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目的分析电子输尿管软镜碎石取石术(FURS)与经皮肾镜碎石取石术(PCNL)治疗肾盂大型结石(长径>2 cm)的疗效与安全性。方法肾盂结石(长径>2 cm)患者36例,分为FURS术组和PCNL术组,每组18例患者,比较两种手术方式的有效性和安全性。结果两组均无术中转开放手术患者。FURS组和PCNL组的平均手术时间分别为(131.2±30.6)分钟和(71.1±28.8)分钟;FURS组和PCNL组的术后平均住院时间分别为(3.4±1.3)天和(7.3±1.5)天;FURS组出血率为11.1%,PCNL组为44.4%;两组的平均手术时间、住院时间及出血发生率比较差异有统计学意义(P<0.05);FURS组和PCNL组首次治疗后一期手术清石率分别为72.2%、94.4%,发热率分别为27.8%,22.2%,两组比较差异无统计学意义(P>0.05)。结论 FURS和PCNL均为肾盂结石(长径>2 cm)患者安全、有效的手术方式;相比于PCNL,FURS在减少术后住院时间,减少出血率等方面有明显优势。
Objective To analyze the efficacy and safety of electronic ureteroscopic lithotripsy (FURS) and percutaneous nephrolithotomy (PCNL) in the treatment of large renal pelvis (long diameter> 2 cm). Methods Thirty-six patients with renal pelvis (diameter> 2 cm) were divided into FURS group and PCNL group, with 18 patients in each group. The effectiveness and safety of the two methods were compared. Results There were no patients undergoing open surgery in both groups. The mean operative time was (131.2 ± 30.6) minutes and (71.1 ± 28.8) minutes in FURS and PCNL groups, respectively. The average postoperative hospital stay in FURS and PCNL groups was (3.4 ± 1.3) days and (7.3 ± 1.5) Day. The bleeding rate in FURS group was 11.1% and in PCNL group was 44.4%. There was significant difference between the two groups in the average operation time, hospitalization time and the incidence of bleeding (P <0.05) The rates of clear stones were 72.2% and 94.4% respectively, and the rates of fever were 27.8% and 22.2% respectively. There was no significant difference between the two groups (P> 0.05). Conclusions Both FURS and PCNL are safe and effective surgical methods for patients with renal pelvis (diameter> 2 cm). Compared with PCNL, FURS has obvious advantages in reducing postoperative hospital stay and reducing bleeding rate.