一次性输尿管软镜钬激光同期盏颈切开联合碎石取石术在治疗肾盏憩室结石中的应用  

Concomitant calicolithotomy and calicolithotripsy under disposable flexible ureteroscopy with holmium laser as a treatment of renal caliceal diverticular stones

作　　者：赵伟[1] 敖金 赵兴旭 原小斌[3] Zhao Wei;Ao Jin;Zhao Xingxu;Yuan Xiaobin(Department of Urology,Sixth Division Hospital,Xinjiang Production and Construction Corps,Wujiaqu 831300,China;不详)

机构地区：[1]新疆生产建设兵团第六师医院泌尿外科,五家渠831300 [2]新疆生产建设兵团第六师医院影像中心,五家渠831300 [3]山西医科大学第一医院泌尿外科

出　　处：《中国药物与临床》2021年第13期2240-2243,共4页Chinese Remedies & Clinics

基　　金：山西省回国留学人员科研资助项目(HGKY2019097);山西医科大学第一医院博士基金(YB161710)。

摘　　要：目的探讨评估一次性输尿管软镜钬激光同期盏颈切开联合碎石取石术治疗肾盏憩室结石的安全性及有效性。方法回顾性分析2014年1月至2021年1月间在我科手术治疗肾盏憩室结石的42例患者的临床资料,其中2014年1月至2019年1月我科采用超声引导下经皮肾镜钬激光碎石取石术治疗肾盏憩室结石(23例),2019年2月至2021年1月则实施一次性输尿管软镜钬激光同期盏颈切开+碎石取石术(19例,观察组)。根据病例对照研究设计原则,从23例经皮肾镜手术患者中选取出17例患者作为对照组,以确保2组患者基线水平可比。比较2组患者在术中出血量、手术时间、术后住院天数、结石清除率(术后4周评估)、围手术期并发症发生情况(改良的Clavien-Dindo分级系统)、术后1周体力恢复状况(Karnofsky体力评分)等指标。结果与对照组患者相比,观察组患者术中出血量、手术时间及术后住院天数均显著下降,术后1周体力恢复状况则显著提高(均P<0.05)。结石清除率及围手术期并发症发生情况在两组患者差异均无统计学意义(P>0.05)。结论一次性输尿管软镜钬激光同期盏颈切开+碎石取石术治疗肾盏憩室结石安全、有效、恢复快。Objective To evaluate the safety and effectiveness of concomitant calicolithotomy and calicolithotripsy under disposable flexible ureteroscopy with holmium laser as a treatment of renal caliceal diverticular stones.Methods A retrospective analysis was performed on clinical data of 42 patients who underwent surgery for renal caliceal diverticular stones in our department between January 2014 and January 2021.Patients admitted to our department between January 2014 and January 2019 underwent percutaneous ultrasound-guided nephroscopic lithotripsy with holmium laser(n=23),and those between February 2019 and January 2021 underwent concomitant calicolithotomy and calicolithotripsy under disposable flexible ureteroscopy with holmium laser(n=23),for treatment of the renal caliceal diverticular stones.According to the design of the case-control study,17 patients were selected from the 23 patients undergoing percutaneous nephroscopy as the control group to match the 19 patients undergoing flexible ureteroscopy(observation group),to ensure that the two groups of patients were comparable at baseline.The two groups of patients were compared for intraoperative blood loss,operation time,postoperative days of hospital stay,stone clearance(as assessed at four weeks postoperatively),perioperative complications(per revised Clavien-Dindo classification system),and postoperative one-week physical strength score(Karnofsky performance score).Results Compared with those in control group,the patients in observation group had significantly less or fewer intraoperative blood loss,operation time,postoperative days of hospital stay(3.1 vs 5.4 d,P<0.05),and improved physical performance recovery at one week after the surgery.There were no significant differences in stone clearance rate and perioperative complications between the two groups(P>0.05).Conclusion Concomitant calicolithotomy and calicolithotripsy under disposable flexible ureteroscopy with holmium laser is safe,effective and recovery-conducive as a treatment of renal caliceal dive

关 键 词：激光 固体 肾盏 憩室 结石 一次性输尿管软镜 

分 类 号：R699.2[医药卫生—泌尿科学]