复杂鹿角型肾结石采用斜仰卧截石位经皮肾镜联用逆行输尿管软镜的效果评价

Effect Evaluation of Percutaneous Nephroscopy Combined With Retrograde Ureteroscopy In Oblique Supine Lithotomy Position For Complex Staghorn Renal Calculi

目的评价复杂鹿角型肾结石采用斜仰卧截石位经皮肾镜联用逆行输尿管软镜的效果。方法选取我院在2016年3月-2018年2月收治的166例完全性鹿角形肾结石患者作为研究对象,对照组采用俯卧位标准通道PCNL术治疗。研究组给予斜仰卧截石位经皮肾镜联用逆行输尿管软镜进行治疗。对比两组手术时间、术后住院时间、首日清石率、2W清石率、血红蛋白下降幅度、输血率、尿路感染率、术后血清降钙素原(PCT)水平。结果两组手术时间无显著差异(P>0.05),研究组术后住院时间、首日清石率及2W清石率显著优于对照组(P<0.05)。研究组术后血红蛋白下降幅度、输血率、尿路感染率及术后PCT均显著优于对照组(P<0.05)。结论复杂鹿角型肾结石采用斜仰卧截石位经皮肾镜联用逆行输尿管软镜在不会显著增加手术复杂度的情况下可显著减轻外科创伤,促进结石清除,降低术后并发症发生风险。

Objective To evaluate effect of oblique supine lithotomy combined with retrograde ureteroscopy for complex staghorn renal calculi.Methods The paper chose 166 patients with complete staghorn kidney stones treated in our hospital from March 2016 to February 2018 as research objects.Control group was treated with prone standard channel PCNL,and study group with oblique supine lithotomy position percutaneous nephroscopy combined with retrograde ureteroscopy.Operation time,postoperative hospital stay,stone removal rate on the first day,stone removal rate at 2W,hemoglobin decline,blood transfusion rate,urinary tract infection rate and postoperative serum procalcitonin(PCT)level were compared between two groups.Results There was no significant difference in operation time between two groups(P>0.05).Postoperative hospital stay,stone removal rate on the first day and stone removal rate at 2W in study group was significantly better than control group,(P<0.05).Decrease of hemoglobin,blood transfusion rate,urinary tract infection rate and postoperative PCT in study group was significantly better than control group(P<0.05).Conclusion Percutaneous nephroscopy combined with retrograde ureteroscopy in oblique supine lithotomy position can reduce surgical trauma significantly,promote stone removal and reduce risk of postoperative complications for complex staghorn renal calculi without increasing operation complexity significantly.