经皮肾镜联合输尿管软镜钬激光碎石术治疗复杂性肾结石的临床疗效评价  

Evaluation on the clinical efficacy of percutaneous nephrolithotomy combined with flexible ureteroscopic holmium laser lithotripsy for complex renal calculi

作　　者：潘文博[1] 吴天俊 魏波[1] 龙海[1] PAN Wenbo;WU Tianjun;WEI Bo;LONG Hai(Department of Urology Surgery,the Second People's Hospital of Qinzhou,Guangxi,Qinzhou 535000,China)

机构地区：[1]广西壮族自治区钦州市第二人民医院泌尿外科,广西钦州535000

出　　处：《中国医药科学》2021年第14期191-194,共4页China Medicine And Pharmacy

基　　金：广西壮族自治区钦州市科学研究与技术开发计划项目(20202735)。

摘　　要：目的研究经皮肾镜联合输尿管软镜钬激光碎石术治疗复杂性肾结石的临床疗效。方法纳入2015年1月至2020年11月钦州市第二人民医院收治的60例复杂性肾结石患者展开研究,按照随机数字表法分为两组,对照组30例应用经皮肾镜碎石术治疗,观察组30例应用经皮肾镜联合输尿管软镜钬激光碎石术治疗。将两组的围术期相关指标、肾功能指标、并发症发生情况、随访情况进行比较。结果观察组患者的术中出血量少于对照组,手术时间长于对照组,住院时间短于对照组,一期结石清除率高于对照组,差异有统计学意义(P<0.05);观察组患者治疗后的血清肌酐(Scr)、尿素氮(BUN)、尿β_(2)-微球蛋白(β_(2)-MG)均低于对照组,并发症总发生率及术后1周结石残留率、二期经皮肾镜取石术比例、二期体外冲击波碎石术比例低于对照组,术后1个月结石清除率高于对照组,差异有统计学意义(P<0.05)。结论对复杂性肾结石患者采用经皮肾镜联合输尿管软镜钬激光碎石术治疗安全有效,可促进结石清除率的提高以及肾功能的改善,降低二次手术率。Objective To investigate the clinical efficacy of percutaneous nephrolithotomy combined with flexible ureteroscopic holmium laser lithotripsy for complex renal calculi.Methods A total of 60 patients with complex renal calculi admitted to and treated in the Second People's Hospital of Qinzhou from January 2015 to November 2020 was included in this research.They were divided into the control group(n=30)and the observation group(n=30)according to the random number table method.The control group was treated with percutaneous nephrolithotomy,while the observation group was treated with percutaneous nephrolithotomy combined with flexible ureteroscopic holmium laser lithotripsy.The perioperative related indices,renal function indices,incidence of complications and follow-up were compared between the two groups.Results The intraoperative hemorrhage volume of patients in the observa tion group was less than that of the control group,the operation time was longer than that of the control group,the hospitalization time was shorter than that of the control group,and the first stage calculus clearance rate of the observation group was higher than that of the control group,with statistically significant differences(P<0.05).After treatment,serum creatinine(Scr),blood urea nitrogen(BUN)andβ_(2)-microglobulin(β_(2)-MG)in patients of the observation group were all lower than those in the control group,and the total incidence of complications,the residual rate of calculus at 1 week after operation,the proportion of second-stage percutaneous nephrolithotomy and second-stage extracorporeal shock wave lithotripsy were lower than those in the control group.And 1 month after operation,the calculus clearance rate was higher than that in the control group,with statistically significant difference(P<0.05).Conclusion Percutaneous nephrolithotomy combined with flexible ureteroscopic holmium laser lithotripsy is safe and effective for patients with complex renal calculi,which can promote the improvement of calculus clearance rate and renal

关 键 词：复杂性肾结石 经皮肾镜 输尿管软镜 钬激光碎石术 

分 类 号：R699.2[医药卫生—泌尿科学]