Abstract：Objective: To investigate the effect of soft mirror combined with percutaneous nephrolithotripsy in the treatment of complex renal calculi and its effect on prognosis. Methods: 97 patients with complicated renal calculi in our hospital from April 2016 to July 2015 were selected and divided into the observation group (n=50) and the control group (n=47) according to the different surgical treatment methods. The control group was treated with percutaneous nephrolithotomy. The observation group was treated with percutaneous nephrolithotomy combined with flexible mirror. The rate of stone clearance, residual stone and perioperative operation were compared, and the changes of preoperative and postoperative hemoglobin concentration, blood creatinine, material life, body function and psychological function were compared, and the complications of postoperative infection, ureteral injury, urinary fistula, massive hemorrhage and renal function injury were recorded. Results: After operation, the stone clearance rate of the observation group was 88% significantly higher than that of the control group, the stone clearance rate was 63.83%, the residual rate of stone in the observation group was 12% lower than that of the control group (36.17% (P<0.05)), and the operation time, the time after the operation and the time of hospitalization were shorter in the observation group than the control group (P<0.05), and the amount of intraoperative bleeding in the observation group. It was significantly lower than that of the control group (P<0.05). After the operation, the hemoglobin concentration in the two groups was reduced, the observation group was significantly lower than the control group (P<0.05). After the operation, the blood creatinine in the two groups was significantly higher than that before the operation, and the observation group was higher than the control group (P<0.05). After the operation, the scores of the life quality indexes of the body function, material life and psychological function of the two groups were all higher than those before the operation. And the observation group was significantly higher than that of the control group (P<0.05). After the operation, the two groups had complications such as infection, ureteral injury, urinary fistula, massive hemorrhage and renal function injury, but the total incidence of the observation group was 10% lower than that of the control group (31.91% (P<0.05)). Conclusion: The treatment of complicated renal calculi with soft lens combined with percutaneous nephrolithotomy can improve the stone clearance rate, shorten the patient's time of hospitalization, improve the quality of the saint lake, and have small complications and high safety. It is worthy of clinical application.
岳霄,闫静,王强,王充,李鼎,苗晓林. 软镜联合可视经皮肾镜碎石治疗复杂性肾结石的清除效果及预后影响[J]. 河北医学, 2018, 24(11): 1883-1886.
YUE Xiao, YAN Jing, WANG Qiang, et al. Effect and Prognostic Impact of Soft Mirror combined with Percutaneous Nephrolithotomy in the treatment of Complex Renal Calculi. HeBei Med, 2018, 24(11): 1883-1886.
[1] 唐浩,陈松宁,杨水华.经皮肾镜联合输尿管软镜钬激光碎石术治疗复杂性肾结石的临床疗效分析[J].安徽医药,2016,20(2):341~343. [2] Hu H, Lu Y, Deng H, et al. Comparison of minimally invasive percutaneous nephrolithotomy and flexible ureteroscopy for the treatment of intermediate proximal ureteral and renal stones in the elderly[J]. Urolithiasis, 2016, 44(5):1~8. [3] 刘勇,王涛,果佳.输尿管软镜钬激光碎石术与单通道经皮肾镜取石术联合及单独使用治疗复杂性肾结石的疗效评价及其安全性分析[J].中国医学装备,2016,13(11):80~84. [4] 黄毅,高虹,邹红东,等.经皮肾镜超声联合钬激光气压弹道碎石治疗复杂性肾结石的临床疗效及对患者肾功能的影响[J].贵州医药,2016,40(7):692~694. [5] 翁依华,刘孙标,郭宪伟.经皮肾镜碎石术治疗复杂性肾结石的临床疗效及对患者肾功能的影响[J].医学综述,2016,22(20):4086~4089. [6] Sakr A, Salem E, Kamel M, et al. Minimally invasive percutaneous nephrolithotomy vs standard PCNL for management of renal stones in the flank-free modified supine position: single-center experience.[J]. Urolithiasis, 2017(2):1~5. [7] 郑健忠,梁福律,范先明,等.多通道经皮肾镜与单通道经皮肾镜联合输尿管软镜治疗复杂性肾结石的效果比较[J].现代泌尿外科杂志,2016,21(8):593~596. [8] 安宇,黄建林,廖勇,等.经皮肾镜碎石取石术联合逆行输尿管软镜手术治疗女性鹿角形肾结石[J].山东医药,2016,56(3):68~70. [9] Liang T, Zhao C, Wu G, et al. Multi-tract percutaneous nephrolithotomy combined with EMS lithotripsy for bilateral complex renal stones: our experience:[J]. Bmc Urology, 2017, 17(1):15~18. [10] 邱承俊,敖劲松,程立,等.超声气压弹道和钬激光技术用于经皮肾镜下碎石清石治疗复杂性肾结石的疗效及血清学指标比较[J].海南医学院学报,2017,23(6):779~781. [11] Aminsharifi A, Irani D, Masoumi M, et al. The management of large staghorn renal stones by percutaneous versus laparoscopic versus open nephrolithotomy: a comparative analysis of clinical efficacy and functional outcome[J]. Urolithiasis, 2016, 44(6):1~7. [12] Fata-Chilln F R, Gimbernat-Díaz H, Redondo-Redondo C, et al. Evolution from Percutaneous nephrolithotomy to Mini-PCNL in supine position on the treatment of complex renal calculi: feasibility study.[J]. Archivos Espanoles De Urologia, 2017, 70(5):542~556. [13] Hu X, Jiang K, Chen H, et al. Simultaneous Treatment of Renal and Upper Ureteral Stone and Cysts With Percutaneous Nephrolithotomy and Cyst Laser Intrarenal Incision and Drainage[J]. Urology Journal, 2017, 15(1)16~19.
2018, Vol. 24 
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