微通道经皮肾镜联合输尿管软镜在鹿角形结石患者中的应用  

Application of Minimally Invasive Percutaneous Nephrolithotomy Combined with Flexible Ureteroscopic Lithotripsy on Patients with Staghorn Calculi

作　　者：桂琦 焦湘 刘太阳 李杰 沈雁冰 文秀华 GUI Qi;JIAO Xiang;LIU Taiyang;LI Jie;SHEN Yanbing;WEN Xiuhua(Department of Urology,Zhumadian Central Hospital Affiliated to Huanghuai University(Zhumadian Urology Engineering Technology Research Center),Zhumadian 463000,China)

机构地区：[1]黄淮学院附属驻马店市中心医院(驻马店市泌尿外科工程技术研究中心)泌尿外科,河南驻马店463000

出　　处：《河南医学研究》2025年第2期301-305,共5页Henan Medical Research

摘　　要：目的探讨微通道经皮肾镜(mPCNL)联合输尿管软镜(FURL)在鹿角形结石(SC)患者中的应用。方法选择2021年1月至2022年12月黄淮学院附属驻马店市中心医院收治的130例SC患者,采用随机数字表法将其分为mPCNL组和mPCNL+FURL组,各65例。mPCNL组接受单通道mPCNL治疗,mPCNL+FURL组接受单通道mPCNL+FURL治疗。比较两组手术相关指标、血清炎症因子水平[C反应蛋白(CRP)、白细胞介素6(IL-6)]、肾功能指标水平、结石清除率及术后并发症发生情况。结果mPCNL+FURL组手术时间和术后总住院时间均短于mPCNL组,术中出血量少于mPCNL组(P<0.05)。术后1 d,两组CRP、IL-6、肌酐水平升高(P<0.05),但组间差异无统计学意义(P>0.05)。术后1周、1个月、3个月,mPCNL+FURL组结石清除率均高于mPCNL组(P<0.05)。mPCNL+FURL组术后并发症总发生率低于mPCNL组,但差异无统计学意义(P>0.05)。结论应用mPCNL联合FURL可有效减轻SC患者手术创伤,提高结石清除率,且不会增加对患者肾功能的损害,利于患者术后恢复。Objective To explore the application of minimally invasive percutaneous nephrolithotomy(mPCNL)combined with flexible ureteroscopic lithotripsy(FURL)on patients with staghorn calculi(SC).Methods A total of 130 patients with SC admitted to the Zhumadian Central Hospital Affiliated to Huanghuai University from January 2021 to December 2022 were selected,and were divided into mPCNL group and mPCNL+FURL group,with 65 cases in each group by the random number table method.The mPCNL group received single-channel mPCNL treatment,and the mPCNL+FURL group was treated with single-channel mPCNL+FURL.The surgery-related indicators,serum inflammatory factors[C-reactive protein(CRP),interleukin 6(IL-6)],renal function indicators,stone clearance rate and occurrence of postoperative complications were compared between the two groups.Results The surgical time and total postoperative hospital stay in mPCNL+FURL group were shorter than those in mPCNL group,and the intraoperative blood loss was less than that in mPCNL group(P<0.05).At 1 day after surgery,the CRP,IL-6,creatinine levels were increased in both groups(P<0.05),but there were no statistically differences between the two groups(P>0.05).The stone clearance rate in mPCNL+FURL group was higher than that in mPCNL group within 1 week after surgery and at 1 month and 3 months after surgery(P<0.05).The total incidence rate of postoperative complications in mPCNL+FURL group was lower than that in mPCNL group(P>0.05).Conclusion The application of mPCNL combined with FURL can effectively reduce the surgical trauma and enhance the stone clearance rate in patients with SC,and it will not increase the renal function damage,and it is conducive to postoperative recovery of patients.

关 键 词：微通道经皮肾镜取石术 输尿管软镜取石术 鹿角形结石 结石清除率 

分 类 号：R692.4[医药卫生—泌尿科学]