Ⅰ期单通道经皮肾镜联合经尿道输尿管软镜治疗鹿角型肾结石的疗效

Clinical Effect of First-stage Single-channel Percutaneous Nephroscope Combined with Soft Transurethral Ureteroscope for the Treatment of Antler-type Renal Calculi

【目的】探讨Ⅰ期单通道经皮肾镜联合经尿道输尿管软镜治疗鹿角型肾结石的临床疗效。【方法】186例鹿角型肾结石患者随机分为两组，对照组采用传统的经皮肾镜技术，观察组采用Ⅰ期单通道经皮肾镜联合经尿道输尿管软镜技术治疗鹿角型肾结石。比较两组患者手术情况，结石清除率，术后肾血管超选择介入栓塞率。【结果】观察组结石清除率为97．8％（91／93），高于对照组的84．9％（79／93），且差异有显著性（F〈0.05）；观察组术后肾血管超选择介入栓塞率为2．15％（2／93），明显低于对照组的6．45％（6／93）（P〈0．05）。观察组手术时间，术中出血量，术后住院时间均显著少于对照组，且两组比较差异有显著性（P＜0．05）。【结论】Ⅰ期单通道经皮肾镜联合经尿道输尿管软镜技术治疗鹿角型肾结石具有结石清除率高，出血少，术后住院时间短等优点，值得临床推广。

[Objective]To explore the clinical curative effect of first-stage single-channel percutaneous nephroscope（PCNL） combined with soft transurethral ureteroscope for the treatment of antler-type renal calculi. [Methods]A total of 186 patients with antler-type renal calculi were randomly divided into two groups, with 93 cases each. Patients in the control group received traditional PCNL while patients in the observation group received first- stage single-channel PCNL combined with soft transurethral ureteroscope treatment. The operation status, the rate of calculi clearance, and the rate of postoperative renal vascular superselective embolization after surgery were compared between the two groups.[Results]The rate of calculi clearance was 980% （91/93） in the observation group, which was higher than in control group, which was 85% （79/93）, and the difference was statistically sig- nificant（ P （0.05）. The rate of postoperative renal -vascular superselective embolization was 2.15%（2/93） in the observation group, which was significant lower than that in control group, which was 6.450.% （6/93）（ P 〈0.05）. The operation time, the amount of the bleeding during operation and the time of hospitalization after operation were significant less in the observation group were than in the control group. The difference between the two groups was statistically significant（ P〈0.05）. [Conclusion]First-stage single-channel PCNL combined with soft transurethral ureteroscopy for the treatment of antler-type renal calculi has the advantage of high calculi clearance rate, less bleeding, and a shorter hospitalization after operation.It was worthy of clinical application.