目的: 探讨微创手术治疗老年肾结石患者合并肾功能不全的临床疗效。方法: 选取2015年1月至2016年12月期间接受治疗的肾结石合并肾功能不全的老年患者85例作为研究对象,按照手术方法的不同将其分为微通道经皮肾取石术(microchannel percutaneous nephrolithotripsy,MPCNL)29例(MPCNL组)、输尿管软镜碎石术(flexible ureteroscopic lithotripsy,FURL)28例(FURL组)、经皮肾镜碎石取石术(percutaneous nephroscope lithoipsy,PCNL)28例(PCNL组),对比3种手术方法的手术时间、术中出血量、住院天数、结石清除率以及并发症发生率。结果: 三组患者的术中出血量、住院天数、结石清除率以及并发症发生率相比,FURL组患者的并发症发生率、出血量、住院天数均低于其它两组(P＜0.05)。结论: 输尿管软镜下碎石术治疗合并肾功能不全的老年肾结石患者的临床疗效较好,安全性较高,值得临床推广应用。

Objective: To explore the clinical effect of minimally invasive surgery in the treatment of kidney stone combined with renal insufficiency in elderly patients.Methods: 85 cases of elderly patients with kidney stone and renal insufficiency from January 2015 to December 2016 were selected and, according to the different surgical methods, divided into microchannel percutaneous nephrolithotripsy (MPCNL) group (n=29), flexible ureteroscopic lithotripsy (FURL) group (n=28) and percutaneous nephroscope lithoipsy (PCNL) group (n=28). The operative time, intraoperative blood loss, hospital stay, stone clearance rate and complication rate were analyzed and compared.Results: The average operative time, intraoperative blood loss, hospital stay, stone clearance rate and complication rate in FURL group were significantly lower than those in the other two groups (P＜0.05).Conclusion: The curative effect of FURL in the treatment of elderly patients with kidney stone and renal insufficiency is significant. FURL is highly safe, which is worthy of clinical application.