The clinical analysis of multi-endoscopy lithotomy for patients with staghorn calculi
GUO Zicheng1, CHEN Hongbo1, PENG Ejun2, TAN Yulong1, HU Xiaohui1, WANG Zijian3
1Department of Urology, the Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, Enshi 445000, China; 2Department of Urology, Tongji Hospital, Tongji Medical Collage of HUST; 3Department of Plastic Surgery, Zhongnan Hospital of Wuhan University
摘要目的：探究单通道经皮肾镜与输尿管软镜联用（多镜联用,SPCNL/FU）治疗鹿角形肾结石（SC）的效果。方法：收集2014年4月–2019年6月收治的结石患者信息并根据患者意愿进行分组,将接受多通道经皮肾镜（MPCNL）患者纳入对照组,接受多镜联用者纳入观察组,其中MPCNL组30例,SPCNL/FU组28例,分析两种术式在手术时间、造瘘管留置时间、出血量及并发症发生率等方面的差异。结果：手术均顺利进行,其基线特征无显著差异（P>0.05)。与MPCNL相比,SCPNL/FU患者的血红蛋白减少量低[（27.07±10.65）g/L vs. （18.29±12.72）g/L],造瘘管留置时间短[（7.53±2.11）d vs. (6.25±1.67)d],术后住院时间减少(10.60±2.55)d vs.(8.71±2.26)d,均差异有统计学意义（P<0.05）,其余指标无显著差异（P>0.05）。结论：与传统MPCNL相比,SPCNL/FU可减少术中出血,促进患者恢复,是一种优选的鹿角形肾结石处理方法。
Abstract：Objective： To evaluate the efficacy of single-channel percutaneous nephrolithotomy combined with flexible ureteroscope （SPCNL/FU） in the treatment of staghorn calculi. Methods： The clinical data of patients with staghorn calculi were collected from April 2014 to June 2019. The patients treated with multi-channel percutaneous nephrolithotomy （MPCNL） served as control group （n = 28）, and those with SPCNL/FU were included in observation group （n = 30）. The differences in operation time, nephrostomy time, blood loss and complications between two groups were analyzed. Results： The MPCNL and SPCNL/FU operations were safely performed. There was no significant difference in the basic characteristics between two groups （P > 0.05）. Compared with control group, the hemoglobin reduction in observation group decreased from （27.07 ± 10.65） to （18.29 ± 12.72） g/L （P < 0.05） the nephrostomy time shortened from （7.53 ± 2.11） to （6.25 ± 1.67） d （P < 0.05）, and hospitalization time reduced from （10.60 ± 2.55） to （8.71 ± 2.26） d （P < 0.05）. No significant difference was observed among other indexes （P > 0.05）. Conclusion： SPCNL/FU has many advantages in reducing blood loss and accelerating postoperative recovery, and can provide a promising way to treat staghorn calculi.
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