Zhao Fangzhou,Li Jun,Jiao Jianwei.Comparison of effectiveness and safety for pediatric 1-2 cm lower calyceal stones between micro-percutaneous nephrolithotomy and retrograde intrarenal stone surgery[J].Journal of Clinical Pediatric Surgery,2020,19(08):672-676,682.[doi:10.3969/j.issn.1671-6353.2020.08.003]
可视经皮肾镜碎石术与输尿管软镜碎石术治疗儿童1~2 cm肾下盏结石有效性与安全性的对比研究
- Title:
- Comparison of effectiveness and safety for pediatric 1-2 cm lower calyceal stones between micro-percutaneous nephrolithotomy and retrograde intrarenal stone surgery
- Keywords:
- Kidney Calculi/SU; Lithotripsy; Percutaneous Nephrostomy; Ureteroscopes; Child
- 分类号:
- R692.4;R616.5;R726.1
- 摘要:
- 目的 比较可视经皮肾镜碎石术（Micro-Percutaneous nephrolithotomy，Microperc）与逆行输尿管软镜碎石术（retrograde intrarenal stone surgery，RIRS）治疗儿童1~2 cm肾下盏结石的有效性与安全性。方法 收集2014—2020年于首都医科大学附属北京友谊医院收治的61例1~2 cm肾下盏结石患儿的临床资料，其中男童46例，女童15例，年龄范围6个月至12岁。根据术式不同分为Microperc组（n=27）与RIRS组（n=34），比较两组患儿的年龄、性别、体质指数、患肾侧别、术前发热、术前阳性尿培养、术前肾积水、结石直径等基线资料，进一步分析两组相关手术参数、术后1 d及术后1个月随访结石清除率（Stone free rate，SFR）与并发症发生率。结果 Microperc组与RIRS组SFR分别为92.6%（25/27）和82.4%（28/34），差异无统计学意义（χ2=0.632，P=0.427）；辅助治疗率分别为0.0%和11.8%，差异无统计学意义（P=0.122）；手术时间分别为（41.2±20.0）min和（36.5±11.1）min，差异有统计学意义（t=2.109，P=0.039）；术中灌注量分别为（192.6±101.5）mL和（392.1±171.8）mL，差异有统计学意义（t=-4.357，P=0.005）；住院天数分别为（5.9±2.7）d和（5.4±1.6）d，差异无统计学意义（t=0.812，P=0.420）；并发症发生率分别为22.2%（6/27）和14.7%（5/34），差异无统计学意义（χ2=0.575，P=0.448）。结论 Microperc与RIRS在治疗儿童1~2 cm肾下盏结石方面具有相似的有效性与安全性。
- Abstract:
- Objective To compare the therapeutic effectiveness and safety for pediatric 1-2cm moderately-sized lower calyceal stones between micro-percutaneous nephrolithotomy (Microperc) and retrograde intrarenal stone surgery (RIRS). Methods Between 2014 and 2020, clinical data were collected for 61 children with 1-2 cm lower calyceal stones. There were 46 boys and 15 girls with an age range of 6 to 144 months. They were divided into two groups of Microperc (n=27) and RIRS (n=34). Baseline data of age, gender, body mass index, kidney laterality, fever, preoperative positive urine culture, hydronephrosis and stone diameters were compared to determine the comparability of two groups. Surgical parameters, stone free rate (SFR) and complication rates at Day 1 and Month 1 were recorded. Results For Microperc and RIRS groups, SFR was 92.6% (25/27) vs. 82.4% (28/34) without significant difference (χ2=0.632, P=0.427), auxiliary therapeutic rate 0% vs. 11.8% without significant difference (P=0.122), surgical duration (41.2±20.0 vs. 36.5±11.1) min with statistical significance (t=2.109, P=0.039), fluid irrigation (192.6±101.5) vs. (392.1±171.8) ml with statistical significance (t=-4.357, P=0.005), hospitalization stay (5.9±2.7 vs. 5.4±1.6 days) without significant difference (t=0.812, P=0.420) and complication rate 22.2% vs. 14.7% without statistical significance (χ2=0.575, P=0.448). Conclusion Microperc and RIRS have similar therapeutic effectiveness and safety for pediatric 1-2 cm moderately-sized lower calyceal stones.
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备注/Memo
收稿日期:2020-06-18。
基金项目:北京市医院管理局临床技术创新项目（编号：XMLX201826）
通讯作者:李钧,Email:zfzlijun@126.com