斜仰截石位双镜联合治疗复杂性肾结石疗效分析

肖峰; 陈方敏; 皮生明; 徐宗华; 穆毅; 石家齐

doi:10.13201/j.issn.1001-1420.2020.04.010

斜仰截石位双镜联合治疗复杂性肾结石疗效分析

- 1. 贵阳市第六医院泌尿外科(贵阳, 550006);
- 2. 天津第三中心医院泌尿外科;
- 3. 贵州医科大学附院泌尿外科

详细信息

通讯作者: 肖峰,E-mail:287505951@qq.com

中图分类号: R692.4

收稿日期: 2019-08-02

Therapeutic effect analysis of percutaneous nephrolithotomy combined with flexible ureteroscopy for complex nephrolithiasis in oblique supine lithotomy position

- 1. Department of Urology, Guiyang Sixth Hospital, Guiyang, 550006, China;
- 2. Department of Urology, Tianjin Third Central Hospital;
- 3. Department of Urology, Affiliated Hospital of Guizhou Medical University

More Information

Corresponding author: XIAO Feng, E-mail: 287505951@qq.com

Received Date: 02 August 2019

摘要

摘要: 目的:探索斜仰截石位双镜联合治疗复杂性肾结石疗效。方法:取我院于2017年8月~2018年8月72例复杂性肾结石进行随机分成两组,每组36例。一组采取斜仰截石位双镜联合处理结石作为观察组,即在全麻或连硬外麻醉下,采取斜仰卧位,同时在两套监视系统及碎石设备下行经皮肾镜及逆行输尿管软镜碎石术,另一组仅行经皮肾镜碎石术作对照组,比较两组手术方式结石清除率,术中出血量、手术时间、住院时间、并发症发生率。结果:72例手术均顺利完成。对比观察组与对照组:结石一期清除率[88.9%(33/36)vs.66.7%(24/36)P<0.05],术中出血量[(98.4±8.5)mL vs.(156.7±6.6)mL,P<0.05],手术时间[(86.5±11.0)min vs.(112.4±10.7)min,P<0.05],住院时间[(7.2±1.4)d vs.(7.5±1.8),P>0.05],并发症发生率[22.2%(8/36)vs.58.3%(21/36),P<0.05]。观察组住院时间较对照组差异无统计学意义,一期结石清除率较对照组高,出血少,并发症发生率低。结论:斜仰截石位双镜联合治疗复杂性肾结石具有清石率高,出血少,并发症少等优势,值得推广应用。
- 经皮肾镜 /
- 输尿管软镜 /
- 斜仰卧位 /
- 复杂性肾结石
Abstract: Objective: To evaluate the therapeutic effect of percutaneous nephrolithotomy(PCNL) combined with flexible ureteroscopy for complex nephrolithiasis in oblique supine lithotomy position. Method: A total of 72 cases of complex nephrolithiasis hospitalized from August 2017 to August 2018 were randomly and averagely divided into observation group and control group. Patients of observation group were treated by PCNL combined with flexible ureteroscopic lithotripsy in oblique supine lithotomy position. Two groups of patients were all placed in the oblique supine lithotomy position under tracheal intubation general anesthesia or continuous combined spinal-epidural anesthesia. Two groups of surgical staffs operated PCNL and ureteroscopic lithotripsy respectively under supervisions of two monitors at the same time. Patients of control group were only given PCNL. The stone clearance rate after one-stage operation, intraoperative bleeding volume, operation time, hospital stay and complication rate were compered between the two groups. Result: The surgery was finished smoothly in all the 72 cases. The stone clearance rate after one-stage operation in the observation group was significantly higher than that in the control group[88.9%(33/36) vs. 66.7%(24/36) P<0.05], and intraoperative bleeding volume in the observation group was significantly less than that in the control group[(98.4±8.5) ml vs.(156.7±6.6) ml, P<0.05]. The operation time in the observation group was significantly shorter than that in the control group [(86.5 ±11.0) min vs.(112.4±10.7) min, P<0.05], and the complication rate in the observation group was significantly lower than that in the control group[22.2%(8/36) vs. 58.3%(21/36), P<0.05]. However, there was no significant difference in hospital stay between two groups [(7.2±1.4) d vs.(7.5±1.8)d P> 0.05].Conclusion: PCNL combined with flexible ureteroscopy for complex nephrolithiasis in oblique supine lithotomy position has distinct effects including high stone clearance rate, little intraoperative bleeding volume and low complication rate, so it is worthy of clinical application.
- percutaneous nephroscope /
- flexible ureteroscope /
- oblique supine position /
- complex nephrolithiasis

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