2025 年第 6 期 第 20 卷

微通道经皮肾镜和输尿管软镜治疗高硬度儿童肾结石的效果比较

Comparison of the effects of mini-percutaneous nephrolithotomy and retrograde intrarenal surgery in the treatment of renal stones with high hardness in children

作者：宁晨周厚宇王小川韩威李钧

英文作者：Ning Chen Zhou Houyu Wang Xiaochuan Han Wei Li Jun

单位：首都医科大学附属北京友谊医院泌尿外科北京市卫生健康委员会泌尿外科研究所，北京100050

英文单位：Department of Urology Surgery Beijing Friendship Hospital Capital Medical University Institute of Urology Beijing Municipal Health Commission Beijing 100050 China

关键词：儿童肾结石；微通道经皮肾镜；输尿管软镜；结石硬度

英文关键词：Renalstonesinchildren;Mini-percutaneousnephrolithotomy;Retrogradeintrarenalsurgery;Hardnessofstone

• 摘要：

• 目的 探讨微通道经皮肾镜（Mini-PCNL）与输尿管软镜（RIRS）治疗10~20 mm高硬度儿童肾结石的效果与安全性。方法 回顾性分析2021年6月至2024年6月于首都医科大学附属北京友谊医院接受Mini-PCNL或RIRS治疗的62例儿童肾结石患者的临床资料。根据手术方式将患者分为Mini-PCNL组（29例）和RIRS组（33例）。比较2组患者的一般资料、术中和术后相关资料。结果 2组患者一般资料比较差异均无统计学意义（均P＞0.05）。Mini-PCNL组术后住院时间和血红蛋白下降值均长于/大于RIRS组［（4.7±1.7）d比（2.9±1.5）d，6（4，10）g/L比2（0，4）g/L］，麻醉次数和手术时间均少于/短于RIRS组［（1.9±0.3）次比（2.8±0.4）次，（58±19）min比（69±21）min］，差异均有统计学意义（均P＜0.05）。结论 Mini-PCNL与RIRS在治疗10~20 mm高硬度儿童肾结石方面均具有良好的清石效果和安全性。Mini-PCNL虽住院时间更长，但具有手术时间更短、麻醉次数更少的优势。

• Objective To investigate the efficacy and safety of mini-percutaneous nephrolithotomy (Mini-PCNL) and retrograde intrarenal surgery (RIRS) in the treatment of renal stones with 10-20 mm high hardness in children. Methods The clinical data of 62 children with renal calculi who underwent Mini-PCNL or RIRS at Beijing Friendship Hospital, Capital Medical University from June 2021 to June 2024 were retrospectively analyzed. The patients were divided into Mini-PCNL group (29 cases) and RIRS group (33 cases). The general data, intraoperative and postoperative data of the two groups were compared. Results There were no significant differences in general data between the two groups (all P＞0.05). The length of postoperative hospital stay and the decrease of hemoglobin in Mini-PCNL group were longer/greater than those in RIRS group ［(4.7±1.7)d vs (2.9±1.5)d, 6(4,10)g/L vs 2(0,4)g/L］. The number of anesthesia and operation time in the Mini-PCNL group were less/shorter than those in the RIRS group ［(1.9±0.3)times vs (2.8±0.4)times, (58±19)min vs (69±21)min］(all P＜0.05). Conclusions Mini-PCNL and RIRS have good stone-free effect and safety in the treatment of renal stones with 10-20 mm high hardness in children. Although Mini-PCNL has longer hospital stay, it has the advantages of shorter operation time and fewer times of anesthesia.