肾镜联合输尿管软镜通过20F经皮肾单通道碎石取石一期治疗鹿角形肾结石的效果观察

Efficacy of nephroscope combined with flexible ureteroscope in staghorn renal calculi through 20F percutaneous renal single-channel lithotripsy

目的探究肾镜联合输尿管软镜通过20F经皮肾单通道碎石取石一期治疗鹿角形肾结石的效果。方法选取2018年2月至2019年2月本院收治的30例鹿角形肾结石患者,均行肾镜联合输尿管软镜通过20F经皮肾单通道碎石取石一期治疗,分析临床疗效。结果30例患者中,经下盏建立皮下肾通道29例(96.67%),一期结石清除26例(86.67%);手术时间60~121 min,平均(91.75±15.89)min;术中出血量45~90 mL,平均(68.83±5.57)mL;术后血红蛋白水平3.5~9.1 g/L,平均(5.87±1.24)g/L;术后住院时间4~10 d,平均(6.89±1.24)d;术后不良反应2例(6.67%),均表现为发热,无腹腔积液、肾脏穿孔等不良反应发生。结论鹿角形肾结石患者采用肾镜联合输尿管软镜通过20F经皮肾单通道碎石取石一期治疗效果显著,可有效缩短治疗时间,减少术中出血量,且不良反应少,安全性高,值得临床推广应用。

Objective To investigate the efficacy of nephroscope combined with flexible ureteroscope in the treatment of staghorn renal calculi through 20F percutaneous renal single-channel lithotripsy.Methods 30 patients with staghorn renal calculi admitted to our hospital that underwent nephroscope combined with flexible ureteroscope through 20F percutaneous renal single-channel lithotripsy for the one-stage treatment from Febru-ary 2018 to February 2019 were selected and analysised the treatment effect.Results Among 30 patients,29 cases(96.67%)established subcutane renal channel through the inferior calyx.26 cases(86.67%)cleared calculus in the one-stage.The operative time was 60-121 min,the average of(91.75±15.89)min.The intraoperative blood loss was 45-90 mL,the average of(68.83±5.57)mL.Postoperative hemoglobin levels ranged from 3.5-9.1 g/L,the average of(5.87±1.24)g/L.The postoperative hospital stay was 4-10 d,the average of(6.89±1.24)d.Postoperative adverse reaction oc-curred 2 cases(6.67%),all patients showed fever,and no adverse reactions such as peritoneal effusion and renal perforation occurred.Conclusions 20F percutaneous renal single-channel lithotripsy through nephroscope combined with flexible ureteroscope has significant effect in the one-stage treatment of staghorn renal calculi,which can effectively shorten the treatment time and reduce the amount of intraoperative bleeding,has fewer ad-verse reactions and high safety,which is worthy of clinical promotion and application.