摘要
目的:比较输尿管软镜碎石术(FURL)与经皮肾镜碎石术(PCNL)治疗≤3 cm肾结石患者的效果。方法:选取2020年1月—2024年4月南京医科大学附属逸夫医院收治的98例肾结石患者作为研究对象,将采用FURL治疗的患者纳入研究组(36例),采用PCNL治疗的患者纳入对照组(62例)。比较两组结石清除效果及手术一般情况,监测两组手术前后肾功能[中性粒细胞明胶酶相关脂质运载蛋白(NGAL)、尿素氮(BUN)、肌酐(Scr)]及氧化应激指标[皮质醇(Cor)、丙二醛(MDA)]变化情况。结果:两组术后二期PCNL手术治疗比例、结石完全清除率、术后并发症发生率比较,差异无统计学意义(P>0.05)。研究组手术时间、术后下床时间及住院时间短于对照组,术中出血量及术后1 d疼痛评分低于对照组,差异有统计学意义(P<0.05)。治疗后,研究组BUN、Scr、NGAL较对照组低,差异有统计学意义(P<0.05)。治疗后,研究组Cor、MDA低于对照组,差异有统计学意义(P<0.05)。结论:FURL对≤3 cm肾结石患者的结石清除效果与PCNL相似,但手术时间更短、出血量更少,患者术后恢复更快,对肾功能损伤更小且氧化应激反应更轻。
Objective:To compare the efficacy of flexible ureteroscopic lithotripsy(FURL)and percutaneous nephrolithotomy(PCNL)in the treatment of renal stones≤3 cm.Method:98 patients with kidney stones admitted to the Sir Run Run Hospital Affiliated to Nanjing Medical University from January 2020 to April 2024 were selected as the study objects.FURL patients were included in the study group(36 cases),and PCNL patients were included in the control group(62 cases).The effect of stone removal and the general conditions of operation were compared between the two groups,and the changes of renal function[neutrophil gelatinase-associated lipid carrier protein(NGAL),blood urea nitrogen(BUN),creatinine(Scr)]and oxidative stress indexes[cortisol(Cor),malondialdehyde(MDA)]before and after operation were monitored.Result:There was no significant difference in the proportion of second-stage PCNL operation,the total stone clearance rate and the incidence of postoperative complications between the two groups(P>0.05).The operation time,postoperative getting out of bed time and hospitalization time of the study group were shorter than those of the control group,and the intraoperative blood loss and postoperative pain score on the first day were lower in the study group,with statistical significance(P<0.05).After treatment,BUN,Scr and NGAL in the study group were lower than those in the control group,and the difference was statistically significant(P<0.05).After treatment,Cor and MDA in the study group were lower than those in the control group,and the difference was statistically significant(P<0.05).Conclusion:FURL has similar stone removal effect to PCNL in patients with≤3 cm kidney stones,but the operation time is shorter,the amount of blood loss is less,the postoperative recovery of patients is faster,the damage to renal function is less and the oxidative stress reaction is less.
作者
肖逸
苏煌
陈杰勋
许贤林
XIAO Yi;SU Huang;CHEN Jiexun;XU Xianlin(Sir Run Run Hospital Affiliated to Nanjing Medical University,Nanjing 210000,China;不详)
出处
《中外医学研究》
2025年第6期26-29,共4页
CHINESE AND FOREIGN MEDICAL RESEARCH
基金
南京医科大学科技发展基金项目(NMUB20210356)。
关键词
输尿管软镜碎石术
经皮肾镜碎石术
肾结石
结石清除效果
肾功能
Ureteroscopic lithotripsy
Percutaneous nephrolithotripsy
Kidney stones
Stone removal effect
Renal function
