完全俯卧位下经皮肾镜联合逆行输尿管软镜一期治疗复杂性肾结石的临床研究

Treatment of complex renal calculi by one-stage percutaneous nephoscopy combined with retrograde flexi-ble ureteroscope under complete prone position

目的目前经皮肾镜联合逆行输尿管软镜处理肾内复杂结石较少应用完全俯卧位。文中旨在探讨在完全俯卧位即分腿折刀前倾俯卧位下,进行经皮肾镜联合逆行输尿管软镜一期治疗复杂性肾结石的体位特点、安全性和有效性。方法回顾性分析2016年3月至2017年10月江苏省中医院泌尿外科23例复杂性肾结石患者的临床资料。患者采用完全俯卧位,经皮肾镜联合逆行输尿管软镜一期治疗复杂性肾结石,分析其安全性及有效性。结果患者均顺利完成手术,手术时间为(85.5±22.7)min。术后血红蛋白下降了(12±4.5)g/L,差异有统计学意义(P=0.028),所有患者术后均未输血。Clavien分级:Ⅰ级2例,Ⅱ级1例,无Ⅲ级或以上并发情况。术后结石清除率91.3%。结论完全俯卧位下行经皮肾镜联合逆行输尿管软镜一期治疗复杂性肾结石,是保证肾内大负荷多盏结石双镜联合手术安全有效的体位。

Objective To evaluate the safety, effectivenessand position characteristics of treatment of complex renal calculi by percutaneous nephoscopy combined with retrograde flexible ureteroscope under complete prone position,that is,folding knife forward prone position with split legs. Methods We retrospectively analyzed the clinical data of 23 patients with complex renal calculi in the Department of Urology, Jiangsu Provincial Hospital of Traditional Chinese Medicine from March 2016 to October 2017. The patients were treated by percutaneous nephoscopy combined with retrograde flexible ureteroscopy under complete prone position, and its safety and effectiveness were analyzed. " Results All 23 operations were successfully completed. The operation time was(85.5±22.7)min. Postoperative hemoglobin decreased by(12±4.5)g/Land the difference was statistically significant(P=0.028). No blood transfusion was found in all patients. Clavien classification: 2 cases of grade I, 1 case of grade II, no case of grade III or above. The stone clearance rate was 91.30%. Conclusion Percutaneous nephoscopy combined with retrograde flexible ureteroscopy in the complete prone position for the primary treatment of complex renal calculiis safe and effective.