| 曲树新,刘 洋,姜 舟,刘 鹤,徐万海.输尿管软镜与超微通道经皮肾镜碎石术治疗直径<2cm肾结石的对照分析研究[J].,2021,(7):1310-1314 |
| 输尿管软镜与超微通道经皮肾镜碎石术治疗直径<2cm肾结石的对照分析研究 |
| A Comparative Study of Treatment on Kidney Stone with a Diameter of Less Than 2cm Through Flexible Ureteroscope and Ultra Mini Percutaneous Nephrolithotripsy |
| 投稿时间：2020-06-19 修订日期：2020-07-25 |
| DOI：10.13241/j.cnki.pmb.2021.07.024 |
| 中文关键词: 输尿管软镜碎石术 微通道经皮肾镜碎石术 直径<2 cm肾结石 |
| 英文关键词: FURS UMP Kidney stone with a diameter of less than 2cm |
| 基金项目:黑龙江省财政资助科研基金项目（GA19C001） |
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| 中文摘要: |
| 摘要 目的：对比分析输尿管软镜碎石术与超微通道经皮肾镜碎石术治疗直径<2 cm的肾结石的临床应用效果。方法：选取2017年7月～2019年11月间直径<2 cm肾结石患者200例作为研究对象，随机选择其中的100例患者采用输尿管软镜钬激光碎石术进行治疗(FURS组)，另外的100例患者采用超微通道经皮肾镜钬激光碎石术进行治疗(UMP组)，比较观察两组患者的手术相关指标，其中包括手术时间、术中出血量、清石率，以及患者术后下床活动时间、术后住院天数等指标的差异，同时记录两组患者术后并发症的情况。结果：两组手术均成功完成，未出现严重出血及邻近器官损伤等并发症，在清石率方面，两组均有较高水平，无统计学差异（98% vs 97%，P＞0.05）；在手术并发症发生率方面，差异无统计学意义 (7% vs 8%，P＞0.05)；术中血红蛋白下降水平FURS组少于UMP组（6.82±2.27 vs 16.75±4.92，P＜0.01）；FURS组较UMP组术后下床活动时间（7.53±2.24 vs 15.46±2.61，P＜0.01）以及住院天数（3.46±1.69 vs 6.15±1.27，P<0.01）更少，差异有统计学意义。结论：输尿管软镜钬激光碎石术与微通道经皮肾镜钬激光碎石术都可以成为直径<2 cm肾结石的有效治疗方法，但输尿管软镜钬激光碎石术的患者术中出血少，住院时间短，更为安全，疗效确切，更加具有微创优势，值得优先考虑。 |
| 英文摘要: |
| ABSTRACT Objective: To study the effect and safety based on a comparative analysis between flexible ureteroscope and ultra mini percutaneous nephrolithotomy to treat kidney stone with a diameter of less than 2cm. Methods: 200 patients suffering kidney stone with a diameter of less than 2cm were, 100 patients of which were treated by laser lithotripsy through flexible ureteroscope (FURS), and the other 100 patients of which were treated by laser lithotripsy through ultra mini percutaneous nephrolithotomy (UMP). The two groups of patients were observed and compared in terms of the time of operating, the blood loss, the time of getting out of bed after surgery, the stone clearance rate, the time of hospital stay, and the incidence of postoperative complications. Results: The two groups of patients have neither been punctured, nor have failed in placing the scope. The position of double J tube was normalized after 3-6 days of postoperative. There are no significant differences concerning the incidence rate of complications and stone clearance (P＞0.05); for blood loss in surgery, time of operative, time of getting out of bed after operative, the FURS group are all less than the UMP group, and the differences are of statistical significance (P＜0.01). There are 5 cases of complications for the FURS group, but the symptoms recover soon after suitable treatment. Transfer surgey is never needed. In comparison, there is no complications such as blood loss or serious inflammation needed deal with in the UMP group. Conclusion: Compared with UMP, FURS is safer with higher comfort and better effect. In clinical treatment of kidney stone with a diameter of less than 2 cm, FURS should be given priority. |
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