摘要
目的:探究在2~3 cm肾下盏结石患者治疗过程中,超微经皮肾镜碎石术与输尿管软镜联合的效果。方法:选择2022年2月—2025年2月于驻马店市中心医院就诊的肾下盏结石患者(102例),按照随机数字表法分为联合组(51例)与软镜组(51例),软镜组采用输尿管软镜碎石术进行治疗,联合组在输尿管软镜碎石术治疗基础上联合超微经皮肾镜碎石术治疗。比较联合组与软镜组的手术指标、结石清除情况、肾功能指标、术后不良反应。结果:联合组手术时间显著低于软镜组[(67.57±11.09)min vs(108.92±14.65)min],联合组住院时间显著高于软镜组[(12.51±1.37)d vs(9.73±1.15)d],联合组结石清除率显著高于软镜组[90.20%(46/51)vs 70.59%(36/51)],均差异有统计学意义(P<0.05)。术后联合组血肌酐[(55.26±6.22)μmol/L vs(51.65±6.07)μmol/L]、β_(2)-微球蛋白[(3.11±0.51)ng/mL vs(2.56±0.44)ng/mL]显著高于软镜组,差异有统计学意义(P<0.05)。联合组术后不良反应发生率为9.80%(5/51),软镜组为3.92%(2/51),2组比较差异无统计学意义(P>0.05)。结论:超微经皮肾镜碎石术联合输尿管软镜治疗2~3 cm肾下盏结石手术时间缩短,结石清除率升高,然而住院时间延长,且会对肾功能造成一定损伤。
Objective To investigate the efficacy of super-mini percutaneous nephrolithotomy combined with flexible ureteroscopy in the management of patients with 2-3 cm lower calyx calculi.Methods A total of 102 patients with lower calyceal calculus who visited Zhumadian Central Hospital from February 2022 to February 2025 were selected and randomly divided into the combined group(51 cases)and the flexible ureteroscopy group(51 cases)by random number table method.The flexible ureteroscopy group was treated with flexible ureteroscopy,while the combined group was treated with flexible ureteroscopy combined with super-mini percutaneous nephrolithotomy.The surgical indicators,stone clearance rate,renal function indicators,and postoperative adverse reactions were compared between the combined group and the flexible ureteroscopy group.Results The operation time of the combined group was significantly shorter than that of the flexible ureteroscopy group([67.57±11.09]min vs[108.92±14.65]min),while the hospital stay of the combined group was significantly longer than that of the flexible ureteroscopy group([12.51±1.37]d vs[9.73±1.15]d)(both P<0.05).The stone clearance rate of the combined group was significantly higher than that of the flexible ureteroscopy group(90.20%[46/51]vs 70.59%[36/51])(P<0.05).Postoperatively,the serum creatinine([55.26±6.22]μmol/L vs[51.65±6.07]μmol/L)and β_(2)-microglobulin([3.11±0.51]ng/mL vs[2.56±0.44]ng/mL)of the combined group were significantly higher than those of the flexible ureteroscopy group(P<0.05).There was no statistically significant difference in the incidence of postoperative adverse reactions between the combined group(9.80%,5/51)and the flexible ureteroscopy group(3.92%,2/51)(P>0.05).Conclusion The combined treatment of super-mini percutaneous nephrolithotomy and flexible ureteroscopy for 2-3 cm lower calyceal calculus can shorten the operation time and increase the stone clearance rate,but it prolongs the hospital stay and causes certain damage to renal function.
作者
李军
朱海松
郭晓翔
LI Jun;ZHU Haisong;GUO Xiaoxiang(Department of Urology,Zhumadian Central Hospital,Zhumadian,Henan,463000,China)
出处
《临床泌尿外科杂志》
2026年第2期109-113,共5页
Journal of Clinical Urology
关键词
肾下盏结石
超微经皮肾镜碎石术
输尿管软镜
lower calyx calculi
super-mini percutaneous nephrolithotomy
flexible ureteroscopy
