截石斜仰卧位输尿管镜、肾镜双镜联合治疗上尿路结石

Combined treatment by ureteroscope and nephroscope by lithotomy oblique supine position for upper urinary tract calculi

目的探究截石斜仰卧位输尿管镜、肾镜双镜联合治疗上尿路结石的临床疗效。方法 158例上尿路结石患者,随机分为观察组与对照组,各79例。对照组予以常规俯卧位下输尿管镜、肾镜双镜治疗,观察组予以截石斜仰卧位下输尿管镜、肾镜双镜联合治疗,观察对比两组临床疗效及安全性。结果两组均顺利完成手术,观察组手术时间、术中出血量、术后住院时间及一期清石率均明显优于对照组,差异具有统计学意义(P<0.05)。观察组术后并发症发生率为6.3%(5/79),明显低于对照组的20.3%(16/79),差异具有统计学意义(P<0.05)。结论截石斜仰卧位下输尿管镜、肾镜联合治疗上尿路结石可提高一期清石率,且更为安全可行,值得临床应用。

Objective To investigate clinical effect by combined treatment by ureteroscope and nephroscope by lithotomy oblique supine position for upper urinary tract calculi. Methods A total of 158 patients with upper urinary tract calculi were randomly divided into observation group and control group, with 79 cases in each group. The control group received conventional combined treatment by ureteroscope and nephroscope by prone position, and the observation group received combined treatment by ureteroscope and nephroscope by lithotomy oblique supine position. Clinical effects and safety were observed and compared between the two groups. Results Both groups received successful operation, and the observation group had obviously better operation time, intraoperative bleeding volume, postoperative hospital stay time, and stage one calculi clearance rate than the control group. The difference between the two groups had statistical significance （P〈0.05）. The observation group had much lower incidence of postoperative complications as 6.3% （5/79） than 20.3% （16/79） in the control group, and their difference had statistical significance （P〈0.05）. Conclusion Combined treatment by ureteroscope and nephroscope by lithotomy oblique supine position for upper urinary tract calculi can improve stage one calculi clearance rate, along with high safety and feasibility. This method is worth clinical application.