摘要
目的分析输尿管软镜碎石术联合微创经皮肾镜取石术治疗鹿角状结石的临床疗效。方法部分鹿角状肾结石患者84例,随机分为A、B两组,每组各42例。A组患者以俯卧位接受常规微创经皮肾镜取石术,B组患者以改良Valdivia体位接受输尿管软镜碎石术联合微创经皮肾镜取石术。记录两组患者术后的无石率及并发症情况。结果 B组和A组患者的手术时间分别为(106.44±18.46)分钟和(83.69±10.29)分钟,差异有统计学意义(P<0.05)。B组患者的首次碎石术后无石率为85.71%,出血量为(70.02±9.15)ml,A组患者分别为59.52%和(87.41±9.89)ml,两组比较,差异有统计学意义,(P<0.05)。两组患者术后的常见并发症均为发热(体温>38.5℃),但差异无显著统计学意义(P>0.05)。结论与单纯微创经皮肾镜取石术比较,输尿管软镜碎石术联合微创经皮肾镜取石术治疗部分鹿角状肾结石手术时间更短,出血量更少,首次碎石术后无石率高,且未见明显并发症。
Objective To investigate the clinical efficacy of flexible ureteroscopic lithotripsy combined with percutaneous nephrolithotomy treating for partial staghorn calculi.Methods 84 patients diagnosed as partial staghorn calculi in our hospital were randomly divided into group A and B with each group 42 patients.Patients in group A received the conventional minimally invasive percutaneous nephrolithotomy in the prone position,and patients in group B received the percutaneous nephrolithotomy combined with flexible ureteroscopic lithotripsy in the modified Valdivia position.The post-operative stone free rate and complications were recorded.Results The surgery time in group B was longer than that in group A [（106.44±18.46）min vs（83.69±10.29）min],with statistically significant difference（P〈0.05）.However,the first stone free rate in group B was higher than that in group A（85.71% vs 59.52%,P〈0.05）,and the blood loss in group B was lower than that in group A [（70.02±9.15）ml vs（87.41±9.89）ml,P〈0.05].The common complication of patients in two groups was fever（temperature 〉38.5℃）,but there was no notably difference between the two group（P〉0.05）.Conclusion Compared with the regular percutaneous nephrolithotomy,flexible ureteroscopic lithotripsy combined with percutaneous nephrolithotomy treating partial staghorn calculi has the shorter operation time,the less blood volume and the higher first stone free rate.Furthermore,the combination method did not significantly increasing the incidence of patient＇s complication.
出处
《临床外科杂志》
2017年第4期304-306,共3页
Journal of Clinical Surgery
关键词
输尿管软镜碎石术
微创经皮肾镜取石术
鹿角状肾结石
无石率
flexible ureteroscopic lithotripsy
percutaneous nephrolithotomy
partial staghorn calculi
stone free rate
