CAJ | 학술논문

目的：观察一期经皮肾镜取石术(PCNL)联合二期输尿管软镜手术(RIRS)治疗孤立肾复杂性结石的临床疗效观察。方法回顾分析我科收治的64例孤立肾复杂性结石患者，随机分为观察组和对照组，每组32例。观察组患者在全麻下行PCNL联合RIRS治疗。对照组患者在全麻下行PCNL治疗，术后残留结石者行体外冲击波碎石治疗(ESWL)。两组患者均于术后3个月复查KUB或B超评估结石清除率并评估肾功能恢复情况。结果两组患者经过治疗后均取得满意疗效，观察组患者治疗总有效率96.9%，明显高于对照组75.0%，差异具有统计学意义(P<0.05)；两组患者治疗后血肌酐为均明显降低，观察组指标明显优于对照组(P<0.05)；两组患者在手术总时间和并发症发生率方面未见明显差异(P>0.05)。结论一期PCNL联合二期RIRS治疗孤立肾复杂性结石疗效确切、结石清除率高，具有良好的安全性，值得临床推广。
목적：관찰일기경피신경취석술(PCNL)연합이기수뇨관연경수술(RIRS)치료고립신복잡성결석적림상료효관찰。방법회고분석아과수치적64례고립신복잡성결석환자，수궤분위관찰조화대조조，매조32례。관찰조환자재전마하행PCNL연합RIRS치료。대조조환자재전마하행PCNL치료，술후잔류결석자행체외충격파쇄석치료(ESWL)。량조환자균우술후3개월복사KUB혹B초평고결석청제솔병평고신공능회복정황。결과량조환자경과치료후균취득만의료효，관찰조환자치료총유효솔96.9%，명현고우대조조75.0%，차이구유통계학의의(P<0.05)；량조환자치료후혈기항위균명현강저，관찰조지표명현우우대조조(P<0.05)；량조환자재수술총시간화병발증발생솔방면미견명현차이(P>0.05)。결론일기PCNL연합이기RIRS치료고립신복잡성결석료효학절、결석청제솔고，구유량호적안전성，치득림상추엄。
Objective To observe the clinical efficacy of percutaneous nephrolithotomy (PCNL) combined with retrograde intrarenal surgery (RIRS) to treat the complex renal stones in solitary kidneys. Methods 64 cases with complex renal stones in solitary kidneys were randomly divided into observation group and control group, with 32 patients each. The patients in observation group were treated by PCNL combined with RIRS. The control group was treated by PCNL and ESWL if needed. The stone clearance rate and renal function were observed 3 months after treatment by the KUB or B ultrasound. Results After the therapy, the two groups were significantly improved. The total effective rate in the observation group (96.9%) was significantly higher than the control group (75.0%). The serum creatinine in the observation group reduced more than the control group (P <0.05). The side effects had no difference between the two groups (P >0.05). Conclusions PCNL combined with RIRS could be an effective and safe option for complex stones in solitary kidneys and is worthy of clinical application.