经皮肾造瘘术联合输尿管软镜钬激光碎石术治疗鹿角形肾结石  

Clinical efficacy of percutaneous nephrostomy combined with retrograde intrarenal surgery in the treatment of staghorn nephrolithiasis

作　　者：吴亚龙 黄德斌 王俊凯 谷欣权[1] WU Yalong;HUANG Debin;WANG Junkai;GU Xinquan(Department of Urology,China-Japan Union Hospital,Jilin University,Changchun 130033,China)

机构地区：[1]吉林大学中日联谊医院泌尿外科一病区,长春130033

出　　处：《长春中医药大学学报》2022年第11期1274-1276,共3页Journal of Changchun University of Chinese Medicine

基　　金：吉林省财政厅项目(3D5198425430)。

摘　　要：目的 探讨经皮肾造瘘术(PCNS)联合输尿管软镜钬激光碎石术(RIRS)治疗鹿角形肾结石的临床疗效。方法 将鹿角形肾结石患者79例根据手术方式的不同分为观察组38例及对照组41例。观察组采用经皮肾造瘘术联合输尿管软镜钬激光碎石术治疗,对照组采用经皮肾镜碎石取石术(PCNL)治疗。比较2组手术时间、术后结石清除率、术后住院时间、术后并发症发生率、术后第1天中性粒细胞载脂蛋白(HNL)、术后血红蛋白指标变化。结果 与对照组比较,观察组手术时间更长(P<0.05),一期结石清除率较低但失血量更少(P<0.05),二期结石清除率相当(P>0.05);与对照组比较,观察组术后并发症发生率更低,术后住院时间更短(P<0.05)。结论 经皮肾造瘘术联合输尿管软镜钬激光碎石术治疗鹿角形肾结石安全有效,与经皮肾镜碎石取石术比较,失血量少、并发症发生率低、术后住院时间短,二期碎石效率相当。Objective To explore the clinical efficacy of percutaneous nephrostomy (PCNS) combined with retrograde intrarenal surgery (RIRS) in the treatment of staghorn nephrolithiasis.Methods A total of 79 patients with staghorn nephrolithiasis were divided into the observation group (38 cases) and the control group (41 cases) according to the di?erent surgical methods.The observation group was treated with PCNS combined with RIRS,while the control group was treated with percutaneous nephrolithotomy (PCNL).The operation time,postoperative calculi clearance rate,postoperative hospitalization time,postoperative complication rate,neutrophil apolipoprotein (HNL) on the first day after operation,and changes in postoperative hemoglobin were compared between the two groups.Results Compared with the control group,the observation group had a longer operation time (P<0.05),its primary calculi clearance was lower but the blood loss was less (P<0.05),and its secondary calculi clearance was comparable (P>0.05).Compared with the control group,the incidence of postoperative complications in the observation group was lower,and the postoperative hospitalization time was shorter (P<0.05).Conclusion Compared with percutaneous nephrolithotomy,PCNS combined with RIRS is safe and effective in the treatment of staghorn nephrolithiasis,with a less blood loss,a lower complication rate,a shorter postoperative hospital stay,and a comparable secondary lithotripsy efficiency.

关 键 词：鹿角形肾结石 输尿管软镜 经皮肾造瘘 经皮肾镜 

分 类 号：R692.4[医药卫生—泌尿科学]