机构地区:[1]南方医科大学附属何贤纪念医院泌尿外科,广东广州511400
出 处:《广州医科大学学报》2015年第6期42-46,共5页Academic Journal of Guangzhou Medical University
摘 要:目的:探讨微创通道经皮肾镜联合输尿管软镜治疗鹿角形肾结石的可行性与临床应用价值。方法:回顾分析我院2011年1月-2013年12月收治58例鹿角型肾结石患者的临床资料,其中30例行经皮肾镜弹道碎石术(经皮肾镜组,A组),28例行经皮肾镜联合输尿管软镜(肾镜联合输尿管软镜组,B组),对穿刺通道数量、出血量、结石清除率、结石残留率、平均住院日及术后并发症进行比较。结果:两组患者均手术成功。经皮肾镜组出血量(550.30±85.50)mL,多于肾镜联合输尿管软镜组(380.20±20.50)mL,两组比较具统计学差异(x^2=-5.946,P<0.001);建立通道数量肾镜组65个,高于肾镜联合软镜组30个。术后经皮肾镜组组的平均住院时间为(10.40±6.20)d,高于肾镜联合输尿管软镜组(9.12±1.26)d,两组比较具统计学差异(x^2=8.964,P<0.001);经皮肾镜组结石清除率66.67%(20/30),肾镜联合输尿管软镜组结石清除率92.86%(26/28),两组比较具统计学差异(x^2=19.34,P<0.001);经皮肾镜组结石残留率为23.33%(7/30),高于肾镜联合输尿管软镜组(3.57%,1/28),两组比较无统计学差异(x^2=3.24,P=0.072);两组间术后并发症经皮肾镜组高于肾镜联合输尿管软镜组,比较具统计学差异(x^2=10.370,P=0.001)。结论:微创通道经皮肾镜联合输尿管软镜治疗鹿角形肾结石是一种安全、有效的治疗方法。Objective: To investigate the feasibility and clinical value of minimally invasive percutaneous nephrolithotomy and flexible ureteroscopy in treatment of staghorn calculi. Methods: The clinical data of 58 patients with staghorn calculi hospitalized in our hospital between January 2011 and December 2013 were retrospectively analyzed. Thirty patients underwent percutaneous nephrolithotomy(percutaneous nephrolithotomy group, Group A) and twenty-eight patients underwent percutaneous nephrolithotomy and flexible ureteroscopy(percutaneous nephrolithotomy and flexible ureteroscopy group, Group B). The number of channels of puncture,blood loss, stone clearance rate, residual stone rate, average length of stay and the postoperative complications were compared between Group A and Group B. Results: The surgery in both groups were successful. The blood loss in the percutaneous nephrolithotomy and flexible ureteroscopy group [ 550.30±85.50) mL] was more than that in the percutaneous nephrolithotomy and flexible ureteroscopy group[(380.20±20.50) mL], with statistical difference between the two groups(χ2 =5.946, P〈0.001). The number of established channels in percutaneous nephrolithotomy group(n = 65) was more than that in percutaneous nephrolithotomy and flexible ureteroscopy group(n = 30). The average length of stay in the percutaneous nephrolithotomy group [( 10.40±6.20) days] was more than that in the percutaneous nephrolithotomy and flexible ureteroscopy group [(7.90±6.80)(lays],withstatistical difference between the two groups 8.964, P〈0.001). The stone clearance rate was 66.67%(20/30) and 92.86%(26/28) in the percutaneous nephrolitholomy group and the percutaneous nephrolithotomy and flexible ureteroscopy group, respectively, and ihere was statistically significant difference between the two groups(/V2= 19.34, P〈0.001). The residual stone rate in the percutaneous nephrolithotomy group [23.33%(7/30)]was higher than that in the percutaneous nephrolithot
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