摘要目的:比较经皮肾镜取石术(PCNL)及输尿管软镜碎石术(FURL)治疗输尿管上段结石的效果。方法:回顾性抽取2018年4月至2020年3月周口市中心医院诊治的307例输尿管上段结石(长径>1 cm)患者的临床资料，依据手术方案将其分为PCNL组(154例)和FURL组(153例)。观察两组患者结石清除率、再诊率、术中术后相关指标、术前和术后3 d炎症因子水平及短期并发症发生率。结果:两组患者术后3 d、3个月结石清除率及再次就诊率比较，差异未见统计学意义( P>0.05)；两组患者手术时间、住院天数及住院费用比较，差异未见统计学意义( P>0.05)，FURL组术中出血量及术后第1天疼痛评分低于PCNL组( P<0.05)；术后3 d，两组患者白细胞计数较术前降低( P<0.05)，两组间比较，差异未见统计学意义( P>0.05)；术后3 d，两组患者的白细胞介素-6(IL-6)、超敏C反应蛋白(hs-CRP)水平较术前升高( P<0.05)，且FURL组低于PCNL组( P<0.05)；FURL组术后短期并发症发生率为4.58%，低于PCNL组14.29%( P<0.05)。 结论:PCNL和FURL治疗直径>1 cm输尿管上段结石均有较高的结石清除率，但FURL术中出血量相对较少，术后疼痛及炎症反应轻，并发症发生率更低，值得推广应用。

abstractsObjective:To compare the curative effect of percutaneous nephrolithotomy (PCNL) and flexible ureteroscope lithotripsy(FURL) on upper ureteral calculi.Methods:The clinical data of 307 patients with upper ureteral calculi (the long diameter>1 cm) who were diagnosed and treated in Zhoukou Central Hospital from April 2018 to March 2020 were retrospectively collected. According to different surgical plans, they were divided into PCNL group (154 cases) and FURL group (153 cases). The stone clearance rate, re-diagnosis rate, intraoperative and postoperative related indexes, levels of inflammatory factors before surgery and at 3 days after surgery, and the incidence of short-term complications in both groups were observed.Results:There were no significant differences between the two groups in stone clearance rate and re-diagnosis rate at 3 days and 3 months after surgery ( P>0.05). The operation time, hospitalization days and hospitalization expenses of the two groups were compared, the difference was not significant ( P>0.05). The intraoperative blood loss and pain score at 1 day after surgery in FURL group were lower than those in PCNL group ( P<0.05). At 3 days after surgery, white blood cell counts in both groups were lower than those before surgery ( P<0.05), and there was no significant difference between the two groups ( P>0.05). At 3 days after surgery, levels of interleukin-6 (IL-6) and high-sensitivity C-reactive protein (hs-CRP) in both groups were higher than those before surgery ( P<0.05), which were significantly lower in FURL group than those in PCNL group ( P<0.05). The short-term complication rate of furl group was 4.58%, which was lower than that of PCNL group (14.29%), P<0.05. Conclusions:Both PCNL and FURL are of highstone clearance rate in the treatment of upper ureteral calculi longer than 1 cm. However, intraoperative blood loss of FURL is relatively less, postoperative pain and inflammation response are milder, and the incidence of complications is lower. It is worth popularizing.