经尿道输尿管软镜联合单通道经皮肾镜治疗复杂性肾结石的有效性及安全性分析  

Efficacy and safety of transurethral flexible ureteroscopy combined with single channel minimally invasive percutaneous nephroscopy in the treatment of complex renal calculi

作　　者：张东兴 韩威[1] 王翔宇 佟昕 沈洪亮[1] 肖荆[1] Zhang Dongxing;Han Wei;Wang Xiangyu;Tong Xin;Shen Hongliang;Xiao Jing(Department of Urology,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China)

机构地区：[1]首都医科大学附属北京友谊医院泌尿外科,北京100050

出　　处：《国际外科学杂志》2023年第6期380-385,共6页International Journal of Surgery

摘　　要：目的探讨经尿道输尿管软镜联合单通道经皮肾镜治疗复杂性肾结石的临床疗效及安全性。方法前瞻性选取2019年11月—2022年4月首都医科大学附属北京友谊医院收治的72例复杂性肾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和研究组,每组各36例。对照组患者采用单通道经皮肾镜碎石取石术,研究组患者采用经尿道输尿管软镜联合单通道经皮肾镜碎石取石术。比较两组患者的围手术期指标(手术时间、术后住院时间、术中出血量),结石清除效果,肾功能指标(血尿素氮、血肌酐),并发症发生率等。计量资料以均数±标准差(x±s)表示,组间比较采用t检验;计数资料组间比较采用χ^(2)检验或Fisher确切概率法。结果研究组患者的手术时间[(101.05±11.34)min比(107.84±10.28)min]及术后住院时间[(8.54±3.15)d比(12.36±4.08)d]明显比对照组更短,差异具有统计学意义(P<0.05);研究组患者的术中出血量与对照组接近,差异无统计学意义(P>0.05)。研究组患者的一期结石清除率、总结石清除率分别为91.67%(33/36)和100.00%(36/36),均显著高于对照组的69.44%(25/36)和83.33%(30/36),差异均具有统计学意义(P<0.05)。研究组患者术后血尿素氮、血肌酐水平分别为(5.24±0.31)mmol/L和(90.65±25.57)μmol/L,对照组分别为(7.69±0.78)mmol/L和(131.96±37.80)μmol/L,研究组均显著低于对照组,差异均具有统计学意义(P<0.05)。研究组患者的术后并发症总发生率明显低于对照组(5.56%比16.67%),差异具有统计学意义(P<0.05)。结论经尿道输尿管软镜联合单通道经皮肾镜治疗复杂性肾结石的结石清除效果好,并发症少,并有助于改善肾功能,是治疗复杂性肾结石的理想术式。Objective To investigate the clinical efficacy and safety of transurethral flexible ureteroscopy combined with single channel minimally invasive percutaneous nephroscopy in the treatment of complex renal calculi.Methods A total of 72 patients with complex renal calculi admitted to Beijing Friendship Hospital,Capital Medical University from November 2019 to April 2022 were prospective selected,which were randomly divided into study group and control group by the random number table method,with 36 cases in each group.The control group underwent single channel minimally invasive percutaneous nephrolithotomy,while the study group underwent transurethral flexible ureteroscopy combined with single channel minimally invasive percutaneous nephrolithotomy.The perioperative indexes(operation time,postoperative hospital stay,intraoperative blood loss),stone removal effect,renal function indicators[blood urea nitrogen(BUN),serum creatinine(SCr)]and complication rate were compared between the two groups.Measurement data were expressed as mean±standard deviation(x±s),and t-test was used for inter-group comparison.The Chi-square test or Fisher exact probability method were used to compare the count data of two groups.Results The operation time[(101.05±11.34)min vs(107.84±10.28)min]and postoperative hospital stay[(8.54±3.15)d vs(12.36±4.08)d]in the study group were significantly shorter than those in the control group,and the difference were statistically significant(P<0.05).The amount of intraoperative bleeding was close to that in the control group,but the difference was not statistically significant(P>0.05).The primary stone clearance rate and summary stone clearance rate in the study group were 91.67%(33/36)and 100.0%(36/36),respectively,which were significantly higher than 69.44%(25/36)and 83.33%(30/36)in the control group,and the differences were statistically significant(P<0.05).The postoperative BUN and SCr levels in the study group were(5.24±0.31)mmol/L and(90.65±25.57)μmol/L,respectively,the control group was(

关 键 词：肾结石 输尿管镜 血尿素氮 经皮肾镜碎石取石术 

分 类 号：R699.2[医药卫生—泌尿科学]