输尿管软镜和经皮肾镜联合EMS钬激光治疗不完全性鹿角状肾结石的效果比较

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Abstract Objective To compare the clinical efficacy of flexible ureteroscopic lithotripsy (FURS) and percutaneous nephrolithotripsy (PCNL) combined with EMS holmium laser in the treatment of incomplete staghorn renal calculi.Methods A total of 103 patients with incomplete staghorn nephrolithiasis admitted to Sichuan Provincial People′s Hospital Jinniu Hospital from March 2016 to December 2019 were selected as the research objects and divided into the FURS group(48 cases)and the PCNL group(55 cases)according to different treatment methods.The operative time,intraoperative blood loss, postoperative haemoglobin decline, hospital expenses, length of stay, success rate of stone extraction in phase Ⅰ, total stone clearance rate and total incidence of complications of two surgical methods combined with EMS holmium laser in the treatment of incomplete staghorn renal calculi were compared.Results The operation time of FURS group was longer than that of PCNL group, intraoperative blood loss of FURS group was less than that of PCNL group, the postoperative haemoglobin decline of FURS group was lower than that of PCNL group, the length of stay of FURS group was shorter than that of PCNL group, success rate of stone extraction in phase Ⅰof FURS group was lower than that of PCNL group, the differences were statistically significant (P＜0.05).There were no significant differences between the two groups in the total stone clearance rate and the total incidence of complications (P＞0.05).And seven cases of FURS group employed postoperative EWSL treatment, four cases of PCNL group employed EWSL treatment.Conclusion FURS combined with EMS holmium laser lithotripsy and PCNL combined with EMS holmium laser lithotripsy are safe and effective methods for the treatment of incomplete staghorn calculi.Compared with flexible ureteroscopy, percutaneous nephroscope lithotripsy has a high rate of stone clearance and shorter operation time, it is more suitable for ＞20 mm diameter kidney stones, especially the complete large staghorn stones.It can decrease intraoperative blood loss, reduce the postoperative bleeding rate, and shorter the length of stay of FURS combined with EMS holmium laser lithotripsy.

Key words： Flexible ureteroscopy lithotripsy Percutaneous nephrolithotripsy Holmium laser Incomplete staghorn renal calculi

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