斜仰卧截石位经皮肾镜联合输尿管软镜治疗复杂肾结石  

The Effect of Percutaneous Nephrolithotomy With Oblique Supine Lithotomy Position Combined With Flexible Ureteroscopy in Patients With Complex Renal Calculi

作　　者：胡永文[1] 李华英[2] 陈奎[1] HU Yongwen;LI Huaying;CHEN Kui(Department of Urology,Songzi City People＇s Hospital,Songzi Hubei 434200,China;Department of Oncology)

机构地区：[1]松滋市人民医院泌尿外科,湖北松滋434200 [2]松滋市人民医院肿瘤科,湖北松滋434200

出　　处：《中国继续医学教育》2018年第31期71-73,共3页China Continuing Medical Education

摘　　要：目的探讨复杂肾结石患者行斜仰卧截石位单通道经皮肾镜联合输尿管软镜治疗的效果。方法选入我院于2015年3月—2016年3月所收治的肾多发结石以及鹿角状结石患者60例,采用随机数字表法的形式将其平均分为观察组和对照组,每组各为30例,对照组行多通道经皮肾输尿管镜取石术,观察组患者均行斜仰卧截石位球囊扩张建立标准通道,单通道经皮肾镜联合输尿管软镜碎石处理,对患者的临床数据进行分析,包含患者手术用时,患者术中出血量、患者结石清除率、患者住院时间以及手术并发症。结果观察组平均手术时间为(50.10±0.23)min,对照组手术时间为(50.25±0.25)min,组间对比差异有统计学意义(P <0.05)。观察组结石清除率100%,对照组结石清除率83.3%,组间对比差异有统计学意义(P <0.05)。随访时间最长半年,最短90日,没有手术并发症出现。结论通过斜仰卧截石位单通道经皮肾镜联合输尿管软镜对复杂肾结石病症进行治疗,可有效提升结石清除率,提升患者手术中的舒适感。Objective To investigate the effect of single channel percutaneous nephrolithotomy combined with flexible ureteroscopy in patients with complex renal calculi. Methods 60 patients with renal multiple stones and staghorn calculi treated in our hospital from March 2015 to March 2016 were divided into the observation group and the control group in the form of random digital table. 30 cases in each group and the control group were treated with multichannel percutaneous nephroscope. The patients in the observation group were all treated with oblique supine osteotomy position balloon dilation, a standard channel, a single channel percutaneous hard mirror and a soft mirror combined with lithotripsy. The patient＇s clinical data were used to analyze, including the amount of intraoperative bleeding, the patient＇s stone clearance, the patient＇s time of hospitalization, and the complications of the operation. Results The average operation time of observation group was （50.10±0.23） min, and that of control group was （50.25±0.25） min. The diference was statistically signifcant （P 〈 0.05）. The stone clearance rate of observation group was 100%, while that of control group was 83.3%. The difference was statistically signifcant （P 〈 0.05）. The longest follow-up period was six months, the shortest was 90 days, and no operative complications occurred. Conclusion The treatment of complex nephrolithiasis with single channel transdermal lens and soft mirror by oblique supine osteotomy can efectively improve the stone clearance rate and improve the comfort of the patients.

关 键 词：复杂肾结石 斜仰卧 截石位 单通道 输尿管软镜 效果分析 

分 类 号：R699[医药卫生—泌尿科学]