张义 卢中杰 杨东

【摘要】 目的：觀察经皮肾镜碎石取石术与输尿软管镜钬激光碎石术治疗肾结石的效果。方法：选取笔者所在医院2014年6月-2015年6月接诊的80例肾结石患者为样本人群，采用奇偶分组法将患者均分成研究组和参照组，每组40例，其中研究组行输尿软管镜钬激光碎石术，参照组则行经皮肾镜碎石取石术，对比观察两组不同术式的取石情况。结果：肾结石直径大于2 cm时，研究组除石率（92.30%）与参照组（90.00%）比较差异无统计学意义（P>0.05）；参照组手术时间明显少于研究组，差异有统计学意义（P<0.05）；研究组术中出血量、血红蛋白降低指数均明显低于参照组，差异均有统计学意义（P<0.05）。肾结石直径小于2 cm时，研究组除石率（77.78%）与参照组（96.67%）比较，差异有统计学意义（P<0.05）；参照组手术时间明显少于研究组，组间比较差异有统计学意义（P<0.05）；研究组术中出血量、血红蛋白降低指数均明显低于参照组，组间比较差异有统计学意义（P<0.05）。研究组并发症发生率为2.50%，参照组并发症发生率为10.00%，差异无统计学意义（P>0.05）。研究组平均住院时间（4.50±1.17）d，参照组平均住院时间（7.50±1.39）d，差异有统计学意义（P<0.05）。结论：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效果各具优势，临床治疗需依照病例具体情况选择合适的手术方式。

【关键词】 经皮肾镜碎石； 输尿管软镜钬激光碎石； 碎石取石术； 肾结石

doi：10.14033/j.cnki.cfmr.2018.7.009 文献标识码 B 文章编号 1674-6805（2018）07-0021-03

【Abstract】 Objective：To observe the effect of percutaneous nephrolithotomy and ureteroscopic holmium laser lithotripsy on renal calculi.Method：Eighty cases of renal calculi admitted to the authors hospital from June 2014 to June 2015 were selected as the sample population.The patients were divided into study group and reference group by parity group，each group with 40 cases.Reference group of patients were treated with ureteroscopic holmium laser lithotripsy，study group was treated with percutaneous nephrolithotomy.Result：When the diameter of kidney stones was greater than 2 cm，there was no statistically significant difference between the study group （92.30%） and the reference group （90.00%）（P>0.05）.The operation time of the reference group was significantly less than that of the study group，the difference was statistically significant（P<0.05）.The intraoperative blood loss and hemoglobin decrease index in the study group were significantly lower than those in the control group，the differences were statistically significant（P<0.05）.When the diameter of kidney stones was less than 2 cm， there was statistically significant difference between the study group （77.78%） and the reference group （96.67%）（P<0.05）.The operation time of the reference group was significantly less than that of the study group，the difference was statistically significant（P<0.05）.The intraoperative blood loss and hemoglobin decrease index in the study group were significantly lower than those in the control group，the differences were statistically significant（P<0.05）.The complication rate of the study group was 2.50%，and the control group was 10.00%， there was no statistically significant difference（P>0.05）.The average length of hospital stay in the study group was （4.50±1.17） d，the control group was （7.50±1.39）d，the difference was statistically significant（P<0.05）.Conclusion：Percutaneous nephrolithotomy and ureteroscopic holmium laser lithotripsy are both effective in the treatment of renal calculi.The clinical treatment should choose the appropriate surgical method according to the specific situation of the case.

【Key words】 Percutaneous nephrolithotomy； Ureteral softening holmium laser lithotripsy； Lithotripsy； Kidney stones

First-authors address：Hanchuan Peoples Hospital，Hanchuan 431600，China

肾结石为泌尿系统常见疾病，多以青壮年发病为主，临床症状主要表现为腰疼。大面积结石会导致患者腰部酸胀疼痛，小面积结石则会導致患者剧烈疼痛[1-3]。本文对肾结石患者行经皮肾镜碎石取石术与输尿软管镜钬激光碎石术进行治疗，比较两组患者的治疗效果，具体内容如下。

1 资料与方法

1.1 一般资料

选取笔者所在医院于2014年6月-2015年6月接诊的80例肾结石患者为样本人群，实施奇偶分组法将患者均分成研究组和参照组，每组40例。其中研究组男28例，女12例，年龄30～51岁，平均（40.50±2.51）岁，病史2～15年，平均（8.50±1.18）年，结石直径1.3～3.6 cm，平均（2.45±0.29）cm，直径大于2 cm 13例，直径2 cm以下27例，单发结石22例，多发结石18例。参照组男27例，女13例，年龄28～53岁，平均（40.50±1.12）岁，病史3～16年，平均（9.50±1.11）年，结石直径1.3～4.2 cm，平均（2.75±0.27）cm，直径大于2 cm 10例，直径2 cm以下30例，单发结石23例，多发结石17例。两……