[1]张宝勋 蒋胜利** 吴文弼 赵永录① 费建功 吴迪 贾沛鹏 吴旭.经皮肾镜联合输尿管软镜治疗复杂肾结石[J].中国微创外科杂志,2021,01(10):875-878.
　Zhang Baoxun,Jiang Shengli,Wu Wenbi,et al.Clinical Experience of Percutaneous Nephrolithotomy Combined With Flexible Ureteroscopic Lithotripsy in the Treatment of Complex Renal Calculi[J].Chinese Journal of Minimally Invasive Surgery,2021,01(10):875-878.
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经皮肾镜联合输尿管软镜治疗复杂肾结石()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
01
期数:
2021年10期
页码:
875-878
栏目:
临床研究
出版日期:
2021-10-25

文章信息/Info

Title:
Clinical Experience of Percutaneous Nephrolithotomy Combined With Flexible Ureteroscopic Lithotripsy in the Treatment of Complex Renal Calculi
作者:
张宝勋 蒋胜利** 吴文弼 赵永录① 费建功 吴迪 贾沛鹏 吴旭
（甘肃省平凉市第二人民医院泌尿外科，平凉744000）
Author(s):
Zhang Baoxun;  Jiang Shengli;  Wu Wenbi;  et al.
Department of Urology, Second People Hospital of Pingliang, Pingliang 744000, China
关键词:
经皮肾镜碎石; 输尿管软镜碎石; 复杂性肾结石; 清石率
Keywords:
Percutaneous nephrolithotomy; Flexible ureteroscopic lithotripsy; Complicated kidney stone; Stone clearance rate
文献标志码:
A
摘要:
目的探讨单通道经皮肾镜联合输尿管软镜治疗复杂肾结石的疗效。 方法2019年10月~2020年12月，对37例复杂肾结石行单通道经皮肾镜EMSVario碎石清石联合输尿管软镜钬激光碎石，观察清石率、并发症发生率。结果37例手术均顺利完成，31例顺行碎石，6例顺行+逆行碎石。手术时间50~140 min，平均100 min。出血量10~300 ml，平均70 ml。一期清石率91.9%(34/37)，二期清石率97.3%(36/37)，1例结石残留经体外冲击波碎石排出。术中并发症4例，包括集合系统黏膜损伤2例，大出血1例，冲洗液外渗1例。术后体温>38.5 ℃ 4例。随访3~6个月，无结石残留和并发症发生。 结论经皮肾镜联合输尿管软镜治疗复杂性肾结石安全可行，可在有条件的医院推广使用。
Abstract:
ObjectiveTo study the effect of single channel percutaneous nephrolithotomy (PCNL) combined with flexible ureteroscopic lithotripsy (FURL) in the treatment of complex renal calculi.MethodsClinical data of 37 patients with complex renal calculi who underwent single channel EMSVario PCNL combined with holmium laser FURL from October 2019 to December 2020 were retrospectively analyzed. The stone clearance rate and complication rate were observed.ResultsThe operations were successfully completed in all the 37 cases. Among them, 31 cases underwent antegrade lithotripsy, and 6 cases underwent antegrade and retrograde lithotripsy. The operation time was 50-140 min (mean, 100 min), and the blood loss was 10-300 ml (mean, 70 ml). The stone clearance rate was 91.9% (34/37) in the first stage and 97.3% (36/37) in the second stage. There was 1 case with residual stone, which was treated with extracorporeal shock wave lithotripsy (ESWL) successfully. There were 4 cases of intraoperative complications, including mucosal injury of collecting system in 2 cases, hemorrhage in 1 case and extravasation of irrigating fluid in 1 case. The postoperative temperature was higher than 38.5 ℃ in 4 cases. Followups for 3-6 months found no residual stones or complications.ConclusionPCNL combined with FURL in the treatment of complex renal calculi is safe and feasible, and can be popularized in qualified hospitals.

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备注/Memo

备注/Memo:
基金项目：平凉市科技计划项目(平市科发［2020］77号）**通讯作者，Email：jsl701223@163.com ①（甘肃省武威市人民医院泌尿外科，武威733000）
更新日期/Last Update: 2022-02-08