范伟洪 薛晓荣 陈自立 薛健

【摘要】 目的：观察输尿管软镜碎石术与经皮肾镜取石术治疗肾结石的效果及并发症情况。方法：采集于笔者所在医院2017年10月-2018年10月就诊的78例肾结石患者，分两组，每组39例，对照组行经皮肾镜取石术，观察组行输尿管软镜碎石术，比较两组手术指标、并发症及氧化应激情况。结果：观察组手术时间（92.41±22.28）min，比对照组长，出血量（4.45±1.80）ml，比对照组少，且尿管留置时间、住院时间分别为（1.72±0.48）、（3.26±1.65）d，均比对照组短（P<0.05）;观察组发热2.56%、血尿5.13%、感染2.56%、患侧腰痛5.13%、肾包膜下血肿2.56%，均比对照组低（P<0.05）。结论：输尿管软镜碎石术与经皮肾镜取石术清除肾结石的效果相当，但输尿管软镜碎石术更具优势，术中出血量少、恢复快，且术后并发症少，能减少患者手术应激性。

【关键词】 肾结石; 输尿管软镜碎石术; 经皮肾镜取石术; 并发症

doi：10.14033/j.cnki.cfmr.2019.27.023 文献标识码 B 文章编号 1674-6805（2019）27-00-03

Analysis of the Effect and Complications of Ureteral Lithotripsy and Percutaneous Nephrolithotomy on Renal Calculi/FAN Weihong，XUE Xiaorong，CHEN Zili，et al.//Chinese and Foreign Medical Research，2019，17（27）：52-54

【Abstract】 Objective：To observe the effect and complications of ureteroscopic lithotripsy and percutaneous nephrolithotomy on the treatment of renal calculi.Method：A total of 78 patients with renal calculi who were admitted to our hospital from October 2017 to October 2018 were enrolled in two groups，39 in each group.The control group underwent percutaneous nephrolithotomy，and the observation group underwent ureteroscopic lithotripsy.The surgical indexes，complications and oxidative stress were compared between the two groups.Result：The operation time of the observation group of （92.41±22.28）min was longer than that of the control group，the bleeding amount of （4.45±1.80）ml was less than that of the control group，and the indwelling time of （1.72±0.48）d and hospital stay of （3.26±1.65）d，which were all shorter than those of the control group（P<0.05）.The observation group had fever of 2.56%，hematuria of 5.13%，infection of 2.56%，affected side low back pain of 5.13%，and subcapsular hematoma of 2.56%，which were all less than those of the control group（P<0.05）.Conclusion：The ureteroscopic lithotripsy was equivalent to percutaneous nephrolithotomy for clearing kidney stones，but ureteral soft lithotripsy has advantages.It has less intraoperative blood loss，quick recovery，and less postoperative complications.The patient is surgically stressed.

【Key words】 Kidney calculi; Ureteroscopy lithotripsy; Percutaneous nephrolithotomy; Complications

First-authors address：The Peoples Hospital of Sihui City，Sihui 526200，China

腎结石属于泌尿系统疾病，感染、药物、尿路梗阻、营养缺乏、机体代谢异常等是肾结石的常见致病原因[1]。若结石较大，小范围移动，临床以腰部酸胀或身体活动伴钝痛、隐痛为主[2]。若结石较小，易引起绞痛，以腰腹阵发性剧烈刀割疼痛为主[3]。目前，临床针对肾结石通常采取综合治疗，当结石较大或药物无法镇痛时，则实施外科手术治疗。笔者所在医院现以收治的78例肾结石患者为研究对象，探究输尿管软镜碎石术、经皮肾镜取石术的疗效，现作如下报告。

1 资料与方法

1.1 一般资料

选取笔者所在医院2017年10月-2018年10月就诊的78例肾结石患者。纳入标准：经X线、超声、CT、静脉肾盂造影等影像检查证实为肾结石，结石最大直径≤2 cm，符合手术指征。排除标准：膀胱或输尿管结石、伴发高热或脓尿、尿道畸形、血液系统疾病、肝肾功能异常、恶性肿瘤等患者。分两组，观察组39例，男女比例25∶14，年龄27～72岁，平均（45.63±15.14）岁，结石部位：上盏14例，中盏10例，下盏12例，肾盂3例;对照组39例，男女比例30∶9，年龄25～70岁，平均（46.37±16.07）岁，结石部位：上盏11例，中盏15例，下盏10例，肾盂3例。……