多镜联用治疗鹿角形肾结石的临床分析

The clinical analysis of multi-endoscopy lithotomy for patients with staghorn calculi

目的:探究单通道经皮肾镜与输尿管软镜联用(多镜联用,SPCNL/FU)治疗鹿角形肾结石(SC)的效果。方法:收集2014年4月-2019年6月收治的结石患者信息并根据患者意愿进行分组,将接受多通道经皮肾镜(MPCNL)患者纳入对照组,接受多镜联用者纳入观察组,其中MPCNL组30例,SPCNL/FU组28例,分析两种术式在手术时间、造瘘管留置时间、出血量及并发症发生率等方面的差异。结果:手术均顺利进行,其基线特征无显著差异(P>0.05)。与MPCNL相比,SCPNL/FU患者的血红蛋白减少量低[(27.07±10.65)g/L vs.(18.29±12.72)g/L],造瘘管留置时间短[(7.53±2.11)d vs.(6.25±1.67)d],术后住院时间减少(10.60±2.55)d vs.(8.71±2.26)d,均差异有统计学意义(P<0.05),其余指标无显著差异(P>0.05)。结论:与传统MPCNL相比,SPCNL/FU可减少术中出血,促进患者恢复,是一种优选的鹿角形肾结石处理方法。

Objective:To evaluate the efficacy of single-channel percutaneous nephrolithotomy combined with flexible ureteroscope(SPCNL/FU)in the treatment of staghorn calculi.Methods:The clinical data of patients with staghorn calculi were collected from April 2014 to June 2019.The patients treated with multi-channel percutaneous nephrolithotomy(MPCNL)served as control group(n=28),and those with SPCNL/FU were included in observation group(n=30).The differences in operation time,nephrostomy time,blood loss and complications between two groups were analyzed.Results:The MPCNL and SPCNL/FU operations were safely performed.There was no significant difference in the basic characteristics between two groups(P>0.05).Compared with control group,the hemoglobin reduction in observation group decreased from(27.07±10.65)to(18.29±12.72)g/L(P<0.05)the nephrostomy time shortened from(7.53±2.11)to(6.25±1.67)d(P<0.05),and hospitalization time reduced from(10.60±2.55)to(8.71±2.26)d(P<0.05).No significant difference was observed among other indexes(P>0.05).Conclusion:SPCNL/FU has many advantages in reducing blood loss and accelerating postoperative recovery,and can provide a promising way to treat staghorn calculi.