超声结合X线引导下不同术式经皮肾镜治疗鹿角型肾结石的疗效分析  

Clinical Efficacy of Different Surgical Method of Percutaneous Nephrolitho-tomyin the Treatment of Renal Staghorn Calculi Under Ultrasound Combined with X-ray-guided

作　　者：万福庆[1] 王赞礼 冯子熠 张学聪[2] 

机构地区：[1]周口市中心医院泌尿外科,河南周口466000 [2]郑州大学第一附属医院泌尿外科,河南郑州450052

出　　处：《中外医疗》2016年第16期20-22,共3页China & Foreign Medical Treatment

摘　　要：目的分析超声结合X线引导下不同术式经皮肾镜(PCNL)治疗鹿角形肾结石的疗效。方法整群选取2012年6月—2015年6月诊治的鹿角形肾结石患者112例,行PCNL联合软性输尿管镜碎石取石术治疗(联合术式组)。记录手术相关资料。同时,选取行单纯PCNL治疗鹿角形肾结石患者98例为对照组。比较两组患者安全性和有效性参数差异。结果联合术式组患者一期结石取净率为90.2%,显著高于对照组(77.6%,P<0.05);手术时间(75.5±16.4)min、住院时间(7.8±1.4)d、穿刺通道数(1.02±0.16)个、术中出血量(71.8±17.5)m L、术后出血量(23.6±16.4)m L、输血率(0)、肾功能损害率(1.8%)及并发症发生率(13.4%)显著低于对照组[(82.5±17.2)min、(8.5±1.6)d、(1.18±0.48)个、(83.6±21.2)m L、(39.8±19.9)m L、6.1%、9.2%和25.5%,(P<0.05)],差异有统计学意义。结论 PCNL联合软性输尿管镜治疗鹿角形肾结石安全、有效、并发症少,具有较高临床应用价值。Objective To analyze the clinical efficacy of different surgical method of percutaneous nephrolithotomy（PCNL）in the treatment of renal staghorn calculi under ultrasound combined with X-ray-guided. Methods Group selection 112 patients with renal staghorn calculi from June, 2012 to June, 2015 were selected. All patients were treated with PCNL combined with flexible ureteroscopy. The operativerelated data were recorded and analyzed. Meanwhile, 98 patients with renal staghorn calculi treated by PCNL were selected as control group. The related parameters of safety and efficacy between two groups were compared. Results The stone clearance rate of PCNL combined with flexible cystoscope group is 90.2%, higher than it of control group（77.6%, P〈0.05）. The operation time（75.5±16.4）min, hospitalization time（7.8±1.4）d, puncture channel number（1.02±0.16）, operation blood loss（71.8±17.5）m L, postoperative blood loss（23.6±16.4）m L, blood transfusion rate（0）, surgery-induced ranaldysfunction（1.8%） rate and complication rate（13.4%） of PCNL combined with ureteroscopy group were lower [（82.5±17.2）min、（8.5±1.6）d、（1.18±0.48）、（83.6±21.2）m L、（39.8±19.9）m L、6.1% 、9.2% 和 25.5%,（P〈0.05）].Conclusion PCNLcombined with flexible ureteroscopy guided by ultrasound combined with X-ray is a good choice in treatment of renal staghorn calculi.

关 键 词：经皮肾镜取石术 软性输尿管镜 鹿角形肾结石 疗效 

分 类 号：R699.2[医药卫生—泌尿科学]