逆行输尿管软镜与经皮肾镜治疗鹿角形肾结石：单中心随机对照研究
发布时间：2019-06-19 04:19
【摘要】：目的：比较逆行输尿管软镜下钬激光碎石(flexible ureteroscopy, FURS)和经皮肾镜钬激光碎石(percutaneous nephrolithotomy, PCNL)治疗鹿角形肾结石的有效性和安全性。 方法：2011年9月至2014年3月邵逸夫医院收治的鹿角形结石患者60例纳入研究,随机分为FURS组、PCNL组各30例。比较两组患者手术时间、术中出血量、输血百分比、术后血红蛋白下降量、术后CRP上升量、术后住院天数、总住院费用、清石率和并发症等。 结果：两组患者年龄、性别、肾积水情况、结石最长径、S.T.O.N.E. Nephrolithometry系统评分等比较差异无统计学意义(P0.05)。FURS组和PCNL组手术时间分别为(102.9±40.2)min和(136.9±46.6)mmin；术中出血量分别为(20.5±20.0)ml和(102.4±249.8)ml；术后住院日分别为(2.6±1.2)d和(5.3±1.8)d；总住院费用分别为(24.5±6.8)千元和(28.6±5.4)千元；血红蛋白分别下降(0.89±0.69)g/L和(1.48±0.98)g/L；差异均有统计学意义(P0.05)。FURS组和PCNL组CRP分别上升(2.59±1.16)mg/L和(5.55±6.81)mg/L,差异无统计学意义(P0.05)。FURS组和PCNL组术中输血百分比分别为0%和3.33%(1/30)。并发症(Clavien分级Ⅱ级)发生率分别为6.67%(2/30)和10%(3/30),差异无统计学意义(P0.05)。其中软镜1例术后感染发热,1例后腹膜炎症；经皮肾镜1例术后出血需输血,1例胸腔积液发热,1例肾周血肿；总清石率(残石≤4mm)分别为86.7%(26/30)和90%(27/30),差异无统计学意义(P0.05),其中FURS组8例术后行ESWL辅助碎石治疗,PCNL组1例术后行ESWL辅助治疗。 结论：逆行输尿管软镜下钬激光碎石和经皮肾镜钬激光碎石治疗鹿角形肾结石都是可行的、安全的手术方式,但FURS具有手术时间短、术中出血少、术后恢复快、住院费用少等优势。
[Abstract]:Objective: to compare the efficacy and safety of retrograde endoscopic holmium laser lithotripsy (flexible ureteroscopy, FURS) and percutaneous holmium laser lithotripsy (percutaneous nephrolithotomy, PCNL) in the treatment of staghorn renal calculi. Methods: from September 2011 to March 2014, 60 patients with staghorn stones were randomly divided into FURS group (n = 30) and PCNL group (n = 30). The operation time, intraoperative blood loss, blood transfusion percentage, postoperative hemoglobin decrease, postoperative CRP rise, postoperative hospitalization days, total hospitalization expenses, stone clearance rate and complications were compared between the two groups. Results: there were no significant differences in age, sex, hydronephrosis, longest diameter of stones and Nephrolithometry system score between the two groups (P 0.05). The operation time of). FURS group and PCNL group were (102.9 卤40.2) min and (136.9 卤46.6) mmin;, respectively. The intraoperative bleeding volume was (20.5 卤20.0) ml and (102.4 卤249.8) ml;, respectively. The postoperative hospitalization days were (2.6 卤1.2) days and (5.3 卤1.8) days, the total hospitalization expenses were (24.5 卤6.8) km and (28.6 卤5.4) km, the hemoglobin decreased by (0.89 卤0.69) g / L and (1.48 卤0.98) g / L, respectively. There was no significant difference in CRP between). FURS group and PCNL group (P 0.05) CRP increased by (2.59 卤1.16) mg/L and (5.55 卤6.81) mg/L, respectively (P < 0.05). The percentage of intraoperative blood transfusion in). FURS group and PCNL group was 0% and 3.33% (1 鈮，
本文编号：2502084
[Abstract]:Objective: to compare the efficacy and safety of retrograde endoscopic holmium laser lithotripsy (flexible ureteroscopy, FURS) and percutaneous holmium laser lithotripsy (percutaneous nephrolithotomy, PCNL) in the treatment of staghorn renal calculi. Methods: from September 2011 to March 2014, 60 patients with staghorn stones were randomly divided into FURS group (n = 30) and PCNL group (n = 30). The operation time, intraoperative blood loss, blood transfusion percentage, postoperative hemoglobin decrease, postoperative CRP rise, postoperative hospitalization days, total hospitalization expenses, stone clearance rate and complications were compared between the two groups. Results: there were no significant differences in age, sex, hydronephrosis, longest diameter of stones and Nephrolithometry system score between the two groups (P 0.05). The operation time of). FURS group and PCNL group were (102.9 卤40.2) min and (136.9 卤46.6) mmin;, respectively. The intraoperative bleeding volume was (20.5 卤20.0) ml and (102.4 卤249.8) ml;, respectively. The postoperative hospitalization days were (2.6 卤1.2) days and (5.3 卤1.8) days, the total hospitalization expenses were (24.5 卤6.8) km and (28.6 卤5.4) km, the hemoglobin decreased by (0.89 卤0.69) g / L and (1.48 卤0.98) g / L, respectively. There was no significant difference in CRP between). FURS group and PCNL group (P 0.05) CRP increased by (2.59 卤1.16) mg/L and (5.55 卤6.81) mg/L, respectively (P < 0.05). The percentage of intraoperative blood transfusion in). FURS group and PCNL group was 0% and 3.33% (1 鈮，
本文编号：2502084
本文链接：https://www.wllwen.com/yixuelunwen/mjlw/2502084.html
最近更新
教材专著
