斜仰卧截石位经皮肾镜联合输尿管镜治疗复杂肾输尿管结石的效果

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摘要目的分析斜仰卧截石位经皮肾镜联合输尿管镜治疗复杂性肾输尿管结石的效果。方法选取2016年10月～2017年10月在我院泌尿外科接受治疗的100例复杂性肾输尿管结石患者作为研究对象，根据随机数字表法将患者分为两组。俯卧位组（50例）实施俯卧位经皮肾镜治疗，斜仰卧截石位组（50例）实施斜仰卧截石位经皮肾镜联合输尿管镜治疗。比较两组患者的一次取石率、结石总清除率、手术时间、输血率、经皮肾镜扩张时通道丢失率以及住院时间各指标，并观察两组患者的并发症发生率以及患者满意度情况。结果斜仰卧截石位组的一次取石率、结石总清除率高于俯卧位组，差异有统计学意义（P＜0.05）；斜仰卧截石位组的手术耗时、住院时间均明显短于俯卧位组，差异有统计学意义（P＜0.05）；斜仰卧截石位组经皮肾镜扩张时通道丢失率低于俯卧位组，差异有统计学意义（P＜0.05）；斜仰卧截石位组的满意度高于俯卧位组，差异有统计学意义（P＜0.05）。结论对于复杂肾输尿管结石患者，采用斜仰卧截石位经皮肾镜联合输尿管镜治疗的效果更佳，结石清除率高，患者满意度高，值得在临床上推广应用。

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关键词 ：复杂肾输尿管结石, 斜仰卧截石位, 经皮肾镜, 输尿管镜

Abstract：Objective To analyze the effect of percutaneous nephrolithotomy combined with ureteroscope in the treatment of complicated renal ureteral calculi with supine anterolateral lithotomy position.Methods A total of 100 patients with complicated renal ureteral calculi undergoing urological surgery in our hospital from October 2016 to October 2017 were selected as the research subjects.The patients were divided into two groups by random number table method.In prone position group (n=50),patients were performed with percutaneous nephrolithotomy in prone position,while in supine anterolateral lithotomy position group(n=50),patients were performed with percutaneous nephrolithotomy combined with ureteroscope.The stone extraction rate once,total stone removal rate,operation time,blood transfusion rate,channel loss rate during dilation of percutaneous nephroscope,and hospital stay in the two groups were compared.The incidence of complications and patient′s satisfaction in the two groups were also observed.Results The success rate of stone extraction once and the total stone clearance rate in the supine anterolateral lithotomy position group was much higher than that in the prone position group,the differences were statistically significant(P＜0.05).The operation time and hospital stay in the supine anterolateral lithotomy position group were both shorter than those in the prone position group,the difference was statistically significant(P＜0.05).The channel loss rate during dilation of percutaneous nephroscope in the supine anterolateral lithotomy position group was lower than that in the prone position group,the difference was statistically significant(P＜0.05).The patients′satisfaction in the supine anterolateral lithotomy position group was higher than that in the prone position group,the difference was statistically significant(P＜0.05).Conclusion For patients with complicated renal ureteral calculi,percutaneous nephrolithotomy combined with ureteroscope in the supine anterolateral lithotomy position obtains a great effect with high stone clearance rate and patient′s satisfaction,which is worthy of recommendation in clinical practice.

Key words： Complicated renal ureteral calculi Supine anterolaterallitho to myposition Percutaneousnephroscope Ureteroscope

作者简介: 何问理（1974-），男，广东梅州人，本科，副主任医师

引用本文:

何问理温海东. 斜仰卧截石位经皮肾镜联合输尿管镜治疗复杂肾输尿管结石的效果[J]. 中国当代医药, 2018, 25(23): 91-94.
HE Wen-li;WEN Hai-dong. Effect of percutaneous nephrolithotomy combined with ureteroscope in the treatment of complicated renal ureteral calculi with supine anterolateral lithotomy position. 中国当代医药, 2018, 25(23): 91-94.

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http://dangdaiyiyao.com/CN/ 或 http://dangdaiyiyao.com/CN/Y2018/V25/I23/91

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