单通道经皮肾镜取石联合软镜取石术与多通道经皮肾取石治疗鹿角型肾结石的疗效比较-外科学(泌尿外科)专业论文.docx

广州医科大学硕士学位论文 广州医科大学硕士学位论文 单通道 PCNL 联合软镜取石与多通道 PCNL 治疗鹿角型结石的疗效比较 PAGE PAGE 10 single-tract percutaneous nephrolithotomy combined with flexible ureteroscopy VS multiple tracts percutaneous nephrolithotomy in the management of staghorn calculi Major: Urology Postgraduate: Feng Zhang Tutor: Prof. Xun Li Abstract PURPOSE: Retrospective to analyze efficacy, safety staged single-tract minimally invasive percutaneous nephrolithotomy combined with flexible ureteroscopy VS multiple tracts percutaneous nephrolithotomy ( PCNL) stage I in the management of staghorn calculi. PATIENTS AND METHODS: The records of 99 patients with staghorn calculi(41 [41%] had complete and 58 [59%] had partial) in our center from April 2010 to October 2012 were reviewed retrospectively. A total of 37 (37%) patients were managed by single-tract MPC NL through a F20 tract and had most of the intrarenal calculi removed at the first stage. The second stage of retrograde flexible ureteroscopy was performed three to five days later after the drainage was cleared. (group A) meanwhile, multiple accesses percutaneous nephrolithotomy ( PCNL) stage I were necessary in 62 (63%) patients (group B). Both groups were compared in terms of perioperative findings and postoperative outcomes. Patients and stone- related factors affecting the efficacy, safety were analyzed. RESULTS: Patients of group A is the ratio of isolated kidney was higher than group B (P = 0.01). the two groups of patients in age, gender, Stone of location and size, infection, hydronephrosis and renal function on preoperative were not statistically significant. Patients in the average hospital stay, postoperative fever, average operation time and the number of operation, the average hospitalization expenses,and the mean changes in creatinine values were not statistically significant between the groups. In the average postoperative VAS pain score(P = 0.032), analgesic drug use(P = 0.032), renal hematoma(P = 0.01), nephrostomy time (P