组合定位法在肾盂旁囊肿并同侧肾结石输尿管软镜术中的作用

Applying combined localization method to flexible ureteroscopy of renal cyst in patients with ipsilateral renal calculi

目的:探讨组合定位法在肾盂旁囊肿并同侧肾结石输尿管软镜术中的作用。方法:将150例肾盂旁囊肿并同侧肾结石患者随机分为对照组与观察组,对照组行常规输尿管软镜治疗,观察组采取组合定位法行输尿管软镜治疗。对比手术指标、住院时间、并发症、手术效果及患者满意度。结果:观察组手术时间[(42.84±7.95)min]、住院时间[(6.76±1.25)d]均短于对照组[(45.68±8.72)min、(7.24±1.36)d](P<0.05),术中出血量[(37.12±3.24)mL]少于对照组[(39.85±4.63)mL](P<0.05);观察组总并发症发生率(2.67%)、术后6个月的结石清除率(94.67%)、囊肿治疗有效率(90.67%)及术后12个月的囊肿复发率(4.00%)与对照组(5.33%、93.33%、88.00%、5.33%)比较差异均无统计学意义(P>0.05);观察组患者对手术的总满意度(93.33%)高于对照组(82.67%)(P<0.05)。结论:肾盂旁囊肿并同侧肾结石输尿管软镜治疗中应用组合定位法,可获得良好的手术效果,且可减轻手术创伤,提高患者满意度,具有临床推广应用价值。

Objective:To investigate the role of combined localization in flexible ureteroscopy of renal cyst in patients with ipsilateral renal calculi.Methods:150 patients with renal cyst and ipsilateral renal calculi were randomly divided into control group and observational group.Patients in the control group received conventional flexible ureteroscopy,and those in the observational group were treated with flexible ureteroscopy by combined localization method.The two groups were compared regarding the operative indexes,length of hospital stay,incidence of complications,operative outcomes and patient′s satisfaction.Results:The operative time and length of hospital stay were shorter,and intraoperative blood loss were lower in the observational group than in the control group[(42.84±7.95)min vs.(45.68±8.72)min;(6.76±1.25)d vs.(7.24±1.36)d;(37.12±3.24)mL vs.(39.85±4.63)mL,respectively,all P<0.05].There was no significant difference in the total incidence rate of complications,stone clearance rate and effective rate of cyst treatment at 6 months after operation and the cyst recurrence rate at 12 months after operation between the observational group and control group(2.67%,94.67%,90.67%and 4.00%vs.5.33%,93.33%,88.00%and 5.33%,P>0.05).Patients in the observational group had higher total satisfaction rate with surgery than those in the control group(93.33%vs.82.67%,P<0.05).Conclusion:Application of combined localization in flexible ureteroscopy of renal cyst in patients with ipsilateral renal calculi is valuable in clinic because it can lead to better surgical results,as well as reduce surgical trauma and improve patient′s satisfaction.