单通道微创经皮肾镜钬激光碎石术联合输尿管软镜钬激光碎石术治疗复杂性肾结石的临床价值研究

Clinical value of single-channel minimally invasive percutaneous nephrolithotomy combined with flexible ureteroscope holmium laser lithotripsy in the treatment of complex renal calculi

目的:探讨单通道微创经皮肾镜钬激光碎石术联合输尿管软镜钬激光碎石术治疗复杂性肾结石的疗效。方法:136例复杂性肾结石患者按随机数字表法均分为A、B两组。A组采用单通道微创经皮肾镜钬激光碎石术联合输尿管软镜钬激光碎石术,B组采用经皮肾镜钬激光碎石术,比较两组患者的疗效。结果:A组的手术时间为(93.79±17.37)min,长于B组(P<0.05),一期结石清除率及二期结石清除率均高于B组(P<0.05)。A组未出现大出血、输尿管断裂等严重并发症。B组术后1例患者出现大出血,给予输血、止血治疗后缓解。结论:单通道微创经皮肾镜钬激光碎石术联合输尿管软镜钬激光碎石术可提高复杂性肾结石的结石清除效果与安全性。

Objective:To investigate the efficacy of single-channel minimally invasive percutaneous nephrolithotomy holmium laser lithotripsy combined with ureteroscope holmium laser lithotripsy in the treatment of complicated renal calculi.Methods:136 patients with complex renal calculi were randomly divided into group A and group B with68 cases in each.In group A,holmium laser lithotripsy with single channel minimally invasive percutaneous nephroscope was applied in combination with holmium laser lithotripsy with flexible ureteroscope.In group B,holmium laser lithotripsy with percutaneous nephroscope was performed.The efficacy and safety of the two groups were compared.Results:The operation time in group A was(93.79±17.37)min,which was significantly longer than that in group B(P<0.05).No serious complications such as massive hemorrhage and ureteral rupture occurred in group A.One patient in group B had massive hemorrhage,which was relieved after blood transfusion and hemostasis.Conclusion:Single channel minimally invasive percutaneous holmium laser lithotripsy combined with ureteroscope holmium laser lithotripsy can improve the stone removal effect and safety of complex renal stones.