微创泌尿外科杂志

目的:比较输尿管软镜碎石术与经皮肾镜碎石术治疗肾结石的临床疗效及安全性。方法:选择2014年1月~2015年1月期间收治的肾结石患者110例,随机分为对照组和观察组,每组各55例。对照组给予经皮肾镜碎石术治疗,观察组给予输尿管软镜碎石术治疗。对两组患者的清石率、手术时间、术中出血量、术后住院时间、血清中性粒细胞明胶酶相关载脂蛋白(NGAL)水平及并发症发生率进行比较。结果:治疗后两组患者的清石率差异无统计学意义(P>0.05);观察组患者的手术时间、术中出血量及术后住院时间均明显少于对照组(P<0.05)。观察组患者术后24、48及72h的血清NGAL水平均明显低于对照组,差异有统计学意义(P<0.05);术后72h观察组患者的血清NGAL水平与术前相比较,差异无统计学意义(P>0.05)。术后观察组患者的肾绞痛、肾包膜下血肿及菌血症并发症发生率明显低于对照组,差异有统计学意义(P<0.05)。结论:对肾结石患者实施输尿管软镜碎石术,可明显缩短术后住院时间,减少手术时间、术中出血量和术后血清NGAL水平,降低术后并发症发生率,值得临床推广与应用。

Objective:To compare the clinical efficacy and security of flexible ureteroscope lithtripsy vs.percutaneous nephrolithotomy in the treatment of patients with renal calculus.Methods:Totally 110 cases of patients with renal calculus in our hospital from January 2014 to January 2015 were randomly divided into observation group and control group.Control group was given percutaneous nephrolithotomy,and observation group was subjected to flexible ureteroscope lithtripsy.The operation time,stone clearance rate,intraoperative bleeding,hospital stay,the level of serum neutrophil gelatinase-associated lipocalin(NGAL)and complications were compared two groups.Results:There was no significant difference between two groups in the stone clearance rate(P>0.05).The operation time,intraoperative bleeding and hospital stay in observation group were significantly reduced as compared with those in control group(P<0.05).The serum NGAL levels in observation group at 24 h,48hand 72 hafter treatment were significantly lower than those in control group(P<0.05).There was no significant difference before and 72 hafter treatment in observation group in the serum NGAL level(P>0.05).The incidence of renal colic,renal subcapsular hematoma and bacteremia in observation group after treatment was significantly lower than that in control group(P<0.05).Conclusions:Flexible ureteroscope lithtripsy for patients with renal calculus can effectively shorten the operation time and hospital stay,decrease intraoperative bleeding and the serum NGAL level,and reduce the incidence of complications.It is worthy of clinical application.