摘要
目的分析输尿管软镜钬激光碎石术(FURSL)与微创经皮肾镜碎石术(PCNL)治疗2-3 cm的肾结石疗效和安全性。方法我院收治的2~3 cm肾结石患者98例,其中49例行FURSL术为研究组,49例行PCNL术为对照组,比较两组治疗及手术相关指标、实验室检查指标,采用视觉模拟评分法(VAS)评估疼痛情况。结果两组首次结石清除率和最终结石清除率比较,差异无统计学意义(P>0.05),研究组出血量、再次就诊率及VAS评分低于对照组,手术时间长于对照组,术后恢复时间短于对照组(P<0.05);术后研究组中性粒细胞明胶酶相关载脂蛋白(NGAL)、尿肾脏损伤因子(Kim-1)、白细胞(WBC)、血肌酐(Scr)水平低于对照组,血清胱抑制素(Cys-C)、血红蛋白(Hb)水平高于对照组(P<0.05);两组术后WBC均高于术前,对照组Hb低于术前,Scr高于术前(P<0.05);研究组术后不良反应总发生率低于对照组(P<0.05)。结论FURSL术与PCNL术相比术后恢复时间更短,不良反应发生率更低,能有效提高2~3 cm肾结石患者手术治疗效果及术后安全性。
Objective To analyze the curative effect and safety of flexible ureteroscopic holmium laser lithotripsy(FURSL)and minimally invasive percutaneous nephrolithotripsy(PCNL)in the treatment of kidney stones of 2~3 cm.Methods Ninety-eight patients with kidney stones of 2~3 cm treated in our hospital were enrolled.The patients included 49 cases treated with FURSL in the study group and 49 cases treated with PCNL in the control group.The treatment and surgery-related indicators and laboratory examination indicators were compared between the two groups.Pain was evaluated by visual analogue scale(VAS).Results There was no statistical difference in the first and final stone clearance rates between the two groups(P>0.05).In the study group,blood loss,re-visit rate and VAS score were less or lower,and the surgical time was longer but the postoperative recovery was shorter when compared with those in the control group(P<0.05).After surgery,neutrophil gelatinase-associated lipocalin(NGAL),urinary kidney injury molecule-1(Kim-1),white blood cells(WBC)and serum creatinine(Scr)in the study group were lower while serum cystatin C(Cys-C)and hemoglobin(Hb)were higher than those in the control group(P<0.05).After surgery,WBC in both groups was higher than that before surgery,and Hb in the control group was lower but Scr was higher when compared with those before surgery(P<0.05).The total incidence rate of postoperative adverse reactions in the study group was lower than that in the control group(P<0.05).Conclusion Compared with PCNL,postoperative recovery time is shorter and incidence of complications is lower of FURSL.The latter one can effectively improve the curative effect and postoperative safety for the patients.
作者
段成斌
王资斌
DUAN Cheng-bin;WANG Zi-bin(Department of Urology, Tibet Chengban Branch, West China Hospital, Sichuan University, Chengdu 610041, China)
出处
《实用医院临床杂志》
2022年第4期128-131,共4页
Practical Journal of Clinical Medicine
关键词
输尿管软镜钬激光碎石术
微创经皮肾镜碎石术
肾结石
安全性
效果
Flexible ureteroscopic holmium laser lithotripsy
Minimally invasive percutaneous nephrolithotripsy
Kidney stone
Safety
Effect
