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目的:比较输尿管软镜钬激光与经皮肾镜超声气压弹道联合治疗肾结石的疗效和安全性。方法:回顾分析2012年3月~2014年3月手术治疗89例肾结石患者临床资料,其中37例采用组合式输尿管软镜钬激光碎石术治疗(URL组),52例采用经皮肾镜超声联合气压弹道碎石术治疗(PCNL组),比较两组的结石取净率和手术并发症。结果:URL组血红蛋白损失量为0~6g/L,平均(2.0±2.0)g/L;结石取净率为81.1%(30/37);术后4例出现轻度贫血、3例出现发热,并发症发生率为18.9%(7/37)。PCNL组血红蛋白损失量为4~36g/L,平均(13.6±7.4)g/L;结石取净率为86.5%(45/52);术后21例出现轻度贫血、3例出现中度贫血,术后4例出现发热,并发症发生率为53.8%(28/52)。结论:PCNL和URL都属于治疗肾结石的微创手术方法,疗效相同。但URL与PCNL相比,具有损伤更小、出血更少、并发症更少等优点,特别在治疗肾结石合并脊柱侧弯等复杂性肾结石时具有独特的优势。
Objective: To compare the efficacy and safety of ureteroscopic ureteroscopic holmium laser and percutaneous nephroscope in the treatment of renal calculus. Methods: The clinical data of 89 patients with nephrolithotomy surgically treated from March 2012 to March 2014 were retrospectively analyzed. Among them, 37 cases were treated with combined ureteroscopic holmium laser lithotripsy (URL group), and 52 cases were treated with percutaneous nephrolithotomy Ultrasound combined with pneumatic lithotripsy (PCNL group), comparing the two groups of stone removal rate and surgical complications. Results: The hemoglobin loss in the URL group was 0 ~ 6g / L, with an average of (2.0 ± 2.0) g / L; the stone removal rate was 81.1% (30/37); mild anemia occurred in 4 patients and fever in 3 patients The complication rate was 18.9% (7/37). In the PCNL group, the hemoglobin loss was 4 ~ 36g / L, with an average of (13.6 ± 7.4) g / L; the stone removal rate was 86.5% (45/52); mild anemia occurred in 21 patients and moderate anemia occurred in 3 patients , 4 cases had fever after operation, the complication rate was 53.8% (28/52). Conclusion: PCNL and URL belong to the minimally invasive surgical treatment of kidney stones, the same effect. However, compared with PCNL, URL has the advantages of less damage, less bleeding and fewer complications, especially in the treatment of complicated kidney stones combined with scoliosis.