Clinical efficacy of ultra-fine nephroscopy in the treatment of 1-2 cm lower calyceal calculi
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摘要: 目的 评价超细肾镜治疗1~2 cm肾下盏结石的有效性和安全性。方法 纳入2018年3月—2021年6月于河南中医药大学第一附属医院住院治疗的67例1~2 cm肾下盏结石患者，根据不同手术方式分成超细肾镜组37例和输尿管软镜组30例。比较两组术后3 d结石清除率、术后并发症发生率、手术时间、术后住院时间、术后1 h血红蛋白下降量和术后12 h不同疼痛程度例数。结果 超细肾镜组和输尿管软镜组术后3 d结石清除率分别为91.9%和70.0%，差异有统计学意义(P < 0.05)；超细肾镜组和输尿管软镜组术后并发症发生率分别为16.2%和26.7%，手术时间分别为(54.43±12.02) min和(59.23±12.00) min，术后住院时间分别为(6.51±1.26) d和(6.30±1.53) d，术后1 h血红蛋白下降量分别为(10.95±3.64) mL和(11.40±3.31) mL，术后不同程度疼痛例数比较，差异无统计学意义(P>0.05)。结论 超细肾镜治疗1~2 cm肾下盏结石是安全、高效的。Abstract: Objective To evaluate the effectiveness and safety of ultra-fine nephroscopy in the treatment of 1-2 cm lower renal calyx stones.Methods Sixty-seven patients with 1-2 cm lower renal calyx stones who were hospitalized at First Affiliated Hospital of Henan University of Traditional Chinese Medicine from March 2018 to June 2021 were selected and divided into 37 cases in the ultra-fine nephroscopy group and 30 cases in the holmium laser lithotripsy with flexible ureteroscope group according to different surgical procedures. The stone removal rate, postoperative complication rate, operative time, postoperative hospital stay, 1h postoperative hemoglobin drop and the number of cases with different pain levels at 12h postoperative were compared between the two groups three days after surgery.Results The stone removal rates at 3 days after surgery were 91.9% and 70.0% in the ultra-fine nephroscopy and flexible ureteroscopy groups, respectively, with statistically significant differences (P < 0.05). The postoperative complication rates were 16.2% and 26.7% in the ultra-fine nephroscopy and flexible ureteroscopy groups, respectively, and the operative time were (54.43±12.02) min and (59.23±12.00) min, respectively. The postoperative hospital stay were (6.51±1.26) d and (6.30±1.53) d, respectively, and the postoperative hemoglobin drop were (10.95±3.64) mL and (11.40±3.31) mL, respectively. There was no statistically significant difference when comparing the number of cases with different degrees of postoperative pain (P > 0.05).Conclusion Ultra-fine nephroscopy is safe and efficient in the treatment of 1-2 cm lower renal calyces stones.
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Key words:
- ultra-fine nephroscopy /
- flexible ureteroscopy /
- subrenal calculus stones
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表 1 两组年龄、性别、结石直径和结石分布比较
X±S 项目 超细肾镜组 输尿管软镜组 P值 年龄/岁 49.57±11.99 50.57±12.26 0.74 男/女/例 18/19 16/14 0.70 结石直径/cm 1.59±0.22 1.62±0.22 0.57 结石分布(左/右)/例 21/16 17/13 0.99 
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表 2 两组结石清除率和术后并发症发生率比较
例(%) 组别 例数 结石清除 术后并发症 超细肾镜组 37 34(91.9) 6(16.2) 输尿管软镜组 30 21(70.0) 8(26.7) P值 0.02 0.35
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表 3 两组手术时间、住院时间、血红蛋白下降量比较
X±S 组别 手术时间/min 术后住院时间/d 术后1 h血红蛋白下降量/(g·L-1) 超细肾镜组 54.43±12.02 6.51±1.26 10.95±3.64 输尿管软镜组 59.23±12.00 6.30±1.53 11.40±3.31 P值 0.11 0.53 0.60
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