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目的:探讨软性输尿管镜钬激光碎石术(FURS)与经皮肾镜碎石取石术(PCNL)术式对复杂性肾结石患者结石清除率、围手术期临床指标及术后并发症的影响。方法:研究对象选取2014年3月~2016年3月收治复杂性肾结石患者共120例,以随机数字表法分为A组(60例)和B组(60例),分别采用FURS与PCNL术式治疗;比较两组患者结石清除率、围手术期临床指标、手术前后NGAL水平及术后并发症发生率等。结果:B组一期手术结石清除率显著高于A组(P<0.05);两组患者二次手术结石清除率比较差异无统计学意义(P>0.05);B组患者手术时间显著短于A组(P<0.05);A组患者术中出血量和住院时间均显著优于B组(P<0.05);A组患者术后12、24及48h的NGAL水平均显著低于B组(P<0.05);两组患者术后并发症发生率比较差异无统计学意义(P>0.05)。结论:FURS与PCNL术式治疗复杂性肾结石均安全有效;FURS术式应用具有创伤小、术后肾功能影响小,机体恢复时间及住院时间短等优势;而PCNL术式应用更有助于缩短手术用时,提高结石清除效果。
Objective: To investigate the effect of soft ureteroscopic holmium laser lithotripsy (FURS) and percutaneous nephrolithotripsy (PCNL) on the stone clearance, perioperative clinical indexes and postoperative complications in patients with complicated nephrolithiasis influences. Methods: A total of 120 patients with complicated nephrolithiasis from March 2014 to March 2016 were selected and randomly divided into group A (60 cases) and group B (60 cases) by random number table. FURS and PCNL Surgical treatment; the stone clearance rate, perioperative clinical indicators, NGAL levels before and after surgery and the incidence of postoperative complications were compared between the two groups. Results: The rate of stone removal in group B was significantly higher than that in group A (P <0.05). There was no significant difference in secondary stone removal between the two groups (P> 0.05). The operation time in group B was significantly shorter than that in group A (P <0.05). The blood loss and hospital stay in group A were significantly better than those in group B (P <0.05). The levels of NGAL in group A at 12, 24 and 48 hours after operation were significantly lower than those in group B P <0.05). There was no significant difference in the incidence of postoperative complications between the two groups (P> 0.05). Conclusions: Both FURS and PCNL are safe and effective in the treatment of complex renal calculi. FURS has the advantages of less trauma, less postoperative renal function, shorter recovery time and shorter hospital stay. However, the application of PCNL is more helpful Shorten the operation time, improve the stone removal effect.