肾盏憩室结石腔内手术治疗单中心分析并文献复习  

Analysis and literature review of intracavitary operation for calyceal diverticulum calculi

作　　者：罗勇 陈铭[1] 刘光阳 苏华建 唐嘉辉 余庆锋 雷鸣[1] LUO Yong;CHEN Ming;LIU Guangyang;SU Huajian;TANG Jiahui;YU Qingfeng;LEI Ming(Department of Urology,Guangdong Provincial Key Laboratory of Urology,The First Affiliated Hospital of Guangzhou Medical University,Guangzhou Institute of Urology,Guangzhou 510145;Department of Urology,The Fifth Affiliated Hospital,Guangzhou Medical University,Guangzhou 510799;Department of Urology,The Third People s Hospital of Shunde District(Beijiao Hospital of Shunde District,Foshan City),Foshan 528000,China)

机构地区：[1]广州医科大学附属第一医院泌尿外科,广东省泌尿外科重点实验室,广州市泌尿外科研究所,广东广州510145 [2]广州医科大学附属第五医院泌尿外科,广东广州510799 [3]佛山市顺德区第三人民医院(佛山市顺德区北滘医院)泌尿外科,广东佛山528000

出　　处：《现代泌尿外科杂志》2024年第8期696-698,共3页Journal of Modern Urology

基　　金：广州市科技局市校联合资助项目(No.202201020477)。

摘　　要：目的分析不同腔内手术治疗肾盏憩室患者的疗效,为提高此类疾病的诊治水平提供参考。方法回顾性分析广州医科大学附属第一医院2025年1月—2021年12月收治的21例肾盏憩室结石患者的临床资料。依据手术方法将患者分为经尿道输尿管软镜手术组(RIRS组,n=14)和经皮肾镜手术组(PCNL组,n=7),并进行组间数据分析。结果RIRS组和PCNL组结石最大径分别为(11.56±4.79)mm和(13.06±6.27)mm,差异无统计学意义(P=0.609)。RIRS组与PCNL组在憩室顶肾实质厚度[(10.08±4.81)mm vs.(5.24±2.23)mm,P=0.005]、手术时间[(58.57±19.23)min vs.(88.29±25.28)min,P=0.007]、住院时间[3(1,5)d vs.11(5,12)d,P=0.023]方面比较差异有统计学意义。而两组术后结石清除率、血红蛋白下降值、术后并发症情况比较差异无统计学意义(P>0.05)。结论对于肾盏憩室结石,RIRS和PCNL都是可供选择的手术方式,RIRS的手术时间和住院时间更短,PCNL可在RIRS手术失败时作为替代手术方式。Objective To analyze the efficacy of different intracavitary operations for calyceal diverticulum calculi,so as to provide reference for the diagnosis and treatment of such disease.Methods A retrospective analysis of the data of 21 patients with calyceal diverticulum calculi was conducted during Jan.2015 and Dec.2021.The patients were divided into the retrograde intrarenal surgery(RIRS,n=14)group and percutaneous nephrolithotomy(PCNL,n=7)group.The perioperative data were compared.Results There was no significant difference in stone load between the RIRS group and PCNL group[(11.56±4.79)mm vs.(13.06±6.27)mm,P=0.609].There were significant differences in the thickness of renal parenchyma at the top of the diverticulum[(10.08±4.81)mm vs.(5.24±2.23)mm,P=0.005],operation time[(58.57±19.23)min vs.(88.29±25.28)min,P=0.007],hospitalization time[3(1,5)vs.12(5,7),P=0.023]days.After operation,there were no significant differences in stone-clearance rate,decrease of hemoglobin,and postoperative complications between the two groups(P>0.05).Conclusion Both RIRS and PCNL are viable options for treating renal calyceal diverticulum calculi.RIRS has advantages of shorter operation time and hospital stay.PCNL can be an alternative treatment when RIRS is unsuccessful.

关 键 词：肾盏憩室结石 肾盏憩室 逆行输尿管软镜手术 经皮肾镜碎石取石术 体外冲击波碎石术 

分 类 号：R459.9[医药卫生—治疗学]