斜仰截石位双镜联合在肥胖患者复杂性肾结石治疗中的临床应用

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Abstract Objective To explore the clinical application value of oblique supine lithotomy position and combined double endoscopy in the treatment of complex renal calculi in obese patients.Methods A total of 100 obese patients with complex renal calculi were treated and selected as the study subjects in Zhanjiang Central People′s Hospital from July 2018 to September 2020.They were divided into the control group and the observation group by the random number table method,with 50 cases in each group.Multi-channel percutaneous nephroscopy in prone position was performed in the control group,and flexible ureteroscope combined with single micro-channel percutaneous nephroscopy in oblique lithotomy position was performed in the observation group.The operation time,intraoperative blood loss,postoperative hospital stay,visual analogue scale(VAS)score,primary calculi clearance rate,intraoperative complications postoperative complications and the difference in the rate of renal artery embolization after surgery were compared between the two groups.Results The VAS score in the observation group was lower than that in the control group,the operation time and postoperative hospital stay were shorter than those in the control group,the intraoperative blood loss in the observation group was less than that in the control group,the differences were statistically significant(P<0.05).There was no statistical difference in the embolization rate of renal artery intervention between the two groups of patients(P>0.05).The primary calculi clearance rate in the observation group was higher than that in the control group,the incidence of intraoperative complications and the incidence of postoperative complications in the observation group were lower than those in the control group,the differences were statistically significant(P<0.05).Conclusions For the treatment of complex renal calculi in obese patients,the model of oblique supine lithotomy position and combined double endoscopy is a safe,effective,comfortable,and minimally invasive treatment method,which is better than the single endoscopic model,has the comfortable posture,less trauma,light postoperative pain,high rate of primary stone clearance,few intraoperative and postoperative complications,and the operation is convenient.The combined double endoscopy can be combined with antegrade or retrograde to treat calculus in the renal calyx,especially suitable for obesity patients according to the patient′s condition.It is worthy of clinical promotion and application.

Key words： Oblique supine lithotomy position Combined double endoscopy Obese patients Complex renal calculi

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