改良俯卧分腿位双镜联合碎石术治疗复杂性肾结石的效果  

Effect of modified prone split-leg position combined with bi-endoscopy lithotripsy in the treatment of complicated renal calculi

作　　者：黄友锋[1] 黄星华 肖正豪 刘昌明[1] HUANG Youfeng;HUANG Xinghua;XIAO Zhenghao;LIU Changming(Department of Urology,Mindong Hospital of Ningde City Affiliated to Fujian Medical University,Fujian Province,Fu′an 355000,China)

机构地区：[1]福建医科大学附属宁德市闽东医院泌尿外科,福建福安355000

出　　处：《中国当代医药》2022年第28期114-117,共4页China Modern Medicine

基　　金：福建省卫生健康科技计划项目(2021CXA048)。

摘　　要：目的探讨改良俯卧分腿位下双镜联合碎石术治疗复杂性肾结石的应用效果。方法选取2019年1月至2021年8月福建医科大学附属宁德市闽东医院收治的83例复杂性上尿路结石患者作为研究对象,采用随机数字表法将其分为对照组(n=41)与观察组(n=42)。对照组使用常规俯卧位下经皮肾镜碎石术(PCNL),观察组采用改良俯卧分腿位下经皮肾镜联合逆行输尿管软镜碎石术(RIRS)。比较两组的术前一般资料、围手术期指标、结石清除率、并发症、再次手术率等指标。结果两组患者均顺利完成手术,无中转开放手术。观察组的手术时间、碎石前准备时间短于对照组,经皮肾通道数目、术后血红蛋白下降值均少于对照组,差异有统计学意义(P<0.05);两组的术后肾功能指标、术后住院时间比较,差异无统计学意义(P>0.05);观察组的结石清除率高于对照组,再次手术率低于对照组,差异有统计学意义(P<0.05);两组的并发症比较,差异无统计学意义(P>0.05)。结论改良俯卧分腿位双镜联合碎石术治疗复杂肾结石安全有效,具有手术时间短、结石清除率高、再次手术率低等优点,值得临床推广应用。Objective To explore the application effect of modified prone split-leg position combined with bi-endoscopy lithotripsy in the treatment of complex renal calculi.Methods A total of 83 patients with complex renal calculi admitted to Mindong Hospital of Ningde City affiliated to Fujian Medical University from January 2019 to August 2021 were selected as the research objects.They were divided into the control group(n=41)and the observation group(n=42)according to random number table method.The control group was treated with conventional percutaneous nephrolithotomy(PCNL)in prone position,and the observation group was treated with modified prone split-leg position percutaneous nephrolithotomy combined with retrograde intrarenal surgery(RIRS).The preoperative general data,perioperative indicators,stone clearance rate,complications and reoperation rate were compared between the two groups.Results Both groups successfully completed the operation without conversion to open surgery.The operation time,preparation time before lithotripsy in the observation group were shorter than those in the control group,the number of percutaneous renal channels,and postoperative hemoglobin decline in the observation group were less than those in the control group,and the differences were statistically significant(P<0.05).There were no significant difference between the two groups in postoperative renal function index and postoperative hospitalization time(P>0.05).The stone clearance rate of the observation group was higher than that of the control group,and the reoperation rate of the observation group was lower than that of the control group,and the differences were statistically significant(P<0.05).There was no significant difference in the postoperative complications between the two groups(P>0.05).Conclusion The modified prone split-leg position combined with bi-endoscopy lithotripsy in the treatment of complicated renal calculi is safe and effective,it has the advantages of short operation time,high stone clearance rate,and low reope

关 键 词：改良俯卧分腿位 双镜联合碎石术 复杂性肾结石 经皮肾镜碎石术 输尿管软镜碎石术 

分 类 号：R692.5[医药卫生—泌尿科学]