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| 改良斜仰卧截石位下双镜联合处理复杂性肾结石的效果 |
| Effect of endoscopic combined simultaneous surgery in the treatment of complex renal calculi based on the modified oblique supine lithotomy position |
| 投稿时间：2023-02-14 |
| DOI：10.3969/j.issn.1000-0399.2023.12.004 |
| 中文关键词: 复杂性肾结石 经皮肾镜 输尿管软镜 斜仰卧截石位 |
| 英文关键词: Complex kidney stones Percutaneous nephroscopy Flexible ureteroscopy Oblique supine lithotomy position |
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| 中文摘要: |
| 目的 探讨改良斜仰卧截石位下经皮肾镜联合输尿管软镜处理复杂性肾结石的效果。方法 回顾性分析2020年9月至2022年10月于南京江北医院收治的65例复杂性肾结石患者病例资料。根据手术方式不同将患者分为改良斜仰卧截石位经皮肾镜联合软镜组(观察组)35例和先截石位后俯卧位经皮肾镜组(对照组)30例。统计并分析两组患者手术时间、出血量、术后住院天数、清石率、疼痛评分及并发症情况。结果 观察组手术时间、术后住院时间及术中出血量均短/少于对照组,差异有统计学意义(t=-3.749、-8.999、-2.578,P均<0.05)。两组患者结石均基本清除,其中对照组有3例患者行二期软镜碎石术,两组清石率比较,差异无统计学意义(χ2=0.458,P=0.498)。观察组患者术后疼痛评分、并发症发生率均明显低于对照组,差异均有统计学意义(t=-6.627,χ2=6.951,P均<0.05)。结论 改良斜仰卧截石位下双镜联合处理复杂性肾结石安全有效,可缩短手术时间,降低并发症发生率,减少再手术率。 |
| 英文摘要: |
| Objective To investigate the effect of percutaneous nephrolithotomy combined with flexible ureteroscopy in the treatment of complex renal calculi based on the modified oblique supine lithotomy position.Methods The clinical data of 65 patients with complex renal calculi admitted to our hospital from September 2020 to October 2022 were retrospectively analyzed. According to the operation method,the patients were divided into the observation group-percutaneous nephrolithotomy combined with flexible lithotomy on modified oblique supine position(35 cases) and the control group-percutaneous nephrolithotomy on the lithotomy position followed by the prone position(30 cases). The operation time, blood loss, postoperative hospital stay, stone clearance rate, pain score and complications of the two groups were statistically analyzed.Results The operation time, intraoperative blood loss and postoperative hospital stay in the observation group were less and shorter than those in the control group, and the differences were statistically significant(t=-3.749,-8.999,-2.578,all P < 0.05). The stones were basically cleared in the two groups, and three patients in the control group underwent secondary flexible lithotripsy. There was no statistically significant difference in the stone free rate between the two groups(χ2=0.458,P=0.498). The postoperative VAS score and the incidence of complications in the observation group were significantly lower than those in the control group, and the differences were statistically significant(t=-6.627,χ2= 6.951,P<0.05).Conclusions The modified oblique supine lithotomy position is safe and effective for the treatment of complex renal calculi, which can shorten the operation time, reduce the incidence of complications and reoperation rate. |
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