| 赵恩阳,刘云力,叶长琦,李学东,吕丽飞,刘思阳.可视化多镜联合治疗复杂鹿角结石的对比研究[J].,2022,(6):1165-1168 |
| 可视化多镜联合治疗复杂鹿角结石的对比研究 |
| Contrastive Study of Visual Treatment for Complex Staghorn Calculi with Multiple Combined Endoscopes |
| 投稿时间：2021-05-29 修订日期：2021-06-25 |
| DOI：10.13241/j.cnki.pmb.2022.06.035 |
| 中文关键词: 复杂肾结石 可视穿刺 针状肾镜 输尿管软镜 |
| 英文关键词: Complex renal calculi Visual puncture Needle-perc F-URS |
| 基金项目:黑龙江省卫生健康委科研项目（2020-067） |
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| 中文摘要: |
| 摘要 目的：研究不同组合方式治疗复杂鹿角样结石的疗效对比。方法：选取 80例我院治疗的复杂鹿角样结石患者，将患者随机分成两组，A组以经皮肾镜 +针状肾镜 （needle-perc） 的方式清理结石，B组以经皮肾镜 +输尿管软镜（flexibleureteroscope，F-URS）的方式清理结石，术后收集患者相关数据包括穿刺时间，单次穿刺成功率，单位结石量手术时间，清石效率，术中出血量，术后并发症，完全清石率等参数评估手术效果。结果：80例患者一期完成，主通道穿刺时间 A组（6± 1.62）min小于 B组（10±3.25）min（P<0.001）。单次穿刺成功率 A组（38/40）优于 B组（32/40）（P<0.05）。主通道清石时间 A组（40.94± 8.09）min和 B组（37.29± 4.19）min相比较无统计学意义（P>0.05）。残石处理时间 A组（34.37± 6.68）min小于 B组（49.55± 11.62）min（P<0.05），主通道结石清石效率 A组（0.27± 0.05）cm3/min和 B组（0.26± 0.06）cm3/min相比较无统计学意义（P>0.05），残石清石效率 A组（0.05± 0.01）cm3/min高于 B组（0.03± 0.01）cm3/min（P<0.05）。术后并发症及完全清石率两组无统计学意义（P>0.05）。结论：作为标准通道的辅助手段，needle-perc和输尿管软镜能很好的完成残石的处理，同超声定位穿刺相比较，可视穿刺花费时间更短，穿刺单次穿刺成功率更高，相对于软镜处理残石，needle-perc有更高的清石效率。两种方法的术中及术后并发症发生率，完全清石率无差别。 |
| 英文摘要: |
| ABSTRACT Objective: To study the efficacy of different combination methods in the treatment of complex renal calculi. Methods: 80 cases of complex staghorn calculi patients were studied, patients were randomly divided into two groups, patients in group A were treated with PCNL and needle-perc method while group B with PCNL and F-URS, postoperative dates were collected including puncture time, single puncture success rate, operation time/stone volume, Stone removal efficiency, intraoperative blood loss, postoperative complications, the length of hospital stay, rates of complete stone removal. Results: All operations were finished in one stage. The puncture time of the main channel of Group A（6± 1.62）min were less than Group B（10± 3.25）min（P<0.001）. The success rates of single puncture of Group A（38/40）were better than those of Group B（32/40）（P<0.05）. The time of removal stone through main channel were not statistically significant between Group A（40.94± 8.09）min and Group B（37.29± 4.19）min（P>0.05）. The time of removal residual stones of Group A（34.37± 6.68）min were less than those of Group B（49.55± 11.62）min, the efficiency of removal stone through main channel were not statistically significant between Group A（0.27± 0.05）cm3/min and Group B（0.26± 0.06）cm3/min, the removal efficiency of residual stones in group A（0.05± 0.01）cm3/min were better than those in group B（0.03± 0.01）cm3/min（P<0.05）. The incidence of postoperative complications and complete cleavage rate were not statistically significant in the two groups（P>0.05）. Conclusion: As an auxiliary means of PCNL, needle-perc and F-URS are competent for treatment of residual stones. Compared with ultrasonic localization, visual puncture takes less time, the success rates of single puncture are higher. Compared with F-URS, needle-perc has a higher efficiency of residual stones removal. |
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