单通道经皮肾镜联合输尿管软镜治疗复杂性肾结石临床研究

Clinical study of single channel percutaneous nephrolithoscope combined with flexible ureteroscope in the treatment of complicated renal calculi

目的探讨单通道经皮肾镜(PCNL)联合输尿管软镜(RIRS)治疗复杂性肾结石的临床效果。方法选取2019年1月~2020年5月宜春市人民医院收治的120例复杂性肾结石患者为研究对象,按照随机数字表法分为联合组、单通道PCNL组和多通道PCNL组,每组各40例。联合组采用单通道PCNL联合RIRS治疗,单通道PCNL组采用单通道PCNL治疗,多通道PCNL组采用多通道PCNL治疗。比较三组的临床指标、结石清除率及并发症发生情况。结果联合组手术时间长于单通道PCNL组、多通道PCNL组,术中出血量少于多通道PCNL组,住院时间短于单通道PCNL组、多通道PCNL组,差异有统计学意义(P<0.05);联合组结石清除率高于单通道PCNL组,差异有统计学意义(P<0.05),而与多通道PCNL组比较,差异无统计学意义(P>0.05);三组并发症总发生率比较,差异无统计学意义(P>0.05)。结论复杂性肾结石患者采用单通道PCNL联合RIRS治疗安全可行,具有结石清除率高、损伤小及并发症少的优点,能够促进患者术后早期恢复,可作为复杂性肾结石治疗优选方法于临床推广。

Objective To investigate the clinical value of single channel percutaneous nephrolithotomy(PCNL)combined with flexible ureteroscopy(RIRS)in the treatment of complex renal calculi.Methods A total of 120 patients with complex renal calculi admitted to Yichun People′s Hospital from January 2019 to May 2020 were selected as the research subjects.According to random number table method,they were divided into combined group,single-channel PCNL group and multi-channel PCNL group,with 40 cases in each group.The combined group was treated with single-channel PCNL combined with RIRS,the single-channel PCNL group was treated with single-channel PCNL,and the multi-channel PCNL group was treated with multi-channel PCNL.Clinical indicators,stone clearance rate and complications were compared among the three groups.Results The operation time of the combined group was longer than the single-channel PCNL group and the multi-channel PCNL group;the intraoperative blood loss was less than the multi-channel PCNL group,the hospital stay was shorter than the single-channel PCNL group and the multi-channel PCNL group,the differences were statistically significant(P<0.05).The stone clearance rate of the combined group was higher than that of the single-channel PCNL group,and the difference was statistically significant(P<0.05),while there was no statistically significant difference between the combined group and the multi-channel PCNL group(P>0.05).There was no statistical significance in the total incidence of complications among the three groups(P>0.05).Conclusion Single channel PCNL combined with RIRS is safe and feasible in the treatment of patients with complex renal stones,which has the advantages of high stone clearance rate,small injury and few complications,and can promote the early postoperative recovery of patients.Therefore,it can be used as the preferred method for the treatment of complex kidney stones in clinical promotion.