超声引导下经皮肾镜联合输尿管镜治疗鹿角形肾结石疗效剖析.docVIP

超声引导下经皮肾镜联合输尿管镜治疗鹿角形肾结石疗效剖析 　　[摘要] 目的 分析标准经皮肾镜（PCNL）联合输尿管镜治疗鹿角形肾结石的疗效。 方法 回顾性分析2010年6月～2015年2月在我院泌尿外科采用PCNL联合输尿管镜进行治疗的126例鹿角形肾结石患者的临床资料。所有患者行PCNL联合输尿管镜碎石取石术治疗。记录并分析患者术前、术中和术后的相关资料。同时，选取行单纯PCNL治疗鹿角形肾结石患者89例为对照组。比较两组患者相关参数和疗效差异。 结果 PCNL联合输尿管镜组患者手术时间、出血量及并发症发生率显著低于对照组（P0.05），一期结石取净率显著高于对照组（P0.05）。PCNL联合输尿管镜组患者术后27例出现发热，术后1例出现严重出血，未出现集合系统撕裂或穿孔、胸膜、肠管及重要血管损伤。13例残余结石肾再次行该手术治疗，术后复查无结石残留；48例肾结石术后随访6～36个月未见结石复发。 结论 超声引导下PCNL联合输尿管镜治疗鹿角形肾结石安全有效，是其治疗理想的选择。 　　[关键词] 超声引导；经皮肾镜取石术；输尿管镜；肾结石 　　[中图分类号] R699.2 [文献标识码] B [文章编号] 1673-9701（2015）22-0043-04 　　Efficacy of percutaneous nephrolithotomy combined with ureteroscopy guided by ultrasound in treatment of renal staghorn calculi 　　WANG Zanli1 WAN Fuqing1 FENG Ziyi2 ZHANG Xuechong2 　　1.Department of Urology， Zhoukou Central Hospital in Henan Province，Zhoukou 466000，China；2.Department of Urology， the First Affiliated Hospital of Zhengzhou University， Zhengzhou 450052，China 　　[Abstract] Objective To analyze the efficacy of percutaneous nephrolithotomy（PCNL） combined with ureteroscopy in treatment of renal staghorn calculi. Methods The data of 126 patients with renal staghorn calculi were retrospectively analyzed in the department of urinary surgery of our hospital. All patients were treated with PCNL combined with ureteroscopy. The related data of preoperative， intraoperative and postoperative were recorded and analyzed. Meanwhile， 89 patient with renal staghorn calculi treated by PCNL were selected as control group. The related parameters between two groups were compared. Results Compared with control group， the operation time， amount of bleeding and complication rate of PCNL combined with ureteroscopy group were lower（P0.05）， the stone clearance rate of PCNL combined with ureteroscopy group was higher（P0.05）. Among of PCNL combined with ureteroscopy group， 27 patients suffered from fever after surgery and 1 patient had hemorrhage. No renal collection system tear or perforation， damaged pleura， bowel and major vessel occurred. 15