[1]母健君.16F微通道输尿管镜经皮肾钬激光治疗肾结石与输尿管软镜治疗肾结石的比较[J].中国医学物理学杂志,2019,36(12):1481-1485.[doi:DOI:10.3969/j.issn.1005-202X.2019.12.023]
　MU Jianjun.Comparison of 16F mini-tract percutaneous nephrolithotomy with holmium laser versus flexible ureteroscopy in the treatment of kidney stones[J].Chinese Journal of Medical Physics,2019,36(12):1481-1485.[doi:DOI:10.3969/j.issn.1005-202X.2019.12.023]
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16F微通道输尿管镜经皮肾钬激光治疗肾结石与输尿管软镜治疗肾结石的比较()
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《中国医学物理学杂志》[ISSN:1005-202X/CN:44-1351/R]

卷:
36卷
期数:
2019年第12期
页码:
1481-1485
栏目:
其他（激光医学等）
出版日期:
2019-12-25

文章信息/Info

Title:
Comparison of 16F mini-tract percutaneous nephrolithotomy with holmium laser versus flexible ureteroscopy in the treatment of kidney stones
文章编号:
1005-202X（2019）12-1481-05
作者:
母健君
攀枝花市中心医院， 四川 攀枝花 617067
Author(s):
MU Jianjun
Panzhihua Central Hospital, Panzhihua 617067, China
关键词:
肾结石; 16F微通道; 皮肾镜; 钬激光; 输尿管软镜
Keywords:
Keywords: kidney stone;  16F mini-tract;  percutaneous nephroscope;  holmium laser;  flexible ureteroscope
分类号:
R692.4
DOI:
DOI:10.3969/j.issn.1005-202X.2019.12.023
文献标志码:
A
摘要:
【摘要】目的：分析16F微通道输尿管镜经皮肾钬激光治疗肾结石与输尿管软镜治疗肾结石的临床效果。方法：选择90例肾结石（<2 cm）患者作为研究对象，根据随机数表法将所选患者分为观察组和对照组，每组45例。对照组患者采用16 F微通道输尿管镜经皮肾钬激光治疗，观察组患者采用输尿管软镜治疗。观察两组患者术中出血量、手术时间、血红蛋白下降、住院时间、住院费用、结石清除率、血尿素氮（BUN）、血清肌酐（Cr）水平以及并发症发生情况。结果：观察组患者术中出血量、血红蛋白下降、住院时间及住院费用［（6.19±1.37） mL、（2.37±1.92） g/L、（4.26±1.04） d、（3 325.48±413.51）元］均明显少于对照组［（24.38±6.52） mL、（7.76±5.83） g/L、（7.15±2.17） d、（4 226.15±546.82）元）］，差异有统计学意义（P<0.05）；两组患者在手术时间上的比较差异无统计学意义（P>0.05）；观察组患者术后即刻清石率（95.56%）比对照组（82.22%）更高，对比的差异有统计学意义（P<0.05）；两组患者术后1月清石率比较差异不明显，无统计学意义（P>0.05）；术后，观察组患者BUN和Cr水平［（19.86±0.19） mmol/L、（315.08±10.84） μmol/L］高于对照组［（15.44±0.32） mmol/L、（267.29±19.25） μmol/L］，对比的差异有统计学意义（P<0.05）；观察组患者术后并发症的发病率（8.89%）显著高于对照组（28.89%），比较的差异有统计学意义（P<0.05）。结论：与16F微通道输尿管镜经皮肾钬激光治疗相比，输尿管软镜治疗结石直径<2 cm的肾结石患者具有术中出血量少、创伤小、恢复快、并发症少的优点，建议在临床进一步推广应用。
Abstract:
Abstract: Objective To analyze the therapeutic effects of 16F mini-tract percutaneous nephrolithotomy with holmium laser versus flexible ureteroscopy for the treatment of kidney stones. Methods A total of 90 patients with kidney stones (<2 cm) were selected as subjects, and randomly divided into observation group and control group, with 45 patients in each group. The patients in control group were treated with 16F mini-tract percutaneous nephrolithotomy with holmium laser, while those in observation group were treated with flexible ureteroscopy. The amount of bleeding, operation time, hemoglobin decline, hospitalization time, hospitalization cost, stone-free rate, blood urea nitrogen (BUN) level, serum creatinine (Cr) level and complications in two groups were observed. Results The intraoperative blood loss, hemoglobin decline, hospitalization time and hospitalization cost in observation group were (6.19±1.37) mL, (2.37±1.92) g/L, (4.26±1.04) d and (3 325.48±413.51) yuan, which were significantly lower than (24.38±6.52) mL, (7.76±5.83) g/L, (7.15±2.17) d and (4 226.15±546.82) yuan in control group, with significant differences (P<0.05). There was no significant difference between two groups in operation time (P>0.05). Observation group had a higher immediately postoperative stone-free rate than control group, with statistical significance (95.56% vs 82.22%; P<0.05), while the stone-free rate at 1 month postoperatively were similar in two groups (P>0.05). After surgery, the levels of BUN and Cr in observation group were higher than those in control group, with statistical differences ［(19.86±0.19) mmol/L vs (15.44±0.32) mmol/L, (315.08±10.84) μmol/L vs (267.29±19.25) μmol/L; P<0.05］. Moreover, the incidence of postoperative complications was significantly higher in control group (28.89%) than in observation group (8.89%), and the difference was statistically significant (P<0.05). Conclusion Compared with 16F mini-tract percutaneous nephrolithotomy with holmium laser, flexible ureteroscopy for the treatment of kidney stones with a diameter of <2 cm has the advantages of less intraoperative blood loss, less trauma, quick recovery and fewer complications, and therefore flexible ureteroscopy should be further promoted in clinic.

相似文献/References:

[1]刘海龙,解婷,黄培楷,等.术前CT平扫观察结石成分与经皮肾镜碎石术清石效果的关系[J].中国医学物理学杂志,2018,35(10):1155.[doi:DOI:10.3969/j.issn.1005-202X.2018.10.008]
　LIU Hailong,XIE Ting,HUANG Peikai,et al. Relationship between stone composition detected by preoperative CT plain scan and the therapeutic effect of percutaneous nephrolithotomy[J].Chinese Journal of Medical Physics,2018,35(12):1155.[doi:DOI:10.3969/j.issn.1005-202X.2018.10.008]

备注/Memo

备注/Memo:
【收稿日期】2019-07-16 【作者简介】母健君，副主任医师，研究方向：泌尿系统结石及肿瘤微创治疗，E-mail: tjyklj@163.com
更新日期/Last Update: 2019-12-26