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

Single-channel PCNL combined with flexible ureteroscropy in treatment of complex renal calculi

摘要:

目的 探讨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疗效，对其安全性、高效性及可行性进行评估。方法   回顾性研究2014年8月－2015年10月因复  杂性肾结石在该院行经皮肾镜联合输尿管软镜下碎石治疗的21例患者，其中男12例，女9例，平均年龄48.2岁，多发性结石13例，鹿角形结石8例。结果   所有患者均采用单通道碎石，1例因术中出血、2例因结石较大改行二期碎石术，余18例患者均一期成功处理结石。平均手术时间（106.0±15.0）min，一期结石清除率85.7%（18/21）。术中未出现大出血、尿源性脓毒血症和气胸等严重并发症。结论   经皮肾镜联合输尿管软镜治疗复杂性肾结石是安全有效的，是单一经皮肾镜治疗复杂性肾结石的有效补充。

Abstract:

Objectives To investigate the effects of single-channel percutaneous nephrolithotomy (PCNL) combined with flexible ureteroscropy in treatment of complex renal calculi, and to evaluate the safety, efficiency and feasibility. Methods The retrospective study included 21 patients with complex renal calculi, who were treated by single-channel PCNL combined with flexible ureteroscopy from August 2014 to October 2015. The mean age of patients was 48.2; 13 patients with multiple calculi, and 8 patients with staghorn calculi. Results All the patients were adopted single channel of lithotripsy. 18 cases were performed by one stage operation, except 1 case due to trans-operative bleeding and other 2 cases due to large stone for two times operation. The mean operation time was (106.0 ± 15.0) min, the stone clearance of one-stage operation was 85.7 % (18/21). No intraoperative hemorrhage, urine-induced sepsis, pneumothorax and any other severe complication occurred during the operation. Conclusion Single-channel PCNL combined with flexible ureteroscropy in treatment of complex renal calculi is safe and efficiency. It can be the supplementary way for PCNL treating complex renal calculi.