单通道一期经皮肾镜碎石联合顺行输尿管软镜处理残石治疗复杂性肾结石的临床疗效  

Clinical Efficacy of One Stage Single-tract Percutaneous Nephrolithotomy Combined Antegrade Modular Flexible Ureteroscopy for the Treatment of Complex Renal Calculi

作　　者：张湛英[1] 徐勋[1] 胡明[1] 黄益恒 何军[1] 关礼贤[1] 冯权尧[1] 

机构地区：[1]南方医科大学附属南海医院泌尿外科,528200

出　　处：《岭南急诊医学杂志》2016年第5期486-488,共3页Lingnan Journal of Emergency Medicine

基　　金：广东省佛山市医学类科技攻关项目基金资助(201308193)

摘　　要：目的:探讨单通道一期经皮肾镜碎石联合顺行输尿管软镜处理残石治疗复杂性肾结石的临床疗效及安全性。方法:自2013年1月-2016年6月采用单通道一期经皮肾镜碎石术联合顺行组合式输尿管软镜处理残石治疗复杂性肾结石83例,其中多发肾结石51例,鹿角形肾结石32例。结果:4例因术中出血,输尿管软镜下视野欠清,无法有效碎石,改行二期顺行输尿管软镜碎石,余79例患者均顺利完成经皮肾镜碎石联合顺行组合式输尿管软镜处理残石,平均手术时间(137.7±23.6)min,一期结石清除率为91.6%(76/83)。术中未出现大出血、尿脓毒血症、结肠损伤、胸膜损伤等严重并发症。结论:单通道一期经皮肾镜碎石联合顺行输尿管软镜处理残石治疗复杂性肾结石疗效确切,安全可靠,是提高结石清除率的有效办法,值得临床推广使用。Objective ： To evaluate the clinical efficacy and safety of one stage single-tract percutaneous nephrolithotomy combined antegrade modular flexible ureteroscopy for the treatment of complex renal calculi.Methods：83 cases with complex renal calculi including 32 cases of complete staghorn calculi and 51 cases of multiple kidney calculi From Jan 2013 to Apr 2016 were treated with one stage single-tract percutaneous nephrolithotomy combined antegrade modular flexible ureteroscopy. Results ： Only four patients had significant bleeding in PNL, and changed to second stage of antegrade modular flexible ureteroscopy. Other 79 patients were processed residual calculi successfully at first stage. The average operation time was（137.7 ±23.6） min and first stage stone clearance rate was91.6%（76 / 83）. No intra-operative hemorrhage, uro-sepsis,intestinal damage, pleural damage or other serious complications occurred. Conclusion ： one stage single-tract percutaneous nephrolithotomy combined antegrade modular flexible ureteroscopy can obviously improve the efficiency of calculus removed for complex renal calculi, and has definitely clinical curative effect and was worth of clinical application.

关 键 词：经皮肾镜碎石术 输尿管软镜 复杂性肾结石 

分 类 号：R699.2[医药卫生—泌尿科学]