王武

[摘要] 目的 探讨单通道经皮肾镜取石术联合输尿管软镜治疗鹿角状肾结石的临床效果。 方法 选择2016年1月～2017年1月76例鹿角状肾结石患者作为研究对象，根据不同手术方法分组，每组各38例。对照组采用单通道经皮肾镜取石术进行治疗，研究组采用单通道经皮肾镜取石术联合输尿管软镜治疗。比较两组鹿角状肾结石治疗效果；平均住院时间、手术完成的时间；干预前后患者生存质量；周围脏器损伤、液气胸等并发症发生率。结果 研究组鹿角状肾结石治疗效果高于对照组（P<0.05）；研究组平均住院时间、手术完成时间短于对照组（P<0.05）；干预前两组生存质量比较差异无统计学意义（P>0.05）；干预后研究组生存质量优于对照组（P<0.05）。研究组患者周围脏器损伤、液气胸等并发症发生率显著低于对照組（P<0.05）。 结论 单通道经皮肾镜取石术联合输尿管软镜治疗鹿角状肾结石的临床效果确切，可有效清除结石，缩短手术和住院时间，减少创伤，提高患者生存质量，值得推广。

[关键词] 单通道经皮肾镜取石术；输尿管软镜；鹿角状肾结石；并发症

[中图分类号] R692.4 [文献标识码] B [文章编号] 1673-9701（2017）26-0048-03

Analysis on the clinical effect of single channel percutaneous nephrolithotomy combined with flexible ureteroscope in the treatment of staghorn nephrolithiasis

WANG Wu

Department of Urinary Surgery，Xiamen Haicang Hospital，Xiamen 361000，China

[Abstract] Objective To investigate the clinical effect of single channel percutaneous nephrolithotomy combined with flexible ureteroscope in the treatment of staghorn nephrolithiasis. Methods The patients with staghorn nephrolithiasis from January 2016 to January 2017 were selected as the study subjects and were assigned to groups according to different surgery methods， with 38 cases in each group. The control group was given single channel percutaneous nephrolithotomy， and the study group was given single channel percutaneous nephrolithotomy combined with flexible ureteroscopy. The curative effect of staghorn nephrolithiasis； the average length of hospital stay， the completion time of the operation； the quality of life of patients before and after intervention； incidence rates of surrounding organ damage， fluid pneumothorax and other complications were compared between the two groups. Results The curative effect of staghorn nephrolithiasis in the study group was higher than that in the control group（P<0.05）； the average length of hospital stay and the completion time of operation in the study group was shorter than that in the control group（P<0.05）； the quality of life in the two groups before intervention，the difference was no statistically significant（P>0.05）； the quality of life in the study group was better than that in the control group after intervention（P<0.05）. The incidence rate of complications such as surrounding organ damage and fluid pneumothorax was significantly lower in the study group than that in the control group（P<0.05）. Conclusion The clinical effect of single channel percutaneous nephrolithotomy combined with flexible ureteroscopy in the treatment of staghorn nephrolithiasis is exact， which can effectively remove stones， shorten the operation time and length of hospital stay， reduce trauma， improve patients' quality of life， and is worthy of promotion.endprint

[Key words] Single channel percutaneous nephrolithotomy； Flexible ureteroscope； Staghorn nephrolithiasis； Complications

经皮肾镜取石术是鹿角状肾结石首选治疗方法，但仍可存在残石和出血风险，因此，如何降低血管损伤，减少肾实质损伤和减少残留结石是手术治疗鹿角状肾结石的关键[1]。目前输尿管软镜、单通道经皮肾镜取石术在肾结石治疗中广泛应用，具有创伤小、取石效果好等特点，但关于两者联合应用的研究仍比较少见。为了分析单通道经皮肾镜取石术联合输尿管软镜治疗鹿角状肾结石的效果，本研究选择2016年1月～2017年1月76例鹿角状肾结石患者作为研究对象，根据不同手术方法分组，各38例，采用单一单通道经皮肾镜取石术治疗作为对比，分析单通道经皮肾镜取石术联合输尿管软镜治疗鹿角状肾结石的临床效果，现报道如下。……