输尿管软镜钬激光与经皮肾镜治疗肾下盏结石的对比

邹森凤

[摘要] 目的 探讨输尿管软镜钬激光与经皮肾镜治疗肾下盏结石的疗效差异。方法 随机收集2013年2月—2017年6月该院收治的肾下盏结石100例患者，按随机数字表法分为50例研究组（接受输尿管软镜钬激光手术）和50例对照组（接受经皮肾镜手术）。对比两组结石取净率，两组术后并发症发生率；两组手术相关指标。结果 研究组和对照组结石取净率分别为96%、90%，比较差异有统计学意义（P<0.05）；研究组和对照组术后并发症发生率分别为6%、20%，比较差异有统计学意义（P<0.05）；研究组和对照组手术相关指标（手术时间、出血量）分别为[（54.26±8.52）min、（33.65±12.65）mL、（55.02±9.35）min、（76.98±38.52）mL，比较差异有统计学意义（P<0.05）。结论 经尿道输尿管软镜下钬激光碎石术具有成功率高、创伤小、恢复快、并发症更少等优点，接近无创。

[关键词] 输尿管；软镜；钬激光；经皮肾镜；肾下盏

[中图分类号] R691.4 [文献标识码] A [文章编号] 1674-0742（2018）04（c）-0025-03

Comparison of Ureteroscopic Holmium Laser and Percutaneous Nephroscope in Treatment of Lower Calyceal Calculi

ZOU Sen-feng

Department of Emergency， Haicang Hospital， Xiamen， Fujian Province， 361026 China

[Abstract] Objective To study the difference in the curative effect of ureteroscopic holmium laser and percutaneous nephroscope in treatment of lower calyceal calculi. Methods 100 cases of patients with lower calyceal calculi admitted and treated in our hospital from February 2013 to June 2017 were randomly selected and randomly divided into two groups with 50 cases in each， the research group and the control group were respectively treated with ureteroscopic holmium laser and percutaneous nephroscope， and the stone clearance rate， incidence rate of complications and operation related indicators were compared between the two groups. Results The stone clearance rates in the research group and in the control group were respectively 96%， 90%， and the difference was statictically significant（P<0.05）， and the incidence rate of complications after surgery in the research group and in the control group was respectively 6%， 20%， and the difference was statictically significant（P<0.05）， and the operation related indicators such as operation time， and bleeding amount in the research group and in the control group were respectively [（54.26±8.52）min，（33.65±12.65）mL，（55.02±9.35）min，（76.98±38.52）mL]， and the difference was statictically significant（P<0.05）. Conclusion The success rate of ureteroscopic holmium laser is high with small wound， rapid recovery and few complications， and it is similar to non-invasion.

[Key words] Ureteroscopic； Soft len； Holmium laser； Percutaneous nephroscope； Inferior renal calyx

輸尿管软镜碎石术最早在1964年被国外学者进行报道，近年来随着腔镜制作技术的提高，工作通道、成像系统技术得到质的飞跃，德国钼立公司制造的输尿管软镜具有视野范围大、图像清、无网格等优势，在临床结石的清除中，具有有效、肾结石清除率高的优势。针对上述两种技术手段为临床中广泛运用的治疗方法，该文随机收集2013年2月—2017年6月该院肾下盏结石患者，分析输尿管软镜钬激光与经皮肾镜的治疗差异，现报道如下。

1 资料与方法

1.1 一般资料

随机收集该院肾下盏结石患者100例，按随机数字表法分为研究组（接受输尿管软镜钬激光手术）和对照组（接受经皮肾镜手术）。研究组男28例，女22例，平均年龄（43.65±8.52）岁。对照组男30例，女20例，平均年龄（43.95±10.44）岁。两组性别和年龄比较差异无统计学意义（P>0.05）。

1.2 入选标准

①B超、尿路平片确诊为肾下盏结石，接受2.0～2.5 cm。②重要脏器功能基本正常。③耐受麻醉和手术。④研究取得医院伦理委员会批准，患者知情同意。……