可弯曲负压吸引鞘联合输尿管软镜碎石术和经皮肾镜碎石术治疗 2～ 3cm 肾下盏结石的疗效及安全性比较

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Efficacy and safety of FV-UAS-FURL versus PCNL in treating lower calyx stones of 2-3cm

HE Yingtian，LI Chengyang，LIU Xiao （Department of Urology，The First Afiliated Hospital of Guangxi Medical University，Nanning 530oo，China）

ABSTRACT：ObjectiveTo compare the eficacyand safety of flexible vacum-asisted ureteral accssheath （FV-UAS） plus flexible ureteroscopic lithotripsy （FURL）and percutaneous nephrolithotomy （PCNL） in the treatment of 2-3cm lower calyxstones，soastoprovidereferenceforclinical treatmentoptionsofthis typeof stones.MethodsAretrospectiveanalysis wasconducted on114 patients with lower calyx stones admited toour hospital during May 2021and May 2024.Based on the surgical approaches，the patients were divided into the FV-UAS-FURL group （ n=57 ）and PCNL group（ n=57 ）. The general data，biochemicalindicators，operationtime，complicationrate，stone-freerate（SFR）andotherclinical dataof thetwogroups were compared.Results There were no significant differences in the general data，SFR 1 day （70.2% 15.59.6% P=0.239 ） and 1 month （ 84.2% vs. 78.9% P=0.469 ）（ P>0.05 ） after the surgery between the PCNL group and FV-UAS-FURL group.Compared tothe PCNL group，the FV-UAS-FURLgrouphad greaterdecreasein hemoglobin level ，shorter operation time [87.0（60.5，121.5）minνs.112.0（90 0.0， 122.5）min， P=0.004] ，shorter hospital stay [1.0（1.0，4.0） d vs.8.0（6.5，10.0） d， P<0.001] ，and lower incidence of postoperative hematuria and fever （5.3% vs. 22.8% ， P=0.007 ）.ConclusionBoth PCNL and FV-UAS-FURL can safely and effectively treat 2-3cm lower calyx stones. However，FV-UAS-FURL has advantages over PCNL，including fewer postoperativecomplications，shorteroperation time，and shorter hospital stay，makingitabeter surgical choice.

KEY WORDS： flexiblevacuum-assisted ureteral access sheath；flexible ureteroscopic lithotripsy； percutaneous nephrolithotomy；lower calyx stone

摘要：目的比较可弯曲负压吸引鞘（FV-UAS）联合输尿管软镜碎石术（FURL）与经皮肾镜碎石术（PCNL）治疗 2～3cm 肾下盏结石的有效性及安全性，为该类结石的临床治疗选择提供参考。（剩余9459字）