膀胱软镜辅助下腹腔镜肾盂切开取石术治疗复杂性肾结石的疗效及其安全性评价

doi:10.13481/j.1671-587x.20160627

吉林大学学报(医学版) ›› 2016, Vol. 42 ›› Issue (06): 1189-1193.doi: 10.13481/j.1671-587x.20160627

膀胱软镜辅助下腹腔镜肾盂切开取石术治疗复杂性肾结石的疗效及其安全性评价

张浩¹, 胡成¹, 黄子凡², 黄文涛¹, 高新¹, 司徒杰¹

1. 中山大学附属第三医院泌尿外科, 广东广州 510630;
2. 广东省广州市白云区第一人民医院泌尿外科, 广东广州 510000

收稿日期:2016-07-06 出版日期:2016-11-28 发布日期:2016-12-02
通讯作者: 司徒杰,副主任医师,硕士研究生导师(Tel:020-85252052,E-mail:jackyst@163.com) E-mail:jackyst@163.com
作者简介:张浩(1980-),男,吉林省长春市人,主治医师,医学硕士,主要从事泌尿男科疾病微创治疗方面的研究。
基金资助:
广东省自然科学基金面上项目资助课题（s2013010011540）

Curative effect of laparoscopic pyelolithotomy combined with flexible cystoscope in treatment of complex renal calculi and its safety evaluation

ZHANG Hao¹, HU Cheng¹, HUANG Zifan², HUANG Wentao¹, GAO Xin¹, SITU Jie¹

1. Department of Urology, Third Affiliated Hospital, Sun Yat-sen University, Guangzhou 510630, China;
2. Department of Urinary Surgery, First People's Hospital, Baiyun District, Guangzhou City, Guangdong Province, Guangzhou 510000, China

Received:2016-07-06 Online:2016-11-28 Published:2016-12-02

摘要/Abstract

摘要：

目的：比较膀胱软镜辅助下腹腔镜肾盂切开取石术（LPLFC）和标准通道经皮肾镜碎石取石术（PCNL）处理复杂肾结石的疗效，并评价其安全性。方法：62例复杂性肾结石患者随机分为LPLFC组（n=31）和PCNL组（n=31），LPLFC组患者采用LPLFC治疗，PCNL组患者采用PCNL治疗，比较2组患者的手术时间、住院时间、术后血红蛋白下降值、并发症发生情况和一期结石取尽率。结果：2组患者均顺利完成手术。LPLFC组中有8例患者同时并发患侧肾或肾上腺疾病，同期在腹腔镜下处理。LPLFC组患者手术时间明显短于PCNL组（t=18.3，P<0.01），且LPLFC组患者术后平均血红蛋白下降值明显低于PCNL组（t=33.2，P<0.01）；PCNL组中有5例（16.1%）患者因术中出血，需要输血治疗。2组患者的住院时间和一期结石取尽率比较差异无统计学意义（t=21.2，P=0.70；t=21.9，P=0.71）。结论：LPLFC处理复杂性肾结石创伤小、出血量少、手术时间短，手术安全性高。

关键词: 肾结石, 膀胱软镜, 腹腔镜肾盂切开取石术, 经皮肾镜碎石取石术

Abstract:

Objective: To compare the curative effects of laparoscopic pyelolithotomy combined with flexible cystoscopy (LPLFC) and percutaneous nephrolithotomy (PCNL) in treatment of complex renal calculi, and to evaluate its safety.Methods: A total of 62 patients with complex renal calculi were randomly divided into LPLFC group (n=31,treated with LPLFC) and PCNL group(n=31,treated with PCNL). The operative time, the hospitalization time,the decreased values of postoperative hemoglobin,occurrence of complications and one-stage stone clearance rates of the patients in two groups were compared.Results: All the operations were finished successfully.A total of 8 patients in LPLFC group complicated with homolateral adrenal or renal diseases received synchronic laparosopic surgery. The operative time and the decreased value of postoperative hemoglobin of the patients in LPLFC group were significantly shorter and lower than those in PCNL group(t=18.3,P<0.01;t=33.2,P<0.01). A total of 5 patients(16.1%) in PCNL group required transfusion postopratively because of blood loss. The hopitaliztion time and one-stage stone clearance rate of the patients in two groups had no significant differences (t=21.2,P=0.7;t=21.9,P=0.71).Conclusion: LPLFC is a minimally invasive operation method with less blood loss, shorter operative time and higher operative safety in treatment of complex renal calculi.

Key words: renal calculus, laparoscopic pyelolithotomy, percutaneous nephrolithotomy, flexible cystoscopy

中图分类号:

R692.4

张浩, 胡成, 黄子凡, 黄文涛, 高新, 司徒杰. 膀胱软镜辅助下腹腔镜肾盂切开取石术治疗复杂性肾结石的疗效及其安全性评价[J]. 吉林大学学报(医学版), 2016, 42(06): 1189-1193.

ZHANG Hao, HU Cheng, HUANG Zifan, HUANG Wentao, GAO Xin, SITU Jie. Curative effect of laparoscopic pyelolithotomy combined with flexible cystoscope in treatment of complex renal calculi and its safety evaluation[J]. Journal of Jilin University Medicine Edition, 2016, 42(06): 1189-1193.

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膀胱软镜辅助下腹腔镜肾盂切开取石术治疗复杂性肾结石的疗效及其安全性评价

Curative effect of laparoscopic pyelolithotomy combined with flexible cystoscope in treatment of complex renal calculi and its safety evaluation

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