经皮肾镜取石术和逆行输尿管软镜碎石术处理2cm范围肾结石的临床比较

发布时间：2018-09-12 17:49

【摘要】：目的:比较经皮肾镜取石术(PCNL)和逆行输尿管软镜碎石术(RIRS)处理2cm范围肾结石的疗效。方法:回顾性分析2015年10月至2016年11月广西医科大学第一附属医院泌尿外科收治的96例2cm范围肾结石患者的临床资料,按术式将其分为PCNL组42例和RIRS组54例。比较分析两组手术时间、碎石时间、术后住院时间、住院费用、术后清石率、并发症发生率。结果:42例PCNL患者中,36例患者结石一次碎石完成,3例患者分2次碎石完成,3例患者残留结石。54例RIRS患者中,48例患者结石一次碎石完成,6例患者残留结石。PCNL组和RIRS组术后1周结石清除率分别为78.57%(33/42)和57.41%(31/54),术后1个月结石清除率分别为92.86%(39/42)和88.89%(48/54)。平均手术时间PCNL组(69.55±15.16)min,RIRS组(54.48±12.89)min。平均碎石时间PCNL组(32.36±13.04)min,RIRS组(39.48±12.67)min。术后住院时间PCNL组5(4)d,RIRS组1(1)d。平均住院费用PCNL组(19194.50±3809.24)元,RIRS组(13318.97±1537.15)元。并发症发生率PCNL组23.81%(10/42),RIRS组3.70%(2/54)。结论:对于处理2cm范围内的肾结石,PCNL和RIRS均是安全而有效的措施,但RIRS的手术时间、术后住院天数、并发症发生率及住院费用均明显少于PCNL,而其碎石时间却长于PCNL,术后清石率则与PCNL基本相当。
[Abstract]:Objective: to compare the effect of percutaneous nephrolithotomy (PCNL) and retrograde ureteral soft lithotripsy (RIRS) in the treatment of renal calculi in 2cm range. Methods: the clinical data of 96 patients with 2cm renal calculi treated in Urology Department of the first affiliated Hospital of Guangxi Medical University from October 2015 to November 2016 were retrospectively analyzed. The patients were divided into two groups: PCNL group (n = 42) and RIRS group (n = 54). The operative time, lithotripsy time, postoperative hospitalization time, hospitalization cost, postoperative lithotomy rate and complication rate were compared between the two groups. Results among 42 PCNL patients, 36 patients were treated with lithotripsy in one time. 3 patients were divided into 2 lithotripsy cases and 3 patients were treated with residual stones. 48 out of 54 patients with RIRS were treated with lithotripsy at one time. 6 patients with residual stones. PCNL group and RIRS group. The stone clearance rates were 78.57% (33 / 42) and 57.41% (31 / 54) at 1 week postoperatively, and 92.86% (39 / 42) and 88.89% (48 / 54) at 1 month postoperatively. Mean operative time in PCNL group (69.55 卤15.16) min,RIRS group (54.48 卤12.89) min. Mean lithotripsy time in PCNL group (32.36 卤13.04) min,RIRS group (39.48 卤12.67) min. Postoperative hospitalization time was 1 (1) d in PCNL group (5 (4) d) and RIRS group (1 (1) d). The average hospitalization cost was (19194.50 卤3809.24) yuan in PCNL group and (13318.97 卤1537.15) yuan in Rirs group. The incidence of complications was 23.81% (10 / 42) in PCNL group and 3.70% (2 / 54) in RIRS group. Conclusion: both PCNL and RIRS are safe and effective measures for the treatment of renal calculi within the scope of 2cm, but the operation time of RIRS and the days of hospitalization after RIRS are safe and effective. The incidence of complications and hospitalization cost were significantly less than that of PCNL, but the lithotripsy time was much longer than that of PCNL,. The rate of stone removal was similar to that of PCNL.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R699.4

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