| 摘要: |
| 目的:探讨及分析输尿管软镜联合体外冲击波碎石取石术与部分无管化经皮肾镜碎石取石术治疗复杂性鹿角形肾结石的临床效果。方法:选取2017 年12 月—2019 年7 月在陕西省榆林市第二医院诊治的复杂性鹿角形肾结石患者100 例，随机均分为两组，对照组采用部分无管化经皮肾镜取石术治疗，术后留置双J 管，不留肾造瘘管，对穿刺口皮肤直接缝合。治疗组采用输尿管软镜联合体外冲击碎石术治疗。术后分别对比分析两组患者的手术情况(术中出血、漏尿时间、住院时间、手术时间)，术后VAS 评分以及治疗总有效率等指标。结果:治疗组的术中出血、漏尿时间、住院时间均小于对照组，差异有统计学意义(P <0.05)，两组手术时间差异无统计学意义(P >0.05)，治疗组于手术后6 h、手术后1 d 的VAS 评分均明显低于对照组，差异有统计学意义(P <0.05)；出院当天，两组的VAS 评分差异无统计学意义(P ＞ 0.05)。治疗组患者结石治疗总有效率为96%(48/50)，明显高于对照组的76%(38/50)，差异有统计学意义(P <0.05)。结论:对于复杂性鹿角形肾结石患者，因根据患者全身情况，结石的位置、大小、数量，以及辅助检查的情况进行综合评估，选择合适的手术方式，当患者能够同时采用两种手术并且都能达到预期治疗效果时，建议选择输尿管软镜联合体外冲击波取石术。 |
| 关键词: 复杂性鹿角形肾结石 输尿管软镜 体外冲击波碎石术 无管化经皮肾镜取石术 |
| DOI：10.3969/j.issn.1007-6948.2020.06.024 |
| 投稿时间：2019-12-27 |
| 基金项目: |
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| Comparative Analysis of the Efficacy of Ureteroscope Combined with Extracorporeal Shock Wave Stone Removal and Partial Tubeless Percutaneous Nephrolithotomy for Complex Staghorn Calculi |
| GAO Fei,ZHANG He,XU Ping |
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| Abstract: |
| Objective To explore and analyze the efficacy and clinical significance of ureteroscopy combined with extracorporeal shock wave debridement and partial tubeless percutaneous nephrolithotomy for complex staghorn calculi. Methods 100 patients with complex staghorn calculi who were diagnosed in our hospital from December 2017 to July 2019 and who met the criteria for selection were randomly selected and divided into two groups. Reference group: partial tubeless percutaneous nephrolithotomy was performed. After the operation, the double J tube was placed, and the renal fistula was not left. The puncture of the skin was directly sutured.Treatment group: ureteroscopy combined with extracorporeal impact lithotripsy. Postoperative analysis of the two groups of patients with surgery, postoperative VAS scores and total effective rate of treatment. Results Compared with the reference group, the operation was significantly better than the reference group, and the difference was statistically significant (P <0.05). The VAS score was significantly lower than the reference group at 6h after surgery and on the first day after surgery. The difference was statistically significant (P <0.05).The total effective rate of stone treatment was significantly higher than that of the reference group, and the difference was statistically significant (P <0.05). Conclusion For patients with complex staghorn kidney stones, based on the patient’s general condition, the location, size, number of stones and the status of the auxiliary examination,comprehensive evaluation were performed, and the appropriate surgical method can be selected. When the treatment effect is expected, according to the results of this study, it is recommended to chooseflexible ureteroscopy combined with extracorporeal shock wave stone removal. |
| Key words: Complex staghornrenal calculi flexible ureteroscopy extracorporeal shock wave lithotripsy tubeless percutaneous nephrolithotomy |
