[1]王世先** 杨水法 杨恩明 潘东山 黄旭锋 王俊龙 王飞 洪德时 杨乐乐 李康 林杰斌.输尿管软镜、超微经皮肾镜及微通道经皮肾镜取石术治疗2～3 cm肾下盏结石的疗效比较[J].中国微创外科杂志,2024,01(2):86-91.
　Wang Shixian,Yang Shuifa,Yang Enming,et al.Comparative Study of Flexible Ureteroscope, Supermini Percutaneous Nephrolithotomy, and Minimally Invasive Percutaneous Nephrolithotomy in the Treatment of Lower Calyceal Calculi[J].Chinese Journal of Minimally Invasive Surgery,2024,01(2):86-91.
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输尿管软镜、超微经皮肾镜及微通道经皮肾镜取石术治疗2～3 cm肾下盏结石的疗效比较()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
01
期数:
2024年2期
页码:
86-91
栏目:
临床论著
出版日期:
2024-02-25

文章信息/Info

Title:
Comparative Study of Flexible Ureteroscope, Supermini Percutaneous Nephrolithotomy, and Minimally Invasive Percutaneous Nephrolithotomy in the Treatment of Lower Calyceal Calculi
作者:
王世先** 杨水法 杨恩明 潘东山 黄旭锋 王俊龙 王飞 洪德时 杨乐乐 李康 林杰斌
(厦门医学院附属第二医院泌尿外科，厦门361021)
Author(s):
Wang Shixian;  Yang Shuifa;  Yang Enming;  et al.
Department of Urology, Affiliated Second Hospital of Xiamen Medical College, Xiamen 361021,China
关键词:
输尿管软镜; 超微经皮肾镜取石术; 微通道经皮肾镜取石术; 肾下盏结石
Keywords:
Flexible ureteroscope; Supermini percutaneous nephrolithotomy; Minimally invasive percutaneous nephrolithotomy; Lower calyceal calculi
文献标志码:
A
摘要:
目的比较输尿管软镜(flexible ureteroscope,FURS)碎石术、超微经皮肾镜取石术(supermini percutaneous nephrolithotomy，SMP)与微通道经皮肾镜取石术(minimally invasive percutaneous nephrolithotomy，MPCNL)治疗2～3 cm肾下盏结石的疗效。方法回顾性分析2017年1月~2022年9月我院209例2～3 cm肾下盏结石的临床资料，其中FURS组65例，采用奥林巴斯电子输尿管软镜碎石取石术；SMP组62例，采用SMP进行碎石取石；MPCNL组82例，采用MPCNL。比较3组一次性结石清除率(stonefree rate，SFR)、手术时间、术后即刻血红蛋白下降值、术后迟发性出血发生率、术后住院时间、术后发热、住院费用。结果3组手术时间、术后即刻血红蛋白下降值、术后住院时间、住院费用和一次性SFR差异均有显著性(P<0.05)。MPCNL组一次性SFR(89.0%，73/82)显著高于FURS组(72.3%，47/65)(P=0.009)；MPCNL组手术时间(38.8±7.6)min，明显短于FURS组(52.3±7.2)min与SMP组(47.5±7.8)min(P=0.000，0.001)。FURS组术后即刻血红蛋白下降(1.5±0.5)g/L，显著少于SMP组(5.0±1.6)g/L和MPCNL组(6.3±1.8)g/L(均P=0.000)；FURS组住院时间(2.2±0.5)d，明显短于SMP组(3.5±0.8)d与MPCNL组(5.3±1.4)d(均P=0000);FURS组住院费用(22 543.4±1600.4)元，明显少于SMP组(26 837.7±2003.9)元与MPCNL组(26 784.4±2086.9)元(均P=0.000)，SMP组与MPCNL组差异无显著性(P=0.869)。3组术后发热发生率无显著性差异(χ2=0.462,P=0.794)。结论FURS、SMP与MPCNL均是处理2～3 cm肾下盏结石的有效方法。FURS术中出血最少、住院时间最短、住院费用最少，但一次性SFR最低、手术时间最长。MPCNL手术时间最短，一次性SFR最高，但术中出血最多，住院时间最长。
Abstract:
ObjectiveTo compare the therapeutic effects of flexible ureteroscope (FURS), supermini percutaneous nephrolithotomy (SMP), and microstomy percutaneous nephrolithotomy (MPCNL) in the treatment of 2-3 cm lower calyceal calculi.MethodsClinical data of 209 patients with 2-3 cm lower calyceal calculi in our hospital from January 2017 to September 2022 were retrospectively analyzed. Among them, 65 patients were treated with Olympus electronic FURS (FURS group), 62 patients were treated with SMP for stone removal (SMP group), and 82 patients were treated with MPCNL (MPCNL group). The onesession stonefree rate (SFR), operation time, hemoglobin decrease at postoperation immediately,rate of postoperative delayed bleeding, postoperative hospital stay, postoperative fever, and hospitalization cost were compared between the three groups.ResultsThere were significant differences in operation time, postoperative hospital stay, hospitalization costs and onesession SFR among the three groups (P<0.05). The onesession SFR in the MPCNL group (89.0%, 73/82) was significantly higher than that in the FURS group (72.3%, 47/65; P=0.009). The operation time in the MPCNL group was (38.8±7.6) min, significantly shorter than that in the FURS group ［(52.3±7.2) min, P=0.000］ and the SMP group ［(47.5±7.8) min, P=0001］. The hemoglobin decrease at postoperation immediately in the FURS group was (1.5±0.5) g/L, significantly lower than that in the SMP group ［(5.0±1.6) g/L, P=0.000］ and MPCNL group ［(6.3±1.8) g/L, P=0.000］. The postoperative hospital stay in the FURS group was (2.2±0.5) d, significantly shorter than that in the SMP group ［(3.5±0.8) d, P=0.000］ and the MPCNL group ［(5.3±1.4) d, P=0.000］. The hospitalization cost of the FURS group was (22 543.4±1600.4) yuan, significantly lower than that of the SMP group ［(26 837.7±2003.9) yuan, P=0.000］ and the MPCNL group ［(26 784.4±2086.9) yuan, P=0.000］, but there was no significant difference between the SMP group and the MPCNL group (P=0.869). There was no significant difference in the incidence of postoperative fever among the three groups (χ2=0.462,P=0.784). ConclusionsFURS, SMP, and MPCNL are all effective methods for the treatment of 2-3 cm lower calyceal calculi. FURS has the least intraoperative bleeding, the shortest hospital stay, the lowest hospitalization cost, the lowest onesession stonefree rate, and the longest operation time. MPCNL has the shortest operation time, the highest onesession SFR, the most intraoperative bleeding, and the longest hospital stay.

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备注/Memo

备注/Memo:
基金项目：厦门市科技局科技惠民项目（3502Z20189064）**通讯作者，Email：qy_wangshixian@163.com
更新日期/Last Update: 2024-05-03