Abstract:Objective: To make a comprehensive analysis on the clinical efficacy and safety of percutaneous nephrolithotomy (PCNL) vs. flexible ureteroscopy (FURL) in the treatment of kidney stones. Methods: Fifty-four cases of kidney stone were randomly selected from our hospital during the period from January 2015 to June 2017 and divided into PCNL group and FURL group according to the clinical protocol and treated with PCNL and FURL surgeries respectively. Stone clearance rate and surgical complications were compared between the two groups. Results: The stone clearance rate and time in the PCNL group were 96.30% and (4.5±0.2) weeks, and those in the FURL group were 100% and (6.1±1.5) weeks, respectively. Hemorrhage (3 cases), moderate fever after surgery (2 cases) and high fever with septic shock symptoms (1 case) occurred in the PCNL group, and no hemorrhage and ureteral perforation and four cases of fever occurred in the FURL group. There was significant difference in operative time, hemoglobin loss, blood loss and length of hospital stay (P<0.05) between the two groups. Conclusions: Long-term clinical researches have demonstrated that there is no significant difference in the stone clearance rate between PCNL and FURL surgeries. However, in terms of observation indexes in surgery, complications after surgery and length of hospital stay, FURL has obvious advantages.
周泽光, 刘成倍. 经皮肾镜与经输尿管软镜取石术在肾结石治疗中的的疗效及安全性分析[J]. 微创泌尿外科杂志, 2017, 6(6): 343-347.
Zhou Zeguang, Liu Chengbei. Analysis on the efficacy and safety of Percutaneous Nephrolithotomy versus Flexible Ureteroscopy in the treatment of kidney stones. JOURNAL OF MINIMALLY INVASIVE UROLOGY, 2017, 6(6): 343-347.
[1] 那彦群,叶章群,孙光,等.中国泌尿外科疾病诊断治疗指南.北京:人民卫生出版社,2011:242-252. [2] 吴波.经皮肾穿刺取石术治疗肾和上段输尿管结石的临床观察.湖南中医药大学学报,2010,30(8):35-36. [3] 肖克兵,刘晓龙,臧亚晨,等.经皮肾镜碎石取石术与输尿管软镜钬激光碎石术治疗肾结石的临床观察.江苏医药,2013,39(11):1336-1337. [4] 杨增悦,付强,保庭毅,等.多通道微创经皮肾镜结合钬激光治疗复杂性肾结石的临床研究.中华腔镜泌尿外科杂志(电子版),2010,4(1):30-32. [5] 李学德,于永纲,武英杰,等.经皮肾穿刺取石术中影响肾结石一次清除率的原因.临床泌尿外科杂志,2008,23(1):33-37. [6] Geavlete P, Multescu R, Geavlete B. Influence of pyelocaliceal anatomy on the success of flexible ureteroscopic approach. J Endourol, 2008,22(10):2235-2239. [7] Perlmutter AE, Talug C, Tarry WF, et al. Impact of stone location on success rates of endoscopic lithotripsy for nephrolithiasis. Urology, 2008,71(2):214-217. [8] Rastinehad AR, Andonian S, Smith AD, et al. Management of hemorrhagic complications associated with percutaneous nephrolithotomy. J Endourol, 2009,23(10):1763-1767. [9] 程跃,刘冠琳.输尿管软镜治疗上尿路结石的现状与展望.现代实用医学,2012,24(6):603-606. [10] 施小东,程跃,邱中笑,等.电子输尿管软镜碎石术治疗肾结石疗效观察.现代实用医学,2010,22(9):1018-1019. [11] Rehman J, Monga M, Landman J, et al. Characterization of intrapelvic pressure during ureteropyeloscopy with ureteral access sheaths. Urology, 2003,61(4):713-718.