单通道微创经皮肾镜联合输尿管软镜治疗复杂性肾结石临床效果探讨  

Clinical effect of single-channel minimally invasive percutaneous nephrolithotomy combined with ureteroscopic treatment on complicated renal calculi

作　　者：沈在雄 郑周达 林海利 许振强 郑艺淑 苏锦锋 

机构地区：[1]福建医科大学附属漳州市医院泌尿外科,福建漳州363000

出　　处：《中国现代医生》2018年第6期38-41,共4页China Modern Doctor

摘　　要：目的探讨单通道微创经皮肾镜联合输尿管软镜碎石取石术治疗复杂性肾结石的临床效果及安全性。方法系统回顾性分析2014年1月~2017年6月我院收治的98例复杂性肾结石患者,根据手术方式不同分组。研究组采用单通道微创经皮肾镜联合输尿管软镜(顺行和逆行,1期和2期)碎石取石术治疗(42例),对照组采用多通道微创经皮肾镜碎石取石术治疗(56例),比较两组复杂性肾结石的治疗效果(结石清除率)、手术操作时间、术中总出血量、术后住院时间和并发症发生情况。结果研究组治疗复杂性肾结石术后3~5 d结石清除率与对照组比较,差异无统计学意义(P>0.05);但研究组术后3个月结石清除率明显高于对照组(P<0.05)。研究组手术操作时间长于对照组,术中总出血量明显少于对照组(P<0.05);两者术后住院时间比较,差异无统计学意义(P>0.05)。两组大出血、术后发热、感染性休克、肾功能受损等并发症发生率相比较,研究组总的并发症发生率低于对照组(P<0.05)。结论单通道微创经皮肾镜联合输尿管软镜手术效果确切,其安全性和有效性较高,值得推广应用。Objective To investigate the clinical effect and safety of single-channel minimally invasive percutaneous nephrolithotomy combined with ureteroscopic lithotripsy in the treatment of complex renal calculi. Methods A retro- spective analysis of 98 cases of complicated renal calculi admitted to our hospital from January 2014 to June 2017 was performed. The patients were divided into different groups according to different surgical methods. The experimental group was treated with single-channel minimally invasive percutaneous nephrolithotomy combined with ureteroscope （prograde and retrograde, stage I and stage 2） lithotripsy （42 cases）. The control group was treated with minimally inva- sive percutaneous nephrolithotomy lithotripsy（56 cases）. Complicated renal calculi （calculi removal rate）, operation time, total intraoperative blood loss volume, postoperative hospitalization time and complications were compared between the two groups. Results There was no significant difference in calculi removal rate between the study group and the control group in 3-5 days after the treatment of complex nephrolithiasis（P〉0.05）; however, the calculi removal rate in the exper- imental group at 3 months after operation was significantly higher than that in the control group（P〈0.05）. The operation time of the experimental group was longer than that of the control group, and the total amount of bleeding during oper- ation was significantly less than that of the control group（P〈0.05）. There was no significant difference between the two groups in postoperative hospitalization time（P〉0.05）. Bleeding, postoperative fever, septic shock, impaired renal func- tion such as complications of the two groups were compared. The overall incidence of complications in the study group was lower than that in the control group（P〈0.05）. Conclusion The single-channel minimally invasive percutaneous nephrolithotomy combined with ureteroscopy is effective and safe which is worthy of popularization and applicatio

关 键 词：单通道微创经皮肾镜 输尿管软镜 复杂性肾结石 

分 类 号：R699[医药卫生—泌尿科学]