作　　者： ; ; ;

机构地区： 深圳市第二人民医院

出　　处： 《国际泌尿系统杂志》 2019年第6期1008-1011,共4页

摘　　要： 目的比较输尿管软镜与二期经皮肾镜(PCNL)治疗经皮肾镜术后残石的疗效.方法回顾分析2012年10月至2018年9月在本院行经皮肾镜术后残石患者采用输尿管软镜治疗(输尿管软镜组)68例,术后残石采用二期PCNL治疗(二期PCNL组)67例,比较两种方法的手术时间、术中出血量、清石率,观察不良反应.结果输尿管软镜组术后4周总清石率为85.29%(58/68),二期PCNL组总清石率为80.60%(54/67),差异无统计学意义(P>0.05).输尿管软镜组患者手术时间长于二期PCNL组,术中出血量少于PCNL组,差异有统计学意义(P<0.05).肾上、中盏残石及多发残石输尿管软镜总清石率优于二期PCNL组,肾下盏残石输尿管软镜组总清石率低于二期PCNL组,差异均有统计学意义(P<0.05).结论输尿管软镜是肾上、中盏及多发残石安全可靠的方法,二期PCNL治疗肾下盏残石具有清石率高、手术时间短等优点,特别是较大残石,PCNL仍是首选术式. Objective To compare the efficacy of flexible ureteroscope and percutaneous nephrolithotomy(PCNL)in the treatment of stone remnants after percutaneous nephrolithotomy.Methods From October 2012 to September 2018,68 cases of stone remnants after percutaneous nephrolithotomy were treated by flexible ureteroscopy(flexible ureteroscope group)and 67 cases of stone remnants were treated by PCNL(second-stage PCNL group).Results The total stone removal rate was 85.29%(58/68)at 4 weeks after operation in the flexible ureteroscopy group,and 80.60%(54/67)in the second-stage PCNL group.The operation time of patients in the flexible ureteroscopy group was longer than that in the second-stage PCNL group,and the intraoperative blood loss was less than that in the PCNL group(P<0.05).The total stone removal rate of renal upper and middle calculi and multiple stone ureteroscope was higher than that of the second stage PCNL group,and the total stone removal rate of the second stage PCNL group was lower than that of the second stage PCNL group(P<0.05).Conclusions Flexible ureteroscope is a safe and reliable method for the treatment of upper and middle calices and multiple stone remnants.The second stage PCNL for the treatment of renal lower calculi stone has the advantages of complete stone removal and short operative time,especially for large stone remnants,which is still the main treatment method at present.

关 键 词： 肾造口术 经皮 输尿管镜检查

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