单通道微创经皮肾镜联合输尿管软镜治疗复杂性肾结石临床效果探讨.docVIP

觀辯翹关雜尿爵镢杂往 2018-03-29 10:29:58中国现代医生2018年6期 沈在雄郑周达林海利许振强郑艺淑苏锦锋 ［摘耍］鬥的探討单通道微创经皮肾镜联合输鉍管软镜碎心取石术治疗复杂性肾结心的临床效 果及安全性。方法系统回顾性分析2014年1月?2017年6月我院收治的98例复杂性贤结石患者， 根据手术方式不同分组。研究组采用单通道微创经皮肾镜联合输尿管软镜(顺行和逆行，1期和2期) 碎石取石术治疗(42例)，对照组采用多通道微创经皮肾镜碎石取石术治疗(56例)，比较两组复 杂性肾结石的治疗效果(结石淸除率)、手术操作时间、术中总出血量、术后住院时间和并发症发牛. 情况。结果研宂组治疗复杂性肾结石术后3?5 d结石清除率与对照组比较，差好无统计学意义 (P0.05)；但研宄组术后3个月结石清除率明显高于对照组(P0.05)。研宄组手术操作时间长 于对照组，术中总出血景明显少于对照组(P0.05);两者术后住院吋间比较，差异无统计学意义 (P0.05)。两组大出血、术后发热、感染性休克、肾功能受损等并发症发生率相比较，研究组总的 并发症发生率低于对照组(P0.05)。结论单通道微创经皮肾镜联合输尿管软镜手术效果确切，其 安全性和有效性较高，值得推广应用。 ［关键词］单通道微创经皮肾镜；输尿管软镜；复杂性肾结石 ［ ］R699 ［ ］B ［ 1673-9701 (2018) 06-0038-04 ［Abstract］ Objective To investigate the clinical effect and safety of single-channel minimally invasive percutaneous nephrolithotomy combined with ureteroscopic lithotripsy in the treatment of complex renal calculi. Methods A retrospective analysis of 98 cases of complicated renal calculi admitted to our hospital from January 2014 to June 2017 was performed. The patients were divided into different groups according to different surgical methods. The experimental group was treated with single-channel minimally invasive percutaneous nephrolithotomy combined with ureteroscope (prograde and retrograde, stage I and stage 2) lithotripsy (42 cases) . The control group was treated with minimally invasive percutaneous nephrolithotomy lithotripsy (56 cases) . Complicated renal calculi (calculi removal rate) , operation time, total intraoperative blood loss volume， postoperative hospitalization time and complications were compared between the two groups. Results There was no significant difference in calculi removal rate between the study group and the control group in 3-5 days after the treatment of complex nephrolithiasis (P0.05) ; however, the calculi removal rate in the experimental group at 3 months after operation was significantly higher than that in the control group (P0.05) . The operation time of the experimental group was longer than that of the control group， and t