.05 ）. Mean operation duration was 58.2 ＋ 13.4 min in the flexible ureteroscope group but 38.7 ：t： ll. 6 min in the PCNL group（ P 〈0.0001 ）. Overall complication rates in the PCNL group were higher, but the differences were not statistically sig- nificant. Hospitalization time was significantly shorter in the flexible ureteroscope group （30.0 ＋ 37.4 vs 61.4 ＋ 34. 0 h, respectively ; P 〈 0. 001 ）. Conclusions Satisfactory outcomes can be achieved with multi - session flexible ureteroscope in the treatment of 2 ~ 4 cm renal stones. Flexible ureteroscope can be used as an alternative treatment to PCNL in selected cases with larger renal stones.
出处
《国际泌尿系统杂志》
2013年第1期34-36,共3页
International Journal of Urology and Nephrology
