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目的:比较软性输尿管镜钬激光碎石术与经皮肾镜钬激光碎石术治疗直径≥2cm肾结石的安全性及临床效果。方法:回顾性分析2012年3月~2015年3月收治的60例肾结石患者临床资料,其中30例行软性输尿管镜钬激光碎石术,30例行经皮肾镜钬激光碎石术。比较分析两组手术时间、清石率、住院时间、并发症发生率。组间比较采用t检验,P<0.05时差异有统计学意义。结果:软性输尿管镜组和经皮肾镜组结石大小分别为(2.0±0.5)cm和(2.1±0.4)cm(P>0.05),手术时间分别为(58.4±7.7)min和(39.4±7.5)min,术后住院天数分别为(7.3±1.6)d和(14.6±1.5)d,并发症发生率分别为10%和6.7%。结论:与经皮肾镜碎石术相比软性输尿管镜碎石术处理≥2cm肾结石创伤小,并发症发生率低。软性输尿管镜碎石术是经皮肾镜碎石术可选的替代方案。
OBJECTIVE: To compare the safety and clinical efficacy of soft ureteroscopic holmium laser lithotripsy and percutaneous nephroscope holmium laser lithotripsy in the treatment of renal calculi with a diameter of more than 2 cm. Methods: The clinical data of 60 patients with nephrolithiasis who were treated from March 2012 to March 2015 were retrospectively analyzed. Among them, 30 patients underwent ureteroscopic holmium laser lithotripsy and 30 patients underwent percutaneous nephrolithotomy with holmium laser lithotripsy . Comparative analysis of two groups of operation time, clear stone rate, hospital stay, complication rate. Comparison between groups using t test, P <0.05 difference was statistically significant. Results: The size of stones in soft ureteroscope and percutaneous nephrolithotomy group were (2.0 ± 0.5) cm and (2.1 ± 0.4) cm respectively (P> 0.05), and the operative time was (58.4 ± 7.7) min and (39.4 ± 7.5) min, and postoperative hospital days were (7.3 ± 1.6) days and (14.6 ± 1.5) days respectively. The incidence of complications was 10% and 6.7% respectively. Conclusion: Compared with percutaneous nephrolithotomy, soft ureteroscopic lithotripsy has the advantages of less trauma of kidney stones more than 2 cm and low complication rate. Soft ureteroscopic lithotripsy is an alternative to percutaneous nephrolithotomy.