【摘要】 目的:观察一次性输尿管软镜应用可弯曲负压外鞘治疗2～3 cm肾结石的有效性及安全性。方法:回顾性分析2022年3月—2023年5月郑州大学第二附属医院收治的70例2～3 cm肾结石患者的临床资料，其中输尿管软镜(retrograde intrarenal surgery, RIRS)组38例，超微通道经皮肾镜(super-mini percutaneous nephrolithotomy, SMP)组32例。2组患者结石直径、结石位置、结石CT值、积水程度等差异无统计学意义(P>0.05)。观察2组手术时间、术后并发症、血红蛋白下降值、术后1 d及术后2周清石率。结果:SMP组手术时间为(52.25±6.27) min,短于RIRS组的(65.76±9.27) min;但血红蛋白下降值为(8.56±3.85) g/L,大于RIRS组的(5.73±3.25) g/L;RIRS组术后1 d清石率为65.8%,低于SMP组的87.5%,但2组术后2周清石率(86.8%vs 93.8%)差异无统计学意义。结论:对于2～3 cm肾结石，RIRS应用负压吸引外鞘安全、有效，远期能够保持与SMP相似的清石率，且更加微创。更多还原

【Abstract】 Objective: To evaluate the efficacy and safety of flexible external sheath for the treatment of 2-3 cm renal calculi. Methods: The clinical data of 70 cases of 2-3 cm renal calculi in Second Affiliated Hospital of Zhengzhou University from March 2022 to May 2023 were retrospectively analyzed, including 38 cases in the retrograde intrarenal surgery(RIRS) group and 32 cases in the super-mini percutaneous nephrolithotomy(SMP) group. There were no significant differences in stone diameter, stone location, CT value or degree of hydronephrosis between the two groups(P>0.05). The operation time, postoperative complications, hemoglobin decline and stone removal rate on the first day and 2 weeks after operation were observed. Results: The operation time of SMP group was(52.25±6.27) min, which was better than that of RIRS group([65.76±9.27]min), but the decrease of hemoglobin([8.56±3.85]g/L) was greater than that of RIRS group([5.73±3.25]g/L). The 1-day stone removal rate(65.8%) in the RIRS group was lower than that in the SMP group(87.5%), but the 2-week stone removal rate(86.8% vs 93.8%) showed no significant difference between the two groups. Conclusion: The application of RIRS using negative pressure extractive sheath for 2-3 cm renal calculi is safe, effective, and more minimally invasive, and can maintain a stone removal rate similar to SMP in the long term.更多还原