40~80 Hz钬激光微通道经皮肾镜与输尿管软镜手术治疗肾结石患者的疗效比较

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（1.蚌埠医学院研究生院，安徽蚌埠 233000；2.嘉兴市第一医院泌尿外科，浙江嘉兴 314000）

Compareison of the efficacy of mPCNL and RIRS using 40-80 Hz holmium laser in the treatment of renal calculi

DING Qiang1，2， XIE Wenhua2， HE Yi1，2

（1. Graduate School of Bengbu Medical College，Bengbu 233000；2. Department of Urology，The First Hospital of Jiaxing City， Jiaxing 314000， China）

ABSTRACT：Objective To compare the clinical efficacy of high frequency holmium laser in the treatment of 2-3 cm renal calculi by minimally invasive percutaneous nephrolithotomy （mPCNL） and retrograde intrarenal surgery （RIRS）. MethodsThe clinical data of 105 patients with a solitary 2-3 cm renal calculus treated during Oct. 2020 and Oct. 2022 were retrospectively analyzed. The patients were divided into two groups， including 52 cases in the RIRS group and 53 cases in the mPCNL group. The one-stage stone clearance rate， operation time， hemoglobin decline within 24 hours， inflammatory indicators within 24 hours after operation， postoperative complications， hospital stay and hospitalization costs were compared between the two groups.Results There were no significant differences in the preoperative general data， one-stage stone clearance rate， inflammatory indicators within 24 hours and incidence of postoperative complications between the two groups

（P>0.05）. The RIRS group had less decrease of hemoglobin than the mPCNL group [1（6.35±2.00） g/L vs. （12.25±5.72） g/L， P=0.001]， shorter hospital stay [1（5.13±0.82） d vs. （7.92±1.59） d， P＜0.001]， lower hospitalization costs [1（15221.52±796.46） yuan vs. （19514.51±909.98） yuan， P＜0.001]， but longer operation time [1（58.17±7.67） min vs. （49.60±4.52） min， P＜0.001].Conclusion Both mPCNL and RIRS are safe and effective in the treatment of 2-3 cm renal calculi with 40-80 Hz holmium laser， and the one-stage stone clearance rate is similar. Although RIRS needed longer operation time than mPCNL， it has the advantages of less surgical trauma， faster postoperative recovery and shorter hospital stay， and is more prospective in the treatment of 2-3 cm renal calculi.

KEY WORDS：retrograde intrarenal surgery；minimally invasive percutaneous nephrolithotomy；renal calculi；high frequency holmium laser；percutaneous nephrolithotomy

摘要：目的 比较微通道经皮肾镜碎石取石术（mPCNL）和输尿管软镜碎石术（RIRS）两种方式下利用高频率钬激光治疗2～3 cm肾结石的临床疗效。（剩余6462字）