微通道经皮肾镜联合输尿管软镜钬激光碎石术与双通道经皮肾镜取石术治疗复杂性肾结石的疗效比较

席俊华; 张艳斌; 吴畏; 杨振兴; 井俊峰; 陈运; 倪大伟; 杨晓亮; 魏灿

doi:10.13201/j.issn.1001-1420.2019.10.015

微通道经皮肾镜联合输尿管软镜钬激光碎石术与双通道经皮肾镜取石术治疗复杂性肾结石的疗效比较

- 安徽医科大学附属合肥医院合肥市第二人民医院泌尿外科(合肥, 230000)
基金项目:
合肥市科技局“借转补”项目（编号YW201710120005）；合肥市卫计委应用医学项目（编号hwk2017yb005）

详细信息

通讯作者: 张艳斌,E-mail:doczyb@sina.com

中图分类号: R692.4

收稿日期: 2018-05-12

Comparison between minimally invasive percutaneous nephrolithotomy combined with flexible ureteroscope lithotripsy and double channel percutaneous nephrolithotomy in the treatment of complex renal calculi

- Department of Urology, Hefei Hospital Affiliated to Medical University of Anhui, Second People's Hospital of Hefei, Hefei, 230000, China

More Information

Corresponding author: ZHANG Yanbin, E-mail: doczyb@sina.com

Received Date: 12 May 2018

摘要

摘要: 目的：探讨截石-斜仰卧位微通道经皮肾镜取石术联合输尿管软镜钬激光碎石术（mini-ECIRS）和双通道经皮肾镜取石术（PCNL）治疗复杂性肾结石的疗效。方法：回顾性分析2014年1月~2018年1月我院收治的60例复杂性肾结石患者的临床资料及治疗效果。其中A组30例行mini-ECIRS，B组30例行双通道PCNL。比较两组患者的年龄、结石最大直径、术后血红蛋白（Hb）下降值、术后住院天数、结石清除率和并发症等。结果：所有手术均顺利完成，两组手术时间、术后Hb下降比较差异有统计学意义（P<0.05）；两组术后住院天数、结石清除率和并发症比较差异无统计学意义。结论：截石-斜仰卧位mini-ECIRS与双通道PCNL相比术中出血少，在处理复杂性肾结石上是安全、有效的。
- 经皮肾镜 /
- 输尿管软镜 /
- 复杂性肾结石
Abstract: Objective: To investigate the efficacy and safety of minimally invasive percutaneous nephrolithotomy combined with flexible ureteroscope lithotripsy and double channel percutaneous nephrolithotomy in the treatment of complex renal calculi. Method: The clinical data and therapeutic effects of 60 cases of complex kidney stones treated in our hospital from January 2014 to January 2018 were retrospectively analyzed. Group A(30 patients) underwent minimally invasive percutaneous nephrolithotomy combined with flexible ureteroscope lithotripsy and Group B(30 patients) underwent double channel percutaneous nephrolithotomy by holmium laser lithotripsy. The stone clearance rate, length of hospital stay, and complications were compared between two groups. Result: All operations were completed successfully. The difference of postoperative hemoglobin decrease and operation time between the two groups was statistically significant(P<0.05), but there was no statistical difference between the two groups in postoperative hospital stay, stone clearance or complications.Conclusion: Minimally invasive percutaneous nephrolithotomy combined with flexible ureteroscope lithotripsy under lithotomy and oblique supine position is superior to double channel percutaneous nephrolithotomy holmium laser lithotripsy because of its less intraoperative blood loss, so it's safe and effective in the treatment of complex kidney stones.
- percutaneous nephroscope /
- flexible ureteroscope /
- complex kidney calculi

HTML全文

参考文献(12)

[1]	Türk C, Knoll T, Ptrik A, et al.Guidelines on urolithiasis[J].Urology, 2015, 80(1):1-4.
[2]	Akman T, Sari E, Binbay M, et al.Comparison of outcomes after percutaneousnephrolithotomy of staghorn calculi in those with single and multiple accesses[J].J Endourol, 2010, 24(6):955-960.
[3]	徐鑫, 蒋召强, 刁统祥, 等.经皮肾镜取石术与输尿管软镜碎石术治疗肾结石的Meta分析[J].临床泌尿外科杂志, 2017, 32(5):44-48.
[4]	Rizvi S A H, Hussain M, Askari S H, et al.Surgical outcomes of percutaneous nephrolithotomy in 3402 patients and results of stone analysis in 1559 patients[J].BJU Int, 2017, 120(5).702-709.
[5]	Lai D, He Y, Dai Y, et al.Combined Minimally Invasive Percutaneous Nephrolithotomy and Retrograde Intrarenal Surgery for Staghorn Calculi in Patients with Solitary Kidney[J].PLoS One, 2012, 7(10):e48435-e48435.
[6]	Gorbachinsky I, Wood K, Colaco M, et al.Evaluation of Renal Function after Percutaneous Nephrolithotomy-Does the Number of Percutaneous Access Tracts Matter?[J].J Urol, 2016, 196(1):131-136.
[7]	Akman T, Binbay M, Sari E, et al.Factors affecting bleeding during percutaneous nephrolithotomy:single surgeon experience[J].J Endourol, 2011, 25(2):327-333.
[8]	Atis G, Culpan M, Pelit E S, et al.Comparison of Percutaneous Nephrolithotomy and Retrograde Intrarenal Surgery in Treating 20-40 mm Renal Stones[J].Urol J, 2017, 14(2):2995-2999.
[9]	Wen J, Xu G, Du C, et al.Minimally invasive percutaneous nephrolithotomy versus endoscopic combined intrarenal surgery with flexible ureteroscope for partial staghorn calculi:A randomised controlled trial[J].Int J Surg, 2016, 28:22-27.
[10]	Scoffone C M, Cracco C M.Invited review:the tale of ECIRS(Endoscopic Combined IntraRenal Surgery)in the Galdakao-modified supine Valdivia position[J].Urolithiasis, 2018, 46(1):115-123.
[11]	汪隆旺, 肖瑞海, 余义, 等.侧卧斜仰截石位单通道微创经皮肾镜联合输尿管软镜一期治疗复杂性肾结石的疗效观察[J].临床泌尿外科杂志, 2017, 32(6):19-22.
[12]	Zhu W, Liu Y, Liu L, et al.Minimally invasive versus standard percutaneous nephrolithotomy:a meta-analysis[J].Urolithiasis, 2015, 43(6):563-570.