超微通道经皮肾镜联合输尿管软镜同期治疗复杂性肾结石的可行性  

Feasibility of super-mini-nephrolithotomy combined with flexible ureteroscopy in the treatment

作　　者：胡力仁 范先明[1] 林剑峰[1] 梁福律 涂建平[1] 叶志彬 张明芽 李亚楠[1] 郭昭建[1] HU Li-ren;FAN Xian-ming;LIN Jian-feng(Department of Urology,The Third Hospital of Xiamen Affiliated to Fujian University of Traditional Chinese Medical,Xiamen 365100,China)

机构地区：[1]福建中医药大学附属厦门市第三医院泌尿外科,福建厦门365100

出　　处：《吉林医学》2023年第3期640-643,共4页Jilin Medical Journal

基　　金：福建省卫生创新课题[项目编号:2017-CXB-18]。

摘　　要：目的:探讨超微通道经皮肾镜(SMP)联合输尿管软镜碎石取石术(fURL)治疗复杂性肾结石的临床疗效和安全性。方法:回顾性分析2016年1月~2021年12月福建中医药大学附属厦门市第三医院泌尿外科收治72例复杂性肾结石患者资料,按照手术方式将患者分为研究组和对照组,研究组采用SMP联合fURL手术方式(33例),对照组采用经皮标准通道肾镜碎石取石术(PCNL)手术方式(32例),对两组的结石清除率、手术时间、术后血红蛋白下降值、术后住院时间和并发症发生情况进行比较。结果:研究组的术后3~5 d清除率高于对照组,而手术时间长于对照组,差异有统计学意义(P<0.05),研究组的术后3个月的清除率、术中出血量及术后住院时间少于对照组,差异有统计学意义(P<0.05)。研究组中发生4例ClavienⅠ~Ⅱ级并发症,对照组中发生8例ClavienⅠ~Ⅱ级,1例ClavienⅢ并发症。研究组中肾造瘘管留置率为5.13%,对照组中常规留置肾造瘘管。结论:SMP联合fURL治疗复杂性肾结石的临床疗效确切,安全性高。Objective To investigate the clinical efficacy and safety of super-mini-nephrolithotomy(SMP)combined with flexible ureteroscopy lithotripsy(fURL)in the treatment of complicated renal calculi.Method A retrospective analysis of 72 patients with complicated renal stones was performed at Xiamen Third Hospital affiliated to Fujian University of Traditional Chinese Medicine from January 2016 to December 2021.The patients were divided into study group and control group according to the surgical procedure,the study group used SMP combined fURL(39 cases),and the control group used percutaneous nephrolithotomy(PCNL)(33 cases),comparing the stones clearance,operation time,intraoperative decrease in hemoglobin,postoperative hospitalization time,and complications.Results The clearance rate of the study group was higher than that of the control group 3~5 days after operation,and the operation time was longer than that of the control group(P<0.05).The clearance rate,intraoperative bleeding volume and postoperative hospital stay in the study group were lower than those in the control group(P<0.05).There were 4 cases of ClavienⅠ~Ⅱcomplications in the study group,8 cases of ClavienⅠ~Ⅱand 1 case of ClavienⅢhad occurred in the control group.In the study group,the retention rate of nephrostomy in the study group was 5.13%,while that in the control group was routine.Conclusion SMP combined with fURL in the treatment of complicated renal calculi is highly effective and safe.

关 键 词：超微道微经皮肾镜 输尿管软镜 肾结石 

分 类 号：R699.2[医药卫生—泌尿科学]