1.长沙市中心医院 泌尿外科，湖南 长沙 410004;2.中南大学湘雅医院 护理部， 湖南 长沙 410008
1.Department of Urology, Changsha Central Hospital, Changsha, Hunan 410004, China;2.Department of Nursing, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China
目的 探讨经皮肾镜联合电子肾盂镜或胆道镜与软镜处理鹿角形肾结石的安全性及有效性。方法 回顾性分析2013年12月－2018年12月该院203例4 cm内鹿角形肾结石患者的临床资料，包括电子肾盂镜或胆道镜协同经皮肾镜的双镜联合组（n = 122）和单纯输尿管软镜碎石取石术（RIRS）治疗组（n = 81）。统计两组患者年龄、性别、结石大小和体重指数（BMI）等基线数据，进而对组间围术期数据进行对比分析。结果 两组患者手术时间、并发症发生率和住院费用等比较，差异均无统计学意义（P > 0.05）。但两组患者一期结石清除率、住院时间和第三方患者满意度等方面比较，差异均有统计学意义（P < 0.05）。结论 双镜联合技术治疗4 cm内鹿角形肾结石具有结石一期清除率高和患者满意度高等特点，而RIRS则具有术后恢复快的优势。
Objective To investigate the clinical safety and efficacy of percutaneous nephrolithotomy combined with electronic pyeloscope or choledochoscopy and retrograde intrarenal surgery in treatment of staghorn calculi.Methods Retrospective analysis of clinical data of 203 patients with staghorn calculi within 4 cm from December 2013 to December 2018, including electronic pyeloscope or choledochoscopy combined with percutaneous nephrolithotomy group (n = 122) and simple retrograde intrarenal surgery group (n = 81). Baseline data such as age, gender, stone size, and BMI value of each group were counted, and the perioperative data of each group were compared.Results There were no statistically significant differences between the two groups, such as operative time, complication rate and hospitalization expenses. However, the difference was significant statistical between the two groups in first-stage stone clearance rate, hospitalization time and the third-party patient satisfaction.Conclusion The percutaneous nephrolithotomy combined with retrograde intrarenal surgery in treatment of staghorn calculi within 4 cm has the characteristics of high clearance rate of patients in the first stage and high patient satisfaction, retrograde intrarenal surgery have the advantage of quick recovery after surgery.