摘要
目的比较多通道经皮肾镜(percutaneous nephrolithotomy,PNL)与单通道标准PNL联合输尿管软镜(flexible ureteroscopic lithotripsy,FURSL)治疗复杂性肾结石疗效与并发症。方法回顾性分析2012年1月至2017年12月收治的166例复杂性肾结石的临床资料及治疗方式。其中A组为多通道PNL组(43例);B组为单标准通道PNL联合顺行或者逆行一期FURSL组(57例);C组为单标准通道PNL联合顺行或者逆行二期FURSL组(66例)。比较3组患者的年龄、结石大小、手术时间、术后住院天数、清石率、术后血红蛋白下降值和并发症等。结果3组年龄分别为[(47.65±14.32)vs.(48.46±14.74)vs.(49.53±15.46)岁]、结石长径分别为[(3.78±1.22)vs.(3.85±1.04)vs.(3.95±1.19)cm]、并发症率分别为[(9.3%)vs.(8.8%)vs.(7.6%)],比较差异无统计学意义(均P>0.05)。术后住院天数分别为[(6.45±1.97)vs.(5.21±2.32)vs.(10.35±2.59)d]、术后总结石清除率分别为[(81.4%)vs.(71.9%)vs.(93.9%)],手术时间分别为[(76.51±21.68)vs.(98.87±26.34)vs.(128.48±30.13)min],术后血红蛋白下降值分别为[(16.48±8.34)vs.(11.82±4.65)vs.(12.75±4.62)g/L],比较差异有统计学意义(均P<0.05)。结论对于复杂性肾结石,临床上需要根据医疗设备、医生对手术技能的熟练程度以及患者的实际需求,选择个体化的手术方案。
Objective To compare the efficacy and complications of multi-channel percutaneous nephrolithotomy(PNL)and single-channel standard PNL combined with flexible ureteroscopic lithotripsy(FURSL)in the treatment of complex renal calculi.Methods The clinical data and treatment methods of 166 cases of complex renal calculi admitted from January 2012 to December 2017 were retrospectively analyzed.Group A was multichannel PNL group(43 cases);Group B was single standard channel PNL combined with antegrade or retrograde one-staged FURSL group(57 cases);Group C was single standard channel PNL combined with antegrade or retrograde two-staged FURSL group(66 cases).The patients′age,stone size,operation time,hospitalization days,stone clearance rate,hemoglobin decline and complications were compared among the three groups.Results The average age of the three groups were(47.65 ± 14.32)vs.(48.46 ± 14.74)vs.(49.53 ± 15.46)years old,the stone long diameters were(3.78 ± 1.22)vs.(3.85 ± 1.04)vs.(3.95 ± 1.19)cm,and the complication rates were(9.3%)vs.(8.8%)vs.(7.6%)respectively,in which there were no statistical difference.There were statistical differences in below index:the postoperative hospitalization days were(6.45 ± 1.97)vs.(5.21±2.32)vs.(10.35 ± 2.59)d,postoperative stone clearance rates were(81.4%)vs.(71.9%)vs.(93.9%),operative time was(76.51 ± 21.68)vs.(98.87 ± 26.34)vs.(128.48 ± 30.13)min,hemoglobin declined values were(16.48 ± 8.34)vs.(11.82 ± 4.65)vs.(12.75 ± 4.62)g/L respectively.Conclusion For complex renal calculi,individualized surgical procedures should be selected according to medical equipment,doctors′proficiency in surgical skills and patients′actual needs.
作者
柯坤彬
陈印
顾鹏
赵晖
刘孝东
张建华
KE Kunbin;CHEN Yin;GU Peng;ZHAO Hui;LIU Xiaodong;ZHANG Jianhua(Department of Urology,The First Affiliated Hospital of Kunming Medical University,Kunming 650032,China)
出处
《实用医学杂志》
CAS
北大核心
2019年第14期2230-2233,共4页
The Journal of Practical Medicine
基金
国家自然科学基金资助项目(编号:81802548,81860451)
云南省教育厅基金资助项目(编号:2018JS208)
关键词
经皮肾镜碎石
多镜联合
输尿管软镜碎石
复杂性肾结石
percutaneous nephrolithotomy
multi-endoscopy techniques
flexible ureteroscopic lithotripsy
complex renal calculi
