摘要
Abstract
Objective To explore an appropriate treatment method for renal calculi comparing percutaneous nephrolithotomy and flexible ureteroscope holmium laser lithotripsy for 1-2 cm renal calculi.Methods 47 patients with unilateral renal calculi admitted into Changzhi People's Hospital from Match,2014 to Match,2015 were chosen.The diameter of the stones ranged from 1 to 2 cm.The patients were randomly divided into a percutaneous nephrolithotomy group (n=24) and a flexible ureteroscope holmium laser lithotripsy group (n=23).The patient's age,sex,number of calculi,calculi size,operation time,calculi-free rate after surgery,bleeding volume,incidence of postoperative fever,postoperative pain,length of hospital stay,and surgical expenses were compared between these two groups.Results There were no statistical differences in age,gender,number of calculi,and calculi size between theses two groups (P ＞0.05).The operation time was(57.9±13.4) min in the percutaneous nephrolithotomy group and was (54.3±12.9) min in the flexible ureteroscope holmium laser lithotripsy group,with no statistical difference(P ＜0.05).2 cases were not calculi-free in the percutaneous nephrolithotomy group,with a clearance rate of 91.7％,and 3 in the flexible ureteroscope holmium laser lithotripsy group,with a clearance rate of 86.9％,with no statistical difference(P ＞0.05).The bleeding volume was (76.1±17.2) ml in the percutaneous nephrolithotomy group and was (44.6±15.3) ml in the flexible ureteroscope holmium laser lithotripsy group,with a statistical difference (P ＜0.05).The incidence of postoperative fever was 16.7％(4/24) in the percutaneous nephrolithotomy group and was 13.0％(3/23) in the flexible ureteroscope holmium laser lithotripsy group,with no statistical difference(P ＞0.05).5 got postoperative pain in the percutaneous nephrolithotomy group and none in the flexible ureteroscope holmium laser lithotripsy group,with a statistical difference(P ＜0.05).The length of hospital stay was (8.4±1.6) days in the percutaneous nephrolithotomy group and was (5.2±1.5) days in the flexible ureteroscope holmium laser lithotripsy group,with a statistical difference(P ＞0.05).The surgery cost was (11±1) thousand yuan in the percutaneous nephrolithotomy group and was (15±2) in the flexible ureteroscope holmium laser lithotripsy group,with a statistical difference(P ＜0.05).Conclusions The bleeding volume is smaller,the length of hospital stay shorter,and the incidences of postoperative pain and complications lower in percutaneous nephrolithotomy than in flexible ureteroscope holmium laser lithotripsy.There are no statistical differences in calculi-free rate and operation time between these two operations.Flexible ureteroscope holmium laser lithotripsy is the first choice for 1-2 cm renal calculi.关键词
经皮肾镜/输尿管软镜/肾结石/钬激光Key words
Percutaneous nephrolithotripsy/Flexible ureteroscope/Renal calculi/Holmium laser
