肾脏多发或鹿角形结石多镜联合软镜碎石为主与硬镜碎石为主效果对比分析

Comparison and analysis of advantages and disadvantages of rigid and flexible ureteroscopy in treatment of renal multiple stones or staghorn calculi

摘要:

目的 对比分析多镜联合治疗肾脏多发或鹿角形结石中硬镜碎石为主和软镜碎石为主两种方式的优缺点。方法 2012年5月-2015年3月80例于该院住院的肾多发结石及鹿角状结石，随机分成两组，每组各40例，A组采用球囊扩张建立标准通道硬性肾镜碎石为主软镜辅助治疗方法，B组采用软镜碎石为主硬性肾镜辅助。对比分析两组患者临床资料，包括手术时间，出血量、结石清石率、住院时间和手术并发症发生情况等指标。结果 两组患者均Ⅰ期顺利实施手术，A组手术时间50.4 min，碎石时间25.6 min，B组手术时间90.3 min，碎石时间70.3 min，两组对比差异具有统计学意义。其余指标如出血量、结石清石率和并发症发生率等指标无明显变化。结论 在处理多发或鹿角形肾结石时，为了提高结石清石率，往往采用多镜联合的手术方式，而以硬镜为主的多镜联合手术时间明显较软镜为主的手术短，对于两种手术方式均熟练掌握的单位，应提倡前者。

Abstract:

Objective Comparing and analyzing the advantages and disadvantages of rigid and flexible ureteroscopy in treatment of renal multiple stones or staghorn calculi. Methods 80 patients of renal multiple stones and staghorn calculi from May 2012 to March 2015 were randomly divided into two groups, group A: flexible ureteroscopy as adjuvant technique of balloon dilatation to establish standards channel of rigid nephrolithotripsy, group B: rigid ureteroscopy as auxiliary to flexible ureteroscopy nephrolithotomy. Clinical data of the two groups including operative time, blood loss, stones clearance rate, hospital stay and other indicators of surgical complications were comparatively analyzed. Results TAll the patients received successful surgical procedures. The operation time in group A was 50.4 min, gravel time was 25.6 min, while operation time in group B was 90.3 min, gravel time was 70.3 min. The differences between the two groups was statistically significant. Other indicators such as blood loss, stones clearance rate, complication rate showed no statistical significance. Conclusion Combined techniques of rigid and flexible ureteroscopy was proceeded widely to improve stone clearance rate when dealing with multiple stones and staghorn calculi, while rigid-ureterscopy-based combination has advantages of shorter operation time and this combination should be promoted in top units.