目的:探讨经皮肾镜碎石术(PCNL)与输尿管软镜碎石术(FURS)对>2 cm肾下盏结石患者结石清除效果、围手术期临床指标及并发症的影响。方法:选取我院2014年5月~2016年5月收治的>2 cm肾下盏结石患者共110例为研究对象,以随机数字表法分为FURS组(55例)和PCNL组(55例),分别采用FURS与PCNL术治疗;比较两组患者一次性结石清除率、再次手术结石清除率、手术时间、血红蛋白(Hb)下降值,血清中性粒细胞明胶酶相关脂质运载蛋白(NGAL)增加值、住院时间、总治疗费用及术后并发症发生率等。结果:PCNL组一期手术结石清除率显著高于FURS组(P<0.05);两组患者二次手术结石清除率比较差异无统计学意义(P>0.05);PCNL组患者手术时间显著短于FURS组(P<0.05);FURS组患者术后Hb下降值、NGAL增加值、住院时间及总治疗费用均显著优于PCNL组(P<0.05);同时FURS组患者术后并发症发生率显著低于PCNL组(P<0.05)。结论:PCNL术式治疗>2 cm肾下盏结石患者在一次性结石清除率和手术时间方面具有优势;而FURS术式应用则能够显著减少术中出血,降低肾功能损伤程度,加快术后康复进程,并有助于预防术后并发症发生。 Objective: To investigate the effect of percutaneous nephrolithotomy (PCNL) and ureteroscopic lithotripsy (FURS) on stone clearance, perioperative clinical indexes and complications in patients with> 2 cm nephrolithiasis. Methods: A total of 110 patients with> 2 cm renal calyceal stones admitted from May 2014 to May 2016 in our hospital were selected and divided into FURS group (55 cases) and PCNL group (55 cases ) Were treated with FURS and PCNL respectively. The rates of stone clearance, re-operation stone clearance, operation time, hemoglobin (Hb), serum neutrophil gelatinase-associated lipocalin (NGAL ) Added value, length of stay, total cost of treatment and incidence of postoperative complications. Results: The stone clearance rate of primary surgery in PCNL group was significantly higher than that in FURS group (P <0.05). There was no significant difference in secondary stone removal rate between two groups (P> 0.05). The operation time in PCNL group was significantly shorter than that in FURS group FURS group (P <0.05). The postoperative Hb decrease, NGAL increase, length of hospital stay and total cost of treatment in the FURS group were significantly better than those in the PCNL group (P <0.05). The incidence of postoperative complications was significantly higher in the FURS group Lower than PCNL group (P <0.05). CONCLUSIONS: PCNL surgical treatment of patients with> 2 cm renal calyceal calculus has advantages in terms of one-time stone clearance and operation time, while FURS can significantly reduce intraoperative bleeding, reduce the degree of renal damage and speed up postoperative recovery Process, and help prevent postoperative complications.