斜仰卧-截石位双镜联合治疗复杂性肾结石的临床研究

招云亮; 王跃强; 张贵福; 高媛; 田雨; 马真; 杨智明; 黄曦; 卫娜; 杨剑兵; 杨龙雨禾

doi:10.13201/j.issn.1001-1420.2018.08.015

斜仰卧-截石位双镜联合治疗复杂性肾结石的临床研究

- 1. 红河州第一人民医院泌尿外科(云南蒙自, 661199);
- 2. 红河州第一人民医院输血科

详细信息

通讯作者: 招云亮,E-mail:106296182@qq.com

中图分类号: R699.4

收稿日期: 2017-06-06

Clinical study on combined endoscopy in oblique supine lithotomy position in treatment of complex renal calculi

- 1. Department of Urology, First People's Hospital of Honghe, Mengzi, Yunnan, 661199, China;
- 2. Department of Blood Transfusion, First People's Hospital of Honghe

More Information

Corresponding author: ZHAO Yunliang, E-mail: 106296182@qq.com

Received Date: 06 June 2017

摘要

摘要: 目的:研究斜仰卧-截石位双镜联合(肾镜联合顺-逆行输尿管软镜)治疗复杂性肾结石的疗效和安全性。方法:回顾性分析我院使用斜仰卧-截石位双镜联合治疗的76例复杂性肾结石患者资料,观察碎石、取石效果。结果:69例患者一期手术中双镜联合治疗肾结石(69例均使用顺行输尿管软镜碎石,其中23例顺行输尿管软镜碎石后同期逆行输尿管软镜治疗残留结石),7例二期手术中双镜联合治疗结石。一期手术时间65¹33min,平均(95.66±15.21) min,结石清除率为90.7%(69/76);二期手术时间55~106min,平均(73.26±11.33) min,结石清除率96.1%(73/76)。3例患者二期手术后仍有残留结石,术后1个月行体外冲击波碎石术(ESWL)治疗,1例结石完全排出,2例残留结石直径大小0.6⁰.9cm。结论:斜仰卧-截石位双镜联合治疗复杂性肾结石安全、迅速,一期手术结石清除率高,患者术后恢复快,是一种安全有效的治疗复杂性肾结石的方法。
- 斜仰卧-截石位 /
- 复杂性肾结石 /
- 经皮肾镜 /
- 输尿管软镜
Abstract: Objective:To investigate the safety and effect of combined endoscopy (standard-access percutaneous nephrolithotomy in oblique supine lithotomy position combined with prograde or retrograde flexible ureteroscopy) in treatment of complex renal calculi.Method:We observed the curative effect from retrospective analysis data of 76 patients with complex renal calculi in our department who were treated by oblique supine combined endoscopy.Result:Sixty-nine cases treated with PCNL combined with prograde flexible ureteroscopy in first-stage operation, including 23 cases with retrograde flexible ureteroscopy at the same time.Seven cases treated with PCNL combined with flexible ureteroscopy in second-stage operation.The time of first-stage operation ranged from65 to 133 min (average, 95.66±15.21 min), stone clearance rate was 90.7% (69/76), The time of second-stage was from 55 to 106 min (average, 73.26±11.33 min), stone clearance rate was 96.1% (73/76).Three cases had remained stone after second-stage operation.Residual calculus of one case was removed completely by ESWL one month later, and the diameter of residual calculus of the two cases was 0.6-0.9 cm.Conclusion:Combined endoscopy in oblique supine lithotomy position is a safe and effective operation method with high stone clearance rate and quick recovery for complex renal calculi.
- oblique supine lithotomy position /
- complex renal calculi /
- percutaneous nephrolithotomy /
- flexible ureteroscopy

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参考文献(11)

[1]	陈康宁, 王振显, 王刚, 等.微造瘘经皮肾镜大功率钬激光碎石术治疗复杂性肾结石[J].中国微创外科杂志, 2011, 11 (11):992-994.
[2]	Pearle M S, Goldfarb D S, Assimos D G, et al.Medical management of kidney stones:AUA Guideline[J].J Urol, 2014, 192 (2):316-324.
[3]	Ganpule A P, Shah D H, Desai M R.Postpercutaneous nephrolithotomy bleeding:aetiology and management[J].Curr Opin Urol, 2014, 24 (2):189-194.
[4]	黄来剑, 李剑, 李林锦, 等.组合式软硬镜联合肾盂内压监测治疗输尿管上段结石的应用价值[J].临床泌尿外科杂志, 2016, 31 (7):616-618.
[5]	Hussain M, Archer P, Penev B, et al.Redefining the limits of flexible ureterorenoscopy[J].J Endourol, 2010, 25 (1);45-49.
[6]	高小峰, 李凌.输尿管软镜在肾结石治疗中的应用[J].现代泌尿外科杂志, 2011, 16 (5):387-388.
[7]	程跃, 严泽军, 马建伟, 等.组合式输尿管软镜联合钬激光治疗肾结石46例报告[J].中华泌尿外科杂志, 2012, 33 (1):29-31.
[8]	Takazawa R, Kitayama S, Tsujii T, et al.successful outcome of ureteroscopy with holmium laser lithotripsy for renal stones 2cm or greater[J].Int J Urol, 2012, 19 (3):264-267.
[9]	郭峰, 高兴华, 张龙洋.单通道微创经皮肾镜联合输尿管软镜治疗复杂性肾结石疗效观察[J].现代泌尿外科杂志, 2015, 20 (7):472-474.
[10]	桂志明, 苏劲, 柳健军, 等.输尿管软镜钬激光碎石术与经皮肾镜取石术治疗输尿管上段大结石的疗效比较[J].临床泌尿外科杂志, 2017, 32 (1):61-64.
[11]	徐刚, 虞力航, 周毅.单通道经皮肾镜联合输尿管软镜碎石术治疗复杂性肾结石的临床研究[J].中国内镜杂志, 2016, 22 (15):107-109.